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Positive Women in Prison: Are They Getting the Help They Need

Winter 2000

HIV Clinical Care For Incarcerated Women: Implications for prisons and public health. Among the presenters were Judy Greenspan, prisoners' advocate.

This article is based on what I learned at the 1999 National Women's Conference at the Los Angeles Convention Center.

Many of the women currently incarcerated in the nations' prisons have experienced prior sexual and/or physical abuse. This is known to be a contributing factor to alcohol and drug abuse, which in turn can lead them into a lifestyle of risky behaviors such as trading sex for money or drugs. Such behavior inevitably leads to risk for infection with HIV.

Substance Use

Substance abuse continues to be the leading cause of new infections among the female incarcerated population. Although the inmates may be able to get drugs fairly easily, often times the syringe necessary to inject them is harder to obtain. Frequently this leads to the sharing of works (ie; needles) amongst each other. This has long been known as a major route of transmission for HIV. Many of these women do not get tested for HIV. Others who have tested positive are reluctant to reveal their HIV status due to stigmatization, and in some cases, fear of physical violence.

Standard of Care

There is still much discrimination in the prison system related to HIV/AIDS, therefore, many positives are not being treated for their infections. Those who are receiving treatment, most often do not receive the same standard of care as those of us on the outside. There are very few HIV specific programs in our prisons for either male or female prisoners. The programs that are in place lack adequate funding and support from the prison system. In addition, the Department of Corrections is required to provide medical treatment for infected people but it doesn't always comply.

Although access to all approved medications is limited for incarcerated persons, many who are taking combo therapy don't receive the correct dosage at the right times. Medical personnel need instruction on HIV medication adherence and the importance of sticking to the dosing schedule.

These are just a few of the issues that are currently facing the incarcerated community. "Lack of commitment is one of the biggest barriers against change regarding policies impacting HIV care," says Judy Greenspan. Judy has been working as an advocate for incarcerated women for many years.

Also among the problems noted, is a need for the Department of Corrections to implement a better pre-release program for incarcerated individuals so that they may be better prepared for release back into the community (especially for those parolees who have done extensive lengths of time).

What Can We Do?

This is where we need to look at our case management programs. Are women who need substance abuse treatment being offered this prior to release? Does the person who interviews the prisoner have the appropriate resources and referrals? The prisoners need all the support they can get from their Case Managers along with guidance for setting long term goals. This will help them to succeed with their sobriety and prevent them from relapsing and violating parole.

As community providers we feel a bit helpless when it comes to helping HIV+ people in prisons. However, there is a lot we can do to help women who have paroled.

Where as some agencies are not equipped to handle this population and others do not want to, other agencies including Women Alive welcome formerly incarcerated HIV positive women to participate in all of our programs.

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This article was provided by Women Alive. It is a part of the publication Women Alive Newsletter.