The NewStandard ceased publishing on April 27, 2007.

Activists Fight for Basic Safe-sex Options for Prisoners

by Shreema Mehta

While the rate at which AIDS is spreading in prisons has actually decreased of late, it is still staggeringly high in some places, and advocates say improvements have too-rarely been the result of good policies.

June 1, 2006 – Prison activist Antoine Mahan said that when he was locked up twelve years ago, many inmates would use whatever they could get their hands on to protect themselves during sex.

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Mahan, who has been HIV positive for seventeen years, said that with condoms prohibited in California prisons, he would regularly smuggle rubber gloves or plastic bags from laundry rooms or the nurse’s office to use as makeshift barriers.

With HIV rates higher among the nation’s prisoners than in the general population, activists like Mahan say that prison officials should make condoms and safe-sex education readily available. Only a handful of states and cities distribute condoms to their captive population.

Judy Greenspan, a board member of California Prison Focus, which works to protect prisoners’ rights, said prohibiting condoms is a "head-in-the-sand approach" to preventing sex among prisoners. She added that corrections officials "would never sanction homosexual sex."

"It’s part of the dehumanization of prisoners," she said. "It’s part of the punishment to say you can’t be intimate with anyone."

According to the US Department of Justice, nearly 2 percent of state and federal prisoners nationwide were HIV positive as of 2003 – just over 23,650 inmates. While the rate of HIV infection in prisons has been decreasing since 1999, the nationwide rate has risen steadily since 1995, to 0.4 percent of the total population in 2003.

Given an environment that discourages testing by stifling privacy, advocates for prisoners say measuring the true rate of HIV transmissions is close to impossible.

Very little research has been conducted on the spread of HIV in prisons. Given an environment that discourages testing by stifling privacy, advocates for prisoners say measuring the true rate of HIV transmissions is close to impossible.

Last month, the Centers for Disease Control (CDC) released a study of HIV transmission rates among prisoners who reported male-male sex in Georgia, where 2.3 percent of inmates are HIV positive. Out of the 72 percent of inmates who reported consensual sex, about one in three reported using condoms or "improvised barrier methods" such as rubber gloves. The study also found that between the years 1988 to 2005, 88 Georgia inmates contracted HIV while they were in prison.

With only 88 incidents of HIV contraction in prisons over 17 years, many media outlets hailed the figure as low; public-health officials and AIDS activists expressed surprise at the number. Experts interviewed by The NewStandard also said that the actual number of inmates who contracted HIV while in prison could be higher.

While Georgia mandates HIV testing for prisoners entering the system, tests during and after incarceration are voluntary. But the close confines of prison make maintaining the confidentiality of personal information like HIV status a difficult undertaking. Add that low expectation of privacy to the stigma associated with the virus, AIDS activists say, and it is clear why many inmates may choose to avoid testing.

AIDS experts and advocates agree that while distributing condoms can significantly reduce the spread of HIV in prisons, the practice will not wipe out unsafe sex.

Regardless of transmission rates, people working with prisoners and the communities they come from advocate distributing condoms, alongside prevention education and better health care in prisons, in order to reduce the spread of HIV among incarcerated men and, later, their communities.

The CDC study reported that the Vermont and Mississippi prison systems distribute condoms to married inmates. Jail systems in New York City, Philadelphia, the District of Columbia and San Francisco also carry them, and Los Angeles County began distributing condoms to openly gay inmates in 2001.

Michael Resnick, chief of staff of the Philadelphia prison system, said city facilities began to distribute condoms in 1998.

"At that time, the city began providing HIV counseling to inmates," he told TNS. "Because they were doing all that work, we realized there was a public-health interest in reducing HIV infection, and whether people wanted to accept it or not, inmates engage in sex."

To get condoms, Philadelphia inmates must arrange a visit to the health office and request condoms from a nurse. Resnick said the number of condoms inmates requested, 8,000, was low in comparison to the 35,000 new admits last year.

But Romeo Sanchez, an advocate for former prisoners and low-income people living with AIDS, said a system of formally requesting condoms likely discourages many inmates from seeking protection.

"You have to go to the medical department and request them," said Sanchez, who works with the New York City AIDS Housing Network and is a former prisoner himself. "The person is identified, and there’s a stigma behind it."

Most prisons, however, do not even make condoms available on request. Corrections officials say condoms can be used to smuggle drugs.

Resnick acknowledged that condoms could be used for such purposes. "Inmates are pretty ingenious," he said. "You can hide stuff [in condoms], but we haven’t had any problems like that."

Mel Stevens, a prison AIDS activist and former member of national AIDS activist group Act Up, said that argument avoids the real issue. "The whole contraband issue is just a smokescreen," he said. "What really is the bottom line is [corrections officials] don’t want to know that men are having sex with men."

AIDS experts and advocates agree that while distributing condoms can significantly reduce the spread of HIV in prisons, the practice will not wipe out unsafe sex.

According to the US Department of Justice, which gathered incidents of sexual violence in prisons in 2004, there were more than three allegations of sexual violence per 1,000 inmates nationwide. But like rates of HIV transmission, the DOJ acknowledges that sexualized violence is likely underreported.

"Due to fear of reprisal from perpetrators, a code of silence among inmates, personal embarrassment, and lack of trust in staff, victims are often reluctant to report incidents to correctional authorities," the DOJ said in its report.

Various reports, however, including the CDC Georgia study and a 1999 survey conducted in New York by the Latino Commission on AIDS, have found that most sex among prisoners is consensual. Mahan said the bigger problem was that many inmates would not use condoms even if they were available.

"I used a rubber glove to protect myself from somebody I was with," said Mahan. "I did disclose to them my health status. They were ok with it. Two or three months later they wanted to have unprotected sex," he said, adding that many inmates, especially those serving life sentences do not care about protecting themselves.

"This is going on right now as we speak," Mahan said.

Outreach workers and activists were split on how prisoners affect the rates of HIV in their communities when they are released. Stevens said the media and public wrongly characterize HIV-positive prisoners as demons who wantonly spread the virus to their wives and girlfriends after contracting it through unprotected sex in prison.

Stevens said the prison environment and poor health care create a sense of hopelessness among prisoners.

In New York State, where Stevens does his work, 7.6 percent of inmates are HIV-positive representing the highest rate in the nation; the state incarcerates a fifth of HIV-positive prisoners nationwide. The Correctional Association of New York, which inspects state prisons, reported in 2000 that doctors in the system were untrained in AIDS treatment and that medications were dispensed with oversimplified directions.

"Prison is not about care," Stevens said. "It’s about punishment."

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The NewStandard ceased publishing on April 27, 2007.

This News Article originally appeared in the June 1, 2006 edition of The NewStandard.
Shreema Mehta is a staff journalist.

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