New Mexico AIDS Infonet s2

AIDS InfoNet www.aidsinfonet.org Fact Sheet Number 615 HIV IN PRISONS AND JAILS HIV AND CORRECTIONAL few require it during custody. Others  Current CD4 cell counts and viral load SETTINGS require testing before release.  Any HIV-related illness they have People with HIV sometimes have to spend had (opportunistic infection, see Testing positive in a prison or jail facility time in a jail or prison. Jails are usually fact sheet 500.) These may require may cause problems based on the rules of operated by counties. Prisons are state or monitoring or preventive the facility. Prisoners with HIV have almost federal institutions. medication. no privacy regarding their HIV status. They  The rate of HIV among prisoners is 5  Details on any serious side effects they may be housed separately from non- to 7 times that of the general have had from HIV treatments infected inmates. They may be blocked population. HIV rates are highest from some work assignments. among African American prisoners. Even when an inmate provides good  In 2006, 16.9% of all PLWH in the US information, there can be a delay in getting At some institutions there are inmate peer their HIV medications. Prisoners cannot were in a correctional facility at some educators. They might be a good resource point. bring their own medications with them. This and can provide a support network for HIV+ delay or interruption in treatment increases  In 2008, there were about 20,449 inmates. the risk of resistance (see fact sheet 405,) people with HIV in state and federal prisons. The rate of HIV infection is higher among female inmates (1.9%) HIV CARE FOR PRISONERS RISK FACTORS WHILE than among male inmates (1.7 %.) Some facilities have no health care INCARCERATED provider who knows about HIV care. Others Several studies have found that most HIV- have some access to HIV specialists. positive inmates are infected before they HEALTH CARE IN PRISONS AND Fortunately, prisoners have been helped by JAILS enter prison. HIV risk behaviors often overall advances in HIV treatment. AIDS- continue inside the institution. These Medical care in a prison or jail depends on related deaths in state prisons decreased include injecting drug use, tattooing, body the local facility. In general, prisoners do 82% from 1995 to 2004. piercing, and consensual and not receive health care that meets public nonconsensual sexual activities. The lack health standards. Basic principles of HIV therapy are the of sterile drug paraphernalia leads to same inside or outside of a correctional needle sharing in prison. Needle sharing Each year, many Americans with chronic system. The goals of therapy are the same among soon-to-be released prisoners is diseases are jailed. This includes: (see fact sheet 404): high.  about 25% of HIV-infected Americans  reduce viral load as much as possible  33% of those infected with hepatitis C for as long as possible Incarcerated people face several additional virus (HCV, see fact sheet 507)  restore or preserve the immune health risks. Rates of hepatitis C (see fact  40% of Americans with active system sheet 507) are very high in prisons and tuberculosis (see fact sheet 518)  improve the patient’s quality of life jails. Hep C is transmitted very easily in Among these inmates, up to 50% have  reduce sickness and death due to HIV blood, or through tattooing or sexual mental disorders. As many as 75% have activity. Tattoos received in prison are alcohol or other substance abuse HIV treatment in prisons and jails is linked with increased risk for hepatitis B disorders. These inmates need more than influenced by many factors, including: and C. Condoms are not allowed in most just physical health care.  Prior treatment history jails or prisons.  Current viral load (see fact sheet 125) In the United States, prisoners have a and CD4 (see fact sheet 124) levels constitutional right to healthcare that meets WHAT HAPPENS WHEN HIV-  Resistance to medications (see fact POSITIVE PRISONERS ARE community standards. The Supreme Court sheet 126) case “Estelle v. Gamble” established this RELEASED?  Other health issues, such as injection right. Failure to provide care that meets An inmate’s health is a critical factor in how drug use (see fact sheet 154) mental health these guidelines might be considered “cruel well they make the transition to life back in problems, liver disease, and diabetes and unusual punishment.” their community. Getting a referral to an  Patient preferences AIDS services agency is very important. However, prisoners may need to advocate  Length of prison term Prisoners may need help finding housing, for their own care. They should understand  Medication timing relative to inmate employment, and support services. If you their illness and make sure they get activities, food requirements, and are a prisoner who is getting ready to be appropriate care in jail or prison. refrigeration released, consider visiting the library or asking a friend or family member to send PRISONERS WITH HIV IMPROVING YOUR HIV you the address of a local AIDS service INFECTION TREATMENT organization. They may be able to help you Like the general population, many Prisoners can improve their chances of get set up with some referrals before your prisoners may not know if they are infected getting good HIV health care if they bring release. with HIV. Not all prisons and jails offer HIV information with them. This includes: testing. In others, testing is required. About  What HIV medications they are 15 state prisons require testing at entry. A currently taking or have taken in the past A Project of the International Association of Providers of AIDS Care and the New Mexico AIDS Education and Training Center. Partially funded by the National Library of Medicine. Fact Sheets can be downloaded from the Internet at http://www.aidsinfonet.org Reviewed February 24, 2014

A Project of the International Association of Providers of AIDS Care and the New Mexico AIDS Education and Training Center. Partially funded by the National Library of Medicine. Fact Sheets can be downloaded from the Internet at http://www.aidsinfonet.org