Life Sentences

The Incarceration of HIV-Positive Women in the U.S. Equals IllTreatment

by Diane Goettel

Two words that most Americans never want to associate with themselves or the people in their immediate circle are “criminal” and “infected.” The highly stigmatized circumstances of being HIV-positive and living behind bars are often linked. This is no surprise as it has long been known that the prison system is just as much a catchall for the unfortunates of our society as it is a structure meant to protect the greater population from dangerous criminals. Many studies show that the same behaviors that lead to incarceration also increase one’s risk of becoming HIV-positive. Currently, there are two rapidly increasing populations in United States prisons and state penitentiaries: women and individuals infected with HIV. In fact, the number of women in prisons and jails is increasing at a faster rate than that of men. In 1999, more than eighteen percent of the incarcerated women in New York State were HIV-positive.

Though women are entering prisons at an ever-quickening speed, they are still far outnumbered by men who have a much longer legacy of incarceration. One of the major problems facing incarcerated women is that they are provided with programming and services that were intended for men. It has become clear to many groups, including the National Institute of Justice, that incarcerated women have different requirements than men. Correctional services which are targeted at male prisoners are ineffective if not damaging for women inmates.

Suelynn Shiller is the director of administration at Pittsburgh’s Program for Offenders, Inc. The Program for Offenders provides supportive services for offenders to give them a second chance and to give their children a first chance. During an interview, Shiller explains that most HIV-positive inmates have other serious problems as well. This population very often also has serious mental and physical problems. Many of these people have experienced homelessness, abuse, and are drug users. A large portion of HIV-positive female inmates are mothers as well. When these women are released from prison, they very often bring all of their problems back into their communities, into their families. It is imperative that these women are given adequate care and support so that they can successfully reenter society.

Unfortunately, the support and medical care that is available to inmates is sub-par at best. Some HIV-positive inmates go entirely without medical care. In other instances, inmates with the disease are exiled from the greater prison population. One prison administrator admitted that fifty-three beds in the maximum security section of the facility had been allotted to women with HIV and other illnesses. Thus, due to their illness, they were segregated from the other inmates and denied the privileges of living in low-security quarters even though their sentences had not included high-security residence specifications.

While this state of affairs is certainly unjust, there are also major problems associated with an HIV-positive inmate living in the general minimum-security population. Living with a large group of individuals is especially dangerous for these inmates whose immune systems are drastically weakened by their disease. In prisons, as in schools and office buildings where people work together in close quarters, colds, viruses, and infections are easily passed from person to person.

While most people have immune systems that can handle commonplace illnesses, just a weak strain of the flu can be deadly for people with AIDS. “Prison is a really difficult place to be HIV-positive,” says Cathy Olufs, education director at the Center for Health Justice. Cathy, who is HIV-positive, was incarcerated for nine months at the Chowchilla prison in California. Since her release from prison in December of 1996, Cathy has worked to advocate for HIV-positive women in prison. “I was lucky,” she explains during our interview, “because I was in fairly good health and my T cells were good.” There were plenty of other positive women in the facility, however, who did not fare as well as Cathy. Furthermore, prisons and prison staff are not always equipped to care for inmates with HIV. “It’s getting better in some places, but it depends on the facilities” says Olufs. “There are really only a few places where it is getting better. In some places things are going really backwards.” 

In prison, facility lock downs can mean that inmates do not get their meds. At Chowchilla, prisoners have to walk from the building where their cells are located to the infirmary where medicine is distributed. During lock downs, prisoners are not allowed to leave their cells—not even to get their medicine. On foggy mornings, Chowchilla often goes into lock down. Prison administrators believe that the weather provides enough cover to encourage some inmates to attempt an escape. Foggy mornings can be tough times for medically fragile inmates who need their prescriptions. Despite many problems that plague prison medical systems, Olufs is grateful for having met some wonderful doctors and nurses while she was incarcerated. “There is a myth that all medical care providers view prisoners as the scum of the earth and treat you as such,” she says. “But some of them are really caring and wonderful people.”

If we are going to incarcerate individuals with HIV, then we must take into account and accommodate their specific requirements. Additionally, their prison experience should be parallel with the experiences of HIV-negative inmates. They should have access to the same resources and share the same privileges. An HIV-positive woman in prison should not have to live in solitary confinement just so that she can stay relatively healthy. Even in places where medical care is provided, it is often inadequate. Due to the poor health care and the environment within prisons, it is likely that an inmate with HIV will die. For an individual with this disease, a short-term sentence is more likely to be a life sentence.

In addition to the medical concerns surrounding HIV-positive inmates, there are also a number of psychological issues that need to be addressed. The challenges of caring for women in this predicament are different and possibly more complex than those associated with the HIV-negative inmates. Furthermore, Shiller explains, similar circumstances and experiences often lead to both incarceration and becoming HIV-positive. Issues such as depression, psychological and psychosocial problems, substance abuse, and physical and sexual abuse must be addressed along with the HIV-related issues. It is critical that these women are provided with adequate counseling so that, in the event that they reenter society, they will have learned how to handle and manage their situation as best they can.

If a woman with HIV does make it out of prison with her life, she then faces a whole host of new problems. Ex-convicts leave prison to enter a world in which it is nearly impossible to get a loan, a job, even public housing. If she does not have a family to support her, which is the most common situation, then she will be homeless, without resources, and without medicine or health insurance. No, prison is certainly not a center of rehabilitation, especially for individuals with such serious health issues as HIV. It is crucial to supply these women with support while they are in prison and to help them develop resources outside of the prison to facilitate their reentry into society. As it stands, our prison system propagates recidivism and illness instead of providing rehabilitation.

At the moment, the prison system is responding to the HIV crisis by providing testing and education. Inmates are often wary of being tested while they are in prison because of confidentiality problems. Though women may receive education while they are incarcerated, it is sometimes difficult for them to put this knowledge to use in real life. Furthermore, safer sex within the prison is a futile goal. Many prisons refuse to provide inmates with dental dams, condoms, or latex gloves. Although some individual counselors take the initiative to provide condoms, says Shiller, many prisons simply do not have the funding to invest in these items. “After all,” she notes, “many of them can hardly afford to provide their inmates with adequate nutrition.”

A completely different system of care, treatment, and services needs to be developed for incarcerated women with HIV. HIV-positive female inmates must be provided with adequate medical treatment and counseling. Furthermore, the function of incarceration needs to be rethought. Prisons are touted as institutions of rehabilitation. If they are to serve this function, then the manner in which inmates are treated and serviced must be drastically revised. We cannot allow prisons to harm the individuals who reside inside of them. We cannot allow prisons to be killing grounds for our weakest, torture chambers for our disadvantaged. We cannot deny the humanity of some two-million people who are currently living behind bars.

Diane Goettel is the fiction editor of The Adirondack Review and the managing editor of The Black Lawrence Press. Her film and book reviews appear monthly in The Adirondack Review. She has been published in 42opus, failbetter, and Lichen, among others.

November 2006