Real Politikin': Lovin’ is Best...

Being a native of Kansas, you can imagine my delight when I learned that Oz, the critically-acclaimed HBO series from the late 1990s, wasn’t some lame update of the Frank L. Baum classic featuring Dorothy and the Scarecrow. Instead, it was a gritty, sweaty, nasty prison drama full of gritty, sweaty, nasty men all sharing the same living space 24 hours a day with not a woman in sight.

Yum…

Being that I was a closeted teenage boy, you can also imagine the fantasies my pubescent mind entertained as I watched the Irish, Puerto Rican and Black inmates parade around the penitentiary half-naked and half-cocked out of their gourds with primal rage. And as much as those fantasies got me through some really, really hard times, thankfully none of them ever came true. If they had, I would have stood a good chance of contracting HIV.

It’s a sad and un-sexy reality that the U.S. has no national strategy for preventing the spread of HIV within its prisons. No condoms. No prevention programs. No risk-reduction efforts. Just a complete denial that in every penitentiary there are men having sex with men. The prevalence of HIV/AIDS amongst inmates is three times that of the U.S. population as a whole.

In New York City alone, officials estimate that between 10 and 20 percent of the city’s 14,000 prisoners are HIV positive. And while a 20 percent positive-status rate on the inside might be staggering, it’s how that number affects the outside world that has me concerned. Not only do 90 percent of all inmates return to society, they’ve also been bumping uglies with the prison guards.

According to a 2006 report by the Centers for Disease Control that focused on the state of Georgia, one-third of HIV-positive prisoners reported having sex with male staffers while one-fifth said the same regarding female staffers. And because Vermont is the only state—along with L.A., San Diego, New York, San Fran, Philly and DC being the only cities—that regularly distributes condoms to prisoners, it’s highly likely that all that prison sexin’ down in Dixie was unprotected.

This being a clear danger to public health, you’d think there would be broad-based support for developing a national strategy to fight HIV within the prison system. You’d be wrong. California, Illinois and the United States Congress have all failed in the past three years to pass bills that would have allowed condom distribution in prisons, saying that such programs would run counter to nationwide laws banning prison sex. Unions representing correctional officers are also opposed, saying condoms would hurt prison discipline. And then there are the moralists, like Rev. Harold Bailey, the former head of the Chicago prison system who was quoted saying “Anytime anyone puts two men together, which is against the law of God, then gives them permission to do it with a condom, that's despicable.” So basically, our public health (and my private fantasy) is threatened because politicians think laws prohibiting prison sex are effective (which they obviously aren’t); unions think condoms rile up prisoners (when the L.A. sheriff’s office has reported no major infractions since their condom program began in 2001); and homophobia amongst public officials is shaping policy.

A good first step towards developing a national strategy would be for Congress to pass the JUSTICE Act, first introduced in January 2007. This legislation would order all Federal correctional facilities to allow community organizations to distribute condoms. But passing out prophylactics isn’t enough. Dr. Robert Fullilove, associate dean at Columbia University’s Mailman School of Public Health, wrote in the American Medical Association Journal of Ethics that while “condom distribution might limit exposure to infection while an individual is incarcerated, the risk that requires more attention is the risk to the community into which infected inmates—who are neither aware of their [HIV status] nor getting appropriate monitoring and treatment—are released.” Congress should include provisions in the JUSTICE Act that fund testing at the start and end of a prison sentence for all inmates and a plan that mandates treatment in prison and linkage to care upon the inmate's return to the outside world.

In doing my research for this column, I came across a New York Times article titled “Plan for AIDS Testing In Prison Raises Questions.” It was from 1989. This means that despite all the evidence that our prisons are breeding grounds for the spread of HIV, for two decades too many of our public officials have been clicking their heels together and merely wishing that this problem would go away.

And I thought my fantasy was dangerous.