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Monday, December 1, 2008

AIDS and the At-Risk Male Prison Population

By Eddie Griffin

Monday, December 01, 2008

The United Nations has designated today as World AIDS Day to spread international awareness to the global deadly pandemic of the acquired immune deficiency syndrome (AIDS).

AIDS is now a pandemic of epic proportion. In 2007, an estimated 33.2 million people lived with the disease worldwide, and it killed an estimated 2.1 million people, including 330,000 children.

People with AIDS often have systemic symptoms of infection like fevers, night sweats, swollen glands, chills, weakness, and weight loss. These symptoms and infections result from damages caused to the immune system cause by caused by the human immunodeficiency virus (HIV).

Some estimate that 25% of sub-Sahara Africa is infected with the disease. Indeed, this is where much of the world focus has been trained. By closer to home, nearly 25% of the US prison population is infected.

Based upon findings by Dr. David Wessner, Department of Biology at Davidson College, Ali Cundari reports:

U.S. prison populations are at a record high today, with barely enough room to house incarcerated individuals. Due to the close proximity and high-risk behaviors of inmates, as well as a lack of intervention from authorities, the transmission of HIV in prisons is a major problem today. A combination of both pre-existing and new infections plague prison populations, making them one of UNAIDS’ four major at-risk groups for HIV/AIDS.

In 2005, 1.8% of all state inmates and 1.0% of all federal prison inmates in the U.S. were believed to be HIV positive, leading to a total of 22,480 infected individuals behind bars. These percentages are disproportionate to the rest of the general population, making HIV/AIDS about four times as common among inmates than the population at large. Around 25% of all HIV infected people have spent time in a correctional facility.

In a research report sponsored by the National Commission on Correctional Health Care (NCCHC), the National Institute of Justice, and the Centers for Disease Control and Prevention (CDC), and submitted to Congress in 2002, the Bureau of Justice Statistics of the US Department of Justice presented this data:

On June 30, 1997, more than 6,300 state/federal prison inmates and more than 2800 jail inmates had AIDS… Also, there were more than 2,600 state/federal prison releasees and more than 36 000 jail releasees with AIDS in 1997. Thus, almost 16% of the estimated total of 247,000 persons living with AIDS in the United States in 1997 passed through a correctional facility that year.

After applying our point prevalence range of 1.45% to 2.03%, there were between 17,000 and 25,000 state/federal prison inmates and between 8,000 and 11,000 city/county jail inmates with HIV infection (non-AIDS)… Given the same prevalence range, between 112,000 and 157,000 people with HIV infection (non-AIDS) were released from US prisons and jails in 1997. This estimate suggests that between 22% and 31% of the approximately 503,000 people living with HIV infection (non-AIDS) in the United States in 1997 passed through a correctional facility that year.

Doctors and researchers are not ignorant of the magnitude of the AIDS epidemic in the US prison system. Rather, it is the inmate population that is ignorance.

Dubbed the “first conference of its kind”, The Texas Department of Criminal Justice (TDCJ) brought together some 128 inmates from 16 state prison units to the Darrington Prison Unit in 2002 to distribute information about AIDS and other infectious diseases, with hopes that peer education would cause to the information to spread among the 143,000 inmate population, according to the U.S. Centers for Disease Control and Prevention.

Ignorance about AIDS is widespread among the prison population, the inmates said.

Although the state of Texas now provides HIV testing for incoming and outgoing prisoners, such tests are voluntary and there is still widespread ignorance among inmates about the disease. A Texas State Epidemiologic Profile, 2005 reports that the incidence of HIV is about 7 times higher in the Texas criminal justice system than it is in the general population, and that the state releases a little more than 100 HIV-positive prisoners each month.

The Bureau of Justice Statistics reported that there were 847 AIDS cases and 2,450 HIV in Texas of June 30, 1999. By 2002, TDCJ had released 575 inmates who had tested positive for HIV/AIDS. And, with the high rate of recidivism, TDCJ now finds itself importing almost as many HIV-positive convicts as it releases.

Eddie Griffin Commentary

There are many ways HIV/AIDS can be transmitted among prisoners, such as with sharing dirty needles for injecting illicit drugs, or sharing razors and toothbrushes, or tattooing and body piercing with crude homemade germ-catching devices. But the most common mode of transmission is through consensual and non-consensual sex between inmates. Because of fear and shame associated with same sex practices behind bars, gang rapes, and a foreboding convict code of Omerta, most prisoners will avoid voluntary HIV testing. This gives penal authorities reason to believe the HIV/AIDS pandemic is more widespread in prison that reported.

Prior to the mid-1970s, the acquired immune deficiency syndrome was largely unheard of in the prison environment. Officially, the disease was not discovered until the early 1980s, though there was an earlier newspaper account about the disease in a New York newspaper. The diseased crept into the system and contaminated a large part of the prison population before the U.S. Centers for Disease Control and Prevention and United Nations recognized that the incarcerated were more at risk than the general population, and that the disease would be carried back out into the free world, only to contaminate others.

We find the same level of ignorance among sexually active teenagers. There is a common disbelief that casual sex (or rape) can lead to such a terrible fatal disease. The magnitude of the pandemic is incomprehensible, and the suffering from it inconceivable.

The general approach to a prevention campaign has been through mass public awareness campaign and advocating safe sex practices.

I teach abstinence as the most effective means of prevention, because there is no safe sex, insofar as there is no sin-free sex except by marriage. And, in that case, there are some preventative steps to take before walking down the aisle.

As for how to teach inmates the same lesson of abstention, HIV/AIDS education should focus on what happens to the human body as it degenerates. Some inmates may be suffering the symptoms and yet passing it on without knowledge.

If there is a cruel death in nature, it would be to die with AIDS. The onset of the disease comes with fever and chills, fatigue, nausea, vomiting, diarrhea, weakness, swollen glands, tumors, pneumonia, tuberculosis, and dementia. The progression of the disease follows bad-to-worse before death.

With competent information about the disease, an at-risk prison population is face with a choice in their behavior and the consequences. This is the same way we should present information about the disease to at-risk teens, and the public in general. The format is simple: (1) This is the disease AIDS; (2) This is what it does; (3) This is how it is contracted; (4) These are the preventions; and (5) These are the options short of a cure.

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