In addressing the prevention of the spread of the HIV virus in prisons, we have seen a rush to develop and implement prevention measures. Much attention has centered on such controversial issues as compulsory or voluntary blood testing, isolation versus integration of HIV infected inmates into the prison mainstreams, provision of condoms and disposable needles, and effective educational measures for specific groups within the prison. Unfortunately, this rush to develop and implement preventive measures has resulted in a degree of polarization which has hindered progress towards implementation of effective prevention measures. Prisons and jails offer uniquely important opportunities for improving disease control in the community by providing health care to disease prevention program to a large and concentrated population of individuals at high risk for disease.
Inmates often have little interaction with the health care system before and after being incarcerated. (U. S. News & World Report) The bureau of Justice Statistics (BJS) reported that in 1999, HIV/AIDS in prisons and jails was a growing problem in American correctional facilities.
The AIDS rate in US prisons was five times the rate of general population. (Society. 2003) For a variety of reasons, many inmates do not seek diagnosis or treatment for illness before arriving to prison or jail. Because inmates are literally a "captive" audience, it is vastly more efficient and effective to screen and treat them while incarcerated than to conduct extensive outreach in local communities. (AIDS Weekly. 1998) Uninfected prisoners have sued the authorities for failing to test and segregate.
In a recently reported case, Cameron v. Met cuz 705 F. Supp 454 (N. D.
Ind 1989), an uninfected plaintiff prisoner sued prison authorities for failing to segregate a known infected prisoner with a violent history who had bitten the plaintiff. In that case, the court found that the authorities' failure to segregate a known infected prisoner with a violent history did not amount to gross negligence or reckless indifference to the prisoner who was bitten. (Mead. Vol. 15 no.
5, pp. 197-9). There is a clear case for urgent reform of the law as it relates to prisoners right's to ensure meaningful HIV/AIDS prevention and care strategies for both the prison and general populations. Rights to health care and access to condoms and needle cleansing agents should enshrine in legislation as enforceable rights. Human rights and anti-discrimination legislation should be reviewed to ensure that incarcerated populations have equal access to anti-discrimination remedies and equal rights to freedom from discrimination as the general population.
Every decision made in respect of the administration of prisons must be assessed in terms of its eventual impact on society as a whole.