"Although medical and healing professionals have long denounced the gap in care between those with HIV/AIDS in the community and those in prison, the combination of state budget cuts for AIDS and the national trend toward longer prison sentences for drug offenders is poised to seriously compromise our public health.

"...For the incarcerated -- of which there are disproportionate number of minorities -- the prevailing attitude is that health care need not be of the same quality as mandated by community standards or even federal guidelines. Such groups as AIDS Action Committee and Centro Latino de Chelsea have worked tirelessly to maintain the services and care that are now being threatened. This poses additional challenges to prison care, which is compromised not just by lack of resources but attitudes. Throughout the nation, prison rape is a fact of life and is even condoned by some guards as a form of disciplinary action -- despite what we know today about AIDS transmission.

"To accomplish the goal of meeting the medical needs of those incarcerated -- services that range from HIV testing practices to acceptance and adherence to antiretroviral therapy -- considerable cooperation between health services staff and prison administrations is vital.

"...Dispensing of medication is another practical issue because of dosages, monitoring, and side effects. However, flexible programs with the correctional staff will minimize obstacles to medication, which, when interrupted, can cause irreversible damage to inmates' health.

"...When correctional systems and community educators work together, a climate is created within the prison system that makes identification and treatment more acceptable both to inmates and staff.

"...Budget cuts and a double standard of care between the community and prisons jeopardize the public. When untreated and uneducated prisoners return to their families, they are walking carriers. However, as we have seen from continuum of care models, such as individual programs in Massachusetts and the Rhode Island Prison Release Program, those treated within the correctional system often have the courage to reach out to their home community. When this happens, a continuum of care is created that makes the difference in determining whether or not former inmates become more responsible members of their community."

Watson is co-editor of "Reaching In, Reaching Out: Treating HIV/AIDS in the Correctional Community." Riceberg, a research associate, is pursuing her MPH at Boston University.

Back to other CDC news for July 18, 2002

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