AIDS IN PRISON: THE NEW DEATH ROW FOR PRISONERS?
by Judy Greenspan,
Director, HIV/AIDS in Prison Project, Oakland, California
A great deal has been written lately about the barbaric resurgence of the
death penalty. Many states are pass-ing laws to bring back capital punish-ment.
Hundreds of poor people, mostly African-American, languish on death rows
all across this country. But how many people are aware of the new death
row? The combination of HIV infection, poor medical care, a callous, uncaring
prison administration and the day-to-day violence/stress of prison life
can make a short prison term a death sentence. That's the case today for
most prisoners with HIV/AIDS.
Now in the era of runaway prison construction, three strikes you're out
and the dissolution of the inmate's bill of rights, to be HIV+ in prison
for however long you are incarcerated means that if you survive your imprisonment,
precious years will be taken from your already shortened life. A study in
New York State in 1988 proved that prisoners with HIV/AIDS live half as
long as a similar population on the streets of New York City.
Prisoners with AIDS have historically done what they could to fight this
death sentence. Here in California, in 1991-92, men prisoners at the California
Medical Facility at Vacaville (CMF-Vacaville) organized outside supporters
and inspired a legislative investigation of the State Assembly Public Safety
Committee. In the months following the expose of the inhumane conditions
inside the HIV unit at CMF-Vacaville, a hospice was set up, a peer education
program begun, and pastoral care services for the dying were expanded and
strengthened.
At the women's prisons in California, first at the California Institution
for Women at Frontera (1990) and later at the Central California Women's
Facility at Chowchilla (1993), women prisoners with HIV fought and died
for peer education, compassionate release, and decent medical care. In April
1995, a major class-action lawsuit charging gross medical neglect and abuse
against women prisoners was filed as a result of the activism and advocacy
of these women with HIV.
One of the major mechanisms to get prisoners with HIV off of death row has
been the utilization of the compassionate release procedure. In the late
1980s, lawyers at the Prison Law Office began to use the little-known "recall
of sentence" statute to obtain early release for prisoners dying of
AIDS-related complications. In a few instances it worked. Most times, however,
the pleas for release fell on the uncaring ears of prison administrators
and sentencing judges.
Finally, in 1991-92, a small group of prisoners began to access what came
to be known as the compassionate release procedure. However, in most cases,
the men and women prisoners who attempted to initiate the procedure (or
their families) died before their release or were dropped arbitrarily from
the process along the way. At CMF-Vacaville alone, over 400 men have died
of AIDS over the past ten years. Countless, nameless women have died at
both CIW and CCWF also. Now in the aftermath of the most hopeful of international
AIDS conferences where new treatments promising great things have been showcased,
what lies ahead for prisoners with HIV/AIDS in California and across the
country?
First of all, most of the newly touted drugs will not be made available
to prisoners. In California, only a couple of the men's prisons are offering
protease inhibitors (and probably not widely). None of the women's prisons
are offering these new drugs. In fact, most of the prisons are still offering
AZT in high dosages to prisoners with low CD4 counts. After watching their
fingernails turn black and fall off from AZT toxicity, most women prisoners
I have spoken with refuse to take any AIDS-related drugs. To make matters
worse, the women's prisons in the central valley still have not hired an
infectious disease specialist. There are no special diets or dietary considerations
(except for a limited supply of Ensure) for women prisoners with HIV/AIDS.
Prisoners do not have access to any clinical drug trials in California or
most states across the country.
California still stubbornly clings to the system of segregating prisoners
with HIV into special units, which are located in about 10 prisons around
the state. Each prison administers their unit differently, and HIV/AIDS
services (or none) vary from institution to institution. One thing is certain:
the system of segregated housing drives most of the HIV+ population further
and further underground. Most men and women prisoners refuse to come forward
to admit their seropositivity, even when they become symptomatic. Those
who self-identify or come into the system with medical records revealing
their status, are forced to languish in infirmaries and special medical
units of reception centers for between 6-9 months (sometimes as long as
a year) waiting to be placed in overcrowded HIV units. During this waiting
time, the prisoners with HIV are "unprogrammed and unclassified,"
thus earning only 1/3 good time instead of the 1/2 good time that programmed
prisoners earn. Thus, prisoners with HIV (unless they aggressively "602"
their loss of good time, utilizing the grievance process which is often
stacked against them)wind up doing longer and harder time than the HIV-
population. This waiting period can be extremely stressful, especially in
prisons with little or no support services for prisoners with HIV/AIDS.
Prisoners with HIV/AIDS are not eligible for participation in the family
visiting program with their spouses. Most choose not to have overnight visits
with any family members because of offensive and invasive procedures and
regulations promulgated by the Department of Corrections. Prisoners known
to be HIV+ cannot work in the kitchen or food line (except in some HIV units).
New and harsher sentencing guidelines adversely impact on criminal defendants
with HIV/AIDS. Criminal justice professionals, such as judges and prosecutors
(and even public defenders who allow it to happen), continue to sentence
terminally ill prisoners to long prison terms that are bound to be the equivalent
of a death sentence due to callous medical neglect.
Prisoner-initiated, peer-education programs are gathering more interest
among prisoners, but shrinking in actuality due to, at best, administrative
disinterest and at worst, outright hostility. The latest National Institute
of Justice update on HIV/AIDS in correctional facilities documents that
there are fewer peer education programs today than two years ago. Here in
California, the availability of peer education varies from prison to prison.
However, one thing is certain: if there is not an HIV unit in a prison,
there will not be a peer education program. The California Dept. of Corrections
(CDC)-including many of its wardens-has yet to grasp the importance of educating
both the underground HIV positive prisoners and the uninfected.
California is no closer to providing risk-reduction tools to prisoners-condoms,
dental dams or clean needles. In fact, only six jurisdictions in this country
allow condom distribution in prisons and jails (Vermont and Mississippi
state prisons; and Philadelphia, San Francisco, New York City and Washington,
D.C. jails). This figure has remained unchanged for the past six years.
No prison or jail in the U.S. allows for the distribution of bleach kits
or clean needles for injection drug-users. Canada and Europe are light years
ahead of us.
A recent Bureau of Justice Statistics survey revealed that approximately
25% of California's HIV+ prison population has an AIDS diagnosis. Small
wonder that so many prisoners entering the system with HIV become ill and
go downhill fast. Despite two legislative attempts to reform the current
compassionate-release procedure and strengthen its medical component, the
process is bogged down at every step. The prison doctors and wardens are
afraid to release dying prisoners because of public misconceptions about
criminals and crime. The CDC has to answer to the governor and the politicians
and chooses its cases accordingly. And sentencing judges still don't understand
the critical importance of a speedy compassionate release.
Last year, it took over six months to win the release of Peter Hatzidakis,
a first-time nonviolent offender who was doing a short prison term at the
California Medical Facility at Vacaville (CMF-Vacaville). Hatzidakis, who
had fullblown AIDS when incarcerated, suffered from active Tuberculosis
(which he passed on unwittingly to his family), pneumocystis pneumonia,
and other serious complications. He also had a loving family that was willing
to take care of him. The doctors at CMF-Vacaville took four months to approve
his compassionate release request. By the time Hatzidakis was released,
he was in critical condition. He lived for two weeks with his family before
passing.
Prisoners with HIV/AIDS are still routinely treated more severely for rule
infractions. Dorothy Ware, a 21-year-old African-American woman with fullblown
AIDS, was sentenced to two years in the "hole"-the prison's security
housing unit-for spitting on a guard. She was also charged in an outside
court with attempted murder (later reduced to battery). The CDC maintains
a written policy encouraging corrections officers and medical staff to charge
HIV+ prisoners with attempted murder for merely spitting or biting. In the
real world, the Centers for Disease Control (ironically another CDC) decided
several years ago that contact with saliva is not a mode of transmission
for HIV.
As bad as conditions are for men prisoners with HIV/AIDS, the care and treatment
of women prisoners with HIV/AIDS (and other serious illnesses) is far worse.
On April 4, 1995, a class-action lawsuit was filed challenging the medical
neglect and lack of care for the women. According to the prisoners' legal
counsel, very little has changed over the past year. In fact, there is a
growing intransigence on the part of the CDC to upgrade women's medical
care.
Unfortunately, the shrinking AIDS movement has turned its focus away from
supporting the rights of prisoners with HIV/AIDS. Prisoners with HIV/AIDS
find themselves with fewer and fewer allies on the outside willing to advocate
on their behalf. It is more important than ever that issues affecting prisoners
with HIV/AIDS be added to the agenda of both the AIDS service and activist
communities and the movement to change (overturn) the criminal injustice
system.
