A 1994 study showed that out of a total population of 14,000 federal prisoners 120 were infected with HIV. But AIDS activists believe that for every prisoner who has tested positive for HIV and disclosed that information, there are many more who do not know they have the virus.

The AIDS crisis in our prison system can be seen as a product of government inaction. While some prisons are allowing peer counselling groups to come in and condom distribution programs have been initiated in some of the federal prisons, this is just a start. Prisoners are becoming infected with HIV during their incarceration because they do not have the information and resources to protect themselves. Once infected, their lives are endangered both by a lack of access to doctors specializing in HIV/AIDS and limited access to all available treatments and alternative therapies. The three primary issues around HIV/AIDS are the prevention of new HIV infection, the right to confidentiality and the care and support for those who are already infected with HIV or have AIDS.

Preventing HIV/AIDS in Prison

HIV is transmitted through unsafe needle use and unsafe sex. Prisoners are engaging in these activities and putting themselves at risk for infection because either they do not know these activities are unsafe, they do not know how to engage in them safely, or they do not have the means to engage in them safely. Comprehensive education is the first step, and in order to guarantee that information is current, and to ensure that the prisoners trust those providing the education, community based AIDS and health organizations should lead educational sessions. Education can only be effective if prisoners have the means to act on their knowledge. So the next step in prevention is to implement programs and policies to ensure no further risk to the prison population.

With the advent of its condom distribution program, the federal government has acknowledged that consensual sexual activity takes place in prison. However, because it is still an institutional offense which you can be punished for, prisoners, when having sex, are less likely to have safer sex. Accordingly, consensual sex between prisoners should not be an institutional offense. And condoms, dental dams and other safer sex materials must be made available to all prisoners.

Injection drug use is the second primary mode of infection. Evaluation of an AIDS prevention program including needle distribution for female prisoners in Switzerland has demonstrated clear positive results: the health status of prisoners has improved, no new cases of infection with HIV or hepatitis occurred, a significant decrease in needle sharing was observed, there was no increase in drug consumption, and needles were not used as weapons. The study shows that effective HIV prevention based on harm reduction is feasible in prison. Germany, Spain and Australia are all planning to implement needle exchange programs. Canada must follow suit.

The use of unclean needles in tattooing is a third mode of HIV transmission in prisons. Tattoo equipment and supplies, including latex gloves and sterilizing agents, should be covered under hobby-craft provisions, and be available in every institution.

Confidentiality

People outside of the prison system are able to keep their HIV status confidential through the use of anonymous HIV-antibody testing programs. These programs must be expanded to include prisoners:

• HIV-antibody testing must be done voluntarily and anonymously.
• Testing should be done by outside agencies.
• Confidentiality of all prisoners HIV-antibody status must be respected.
• HIV related information in the possession of health care workers should be released to prison authorities only under extraordinary circumstances and only with the consent of the prisoner.

Care and Support for Prisoners with HIV/AIDS

Prisoners with HIV/AIDS do not have the same life expectancy rates as a person with HIV/AIDS living on the outside. Overcrowding, poor diet, poor medical treatment, stress, TB, difficulty in accessing family and community support, excessive and vindictive sentencing, lack of support programs, racism, prejudice, sexism, violence - all of these societal problems are magnified within the prison setting, and then magnified many times over in their impact on prisoners living with HIV/AIDS. All of these factors work towards shortening a prisoner's life span.

Prisoners living with HIV/AIDS have a right to maintain their health. The law is that whatever medical treatments and health care is available to persons in the community, should also be available to persons in prison. It is clear that canadian prison systems must implement policies to facilitate this right. Prisoners with HIV/AIDS must:

• be guaranteed access to the medical practitioners and treatments of their choice.
• be allowed access to all available treatments including alternative therapies.
• have their special dietary needs, whether needed due to illness or as part of a therapeutic program, met.
• have comfort needs such as extra clothing and blankets provided for.

Of course, it is best for people who have HIV/AIDS to spend as little time as possible in prison. They have better access to medical and social services on the outside and they are more likely to be able to maintain their health if they remain in their communities. So while we fight to improve the conditions for prisoners with HIV/AIDS, we must also fight for compassionate sentencing and early release programs.

1996
Joint Effort