April 19, 2011
Life isn't easy for African American men and women re-entering society after incarceration, but the prevalence of HIV in the Black community creates a new set of challenges. Many former inmates may find themselves at an increased risk of contracting HIV once they leave prison, and those who are already infected often have difficulty finding sufficient medical and emotional resources on the outside.
The barriers for anyone leaving prison are great, says Lena Asmar, director of clinical and support services for AIDS Action Committee of Massachusetts, an organization that advocates for people with HIV and AIDS. Finding affordable housing and getting a job can be frustrating. "All of that coupled with HIV is huge," Asmar says.
Despite urban legends exaggerating the presence of HIV/AIDS in prison, only about 1.5 percent (pdf) of state and federal prisoners are HIV positive, according to the U.S. Department of Justice. For men and women who don't have HIV, there are inherent risks when they return to their homes and communities.
While it's true that many inmates engage in high-risk behavior -- such as unprotected sex, injection drug use and tattooing -- while in prison, it's wrong to assume that former inmates play a huge role in the high HIV-infection rate in the Black community. The data just don't support that fact, says Joseph B. Richardson, Jr., Ph.D., an assistant professor at the University of Maryland's department of African-American studies. In fact, in many communities where the HIV-infection rate is high, former inmates may have a higher risk of contracting HIV on the outside, Dr. Richardson points out.
One of the biggest mistakes a former inmate can make is assuming that a partner has been celibate while he or she has been in prison. Men, in particular, often assume their partners were faithful while they were incarcerated, says Dr. Richardson. However, that partner may have been engaging in other relationships during that time, and new partners whom former inmates meet "can possibly be engaging in unprotected, high-risk sex," Dr. Richardson adds.
Precious Jackson, a women's-health educator at the Los Angeles-based Center for Health Justice, stresses how important it is for couples to communicate about sex, as well as the risk of HIV after a partner has been released from prison -- and suggests that both parties get HIV tests. "You want to make sure that both of you are healthy," she says.
For those former inmates who have HIV, the greatest challenge may be maintaining their health. The prison system is responsible for inmates' care while they are incarcerated, says Edward Harrison, president of the National Commission on Correctional Health Care, but once inmates leave prison, they must find health-care coverage on their own. Not doing so immediately could be harmful. "You need to take HIV medications with regularity," Asmar says. "If you don't, they may not work."
Not surprisingly, it can be difficult to find affordable medical coverage or receive help from programs that provide HIV treatment for the uninsured, such as AIDS Drug Assistance Programs (ADAPs), which often have waiting lists. In addition, the difficulty that a former inmate may face finding a home and a job could also affect his or her health. "What often makes people's health decline after they get out of incarceration is not having stability to take their medication," Asmar says.
If you know someone with HIV who is scheduled to be released from prison, help him or her obtain appropriate care and treatment by following Asmar's tips:
Find an advocate: Local AIDS service organizations, often called ASOs, can tell you about programs and services that may offer financial help. They can also put you in touch with other organizations that can help out with other needs, such as housing and job placement.
Explore local hospital offerings: Some hospitals have community health centers that provide services for free or at a discount. "Look for one that does infectious-disease work and has providers that are not judgmental and know about HIV," Asmar says.
Get emotional assistance: Former inmates often experience feelings of isolation after returning home from prison. "People sometimes come out with no support. Sometimes their families have turned their backs on them and don't want anything to do with them," Asmar says. Look for HIV/AIDS support groups where you can find people who are experiencing some of the same fears and frustrations.
The key is for HIV-positive former inmates to start making connections so that they can better handle the challenges that accompany living with HIV. "The problems of isolation and stigma are huge," Asmar says.
Tamara E. Holmes is a Washington, D.C.-based journalist who writes frequently about emotional health and wellness.