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AIDS Activist Brian Carmichael Reflects on Prison Health Care Then and Now

August 2, 2017

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The Next Step: Institutionalizing Peer HIV/AIDS Education as Paid Prison Work

In New York State prisons, in which officials estimate that 2% of the population has HIV, "programs like KTR and PACE have proven their effectiveness and worth," Carmichael says. However, each educator volunteers to teach his or her peers after working a full day at their prison assignment, which is burdensome.

"Trained graduates of the KTR and PACE programs should be assigned to paid positions within the prison," he says, "just like there are paid positions to sweep and mop the cellblock, serve food or wash laundry. I'm talking about the 25-cents-an-hour standard prison jobs."

Carmichael says that he recently spoke with the prison's superintendent about implementing this idea, as well as about having the prison's print shop create educational materials and posters about HIV/AIDS.

"He was interested and supportive and encouraged me to write him a detailed proposal, and [he] promised to study and consider it all," he recalls. "The guy running this [Elmira] prison is open and interested, eager to hear good ideas, but back in the '90s out in California, I would've been labeled a radical and charged with being a member of ACT UP."


Despite Improvements, Testing and Linkage-to-Care Gaps Remain

Still, Carmichael acknowledges that there's more work to do: "There's always room for improvements." Outside organizations that monitor prison conditions concur. Between 2011 and 2013, the Correctional Association of New York, a non-profit advocacy and monitoring organization, visited 18 state prisons and found that, though a high HIV prevalence exists within the system, the Department of Corrections and Community Supervision (DOCCS) failed to identify half of the people with HIV.

Furthermore, the New York State Department of Health found that only 75% of those who had been identified as HIV positive were receiving treatment and that many reported having problems getting their medications, sometimes experiencing interruptions of up to four months.

Nevertheless, reflects Carmichael, "New York [now] is leaps and bounds ahead of California in the '90s. It's a shame we didn't have these types of programs back then, because you can't help but think about how many thousands of lives could've been saved. So, we just keep doing what we can, right? And never forget."

Victoria Law is a freelance writer and editor. Her work focuses on the intersections of incarceration, gender and resistance. She is the author of Resistance Behind Bars: The Struggles of Incarcerated Women. You can find more of her work at

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