Unprotected: HIV prison policy and the deadly politics of denial

By Robin Steinberg.

HIV/AIDS is reaching epidemic proportions in U.S. prisons and in prison populations worldwide. The United States trails Canada, Australia, and much of Europe in responding to the crisis. What is more disturbing is that the United States does not respond to the prevalence of HIV/AIDS in prisons because policy makers refuse to acknowledge the crisis as worthy of intervention. Across the United States, policy conversations about HIV/AIDS are riddled with judgments about what prisoners do not deserve. However, while these conversations and excuses take place, people are becoming infected and dying in prison and outside of prison. Our refusal to address this issue wholeheartedly and aggressively has effects that stretch farther than prison walls–they reach into poor communities across the country.

In July 2004, at the 25th International AIDS Conference in Bangkok, Thailand, a worldwide panel of experts openly discussed the HIV/AIDS epidemic in prisons across the globe. It appears that everywhere in the world, prisons present a higher rate of infection than in the general population, with rates ranging from 10 percent to 25 percent (Jurgens 2004). What was particularly disturbing about the discussions and outcomes of this conference was the extent to which the United States trails other developed countries on this issue.

Wardens, legislators, and prison administrators in the United States do not seem to care about HIV in prison and have been overwhelmingly opposed to the distribution of condoms or clean needles to prevent sexually transmitted diseases. In 1999, under much fire from the Bush administration, only a handful of penal systems participated in condom distribution programs, including New York City, Philadelphia, San Francisco, Washington, D.C., and state prisons in Vermont and Mississippi (Hammett, Harmon, and Maruschak, 49). The root of the problem lies in the fallacy that denying the existence of sex or drug use in prisons will mean that prisons are, in fact, drug- and sex-free. Nothing could be farther from the truth. Some wardens have spoken against condoning undesirable or illegal behavior in prisons while others have been concerned about security risks. But whatever the proffered excuse, it appears that the United States has, to its great detriment, sat idly by while many other countries have taken steps to address the rampant spread of AIDS in prisons.