The Impervious Wall of HIV Silence and Denial in a Texas Prison
I am a 57-year-old physician who for the past 12 years or so has suffered from a progressive, unrelenting and insidious disease called methamphetamine addiction and dependence. From the 1980s to the first half of the 2000s, I had an extremely fruitful and prosperous medical career devoted to serving the victims of the burgeoning HIV epidemic that was sweeping the country, especially the large urban centers.
Born in Puerto Rico, I moved to New York City to pursue a medical career and was faced with the devastation and ugly face of AIDS among my closest friends, significant others, colleagues and patients. I witnessed the incredible activism and advocacy movements of the affected communities, the horror and pain of young persons dying in scores as the new therapies inched their way forward in the development process, and the gradual conversion of the scourge into a chronic manageable disease. I was honored to work in the trenches with the most noteworthy clinicians, researchers, activists and advocates, many persons living with HIV who taught me the tenets of self-empowerment.
Unfortunately, the perfidy of my addiction embroiled me in a struggle that destroyed my life and led to the situation in which I am now living. Coupled with my mother's death from pancreatic cancer and my lover's sudden death, my life took a downward spiral that led to the demise of my career, loss of my medical practice, revocation of my license and eviction from my home.
At one point, I was homeless on the streets of New York before a long-term colleague, Regina Quattrocchi, rescued me and offered me housing in a congregate facility called the Bailey-Holt House, and I was able to move from an 8'x10' single occupancy roach-infested room at the Camden Hotel in upper Manhattan, where I had been placed by the city.
Subsequently, I was diagnosed with HIV and suffered a physical accident in which all the tendons in my right arm were severed, qualifying me for Social Security Disability. My addiction worsened, and I resorted to selling methamphetamines to finance my habit and supplement my meager disability income -- criminal activities that eventually led to two arrests for possession, sale and distribution of controlled substances.
I had moved to Puerto Rico to assist in the care of my terminally ill father at the time of my second arrest, having been out on bail for the first arrest in New York in 2011. In November 2015, I was sentenced by a federal magistrate in San Juan to 37 months of incarceration and designated to serve the remainder of my sentence at a low-security prison called FCC Beaumont-Low in southeast Texas. I am presently awaiting extradition to New York to be tried for the drug charges that led to my first arrest, and I am possibly facing additional state time.
Living in New York City in a milieu of liberalism, diversity and advocacy for human rights, self-empowerment of the gay/lesbian/transgender and HIV communities, and self-determination built on equality-based moral and ethical values did not prepare me for the inimical environment I was to face in prison. No amount of self-reliance and confidence could have inured me to the flagrant homophobia, racism and HIV stigmatization I confronted upon entering prison.
This prison's population consists of three major groups, each one segregated from the other and in constant conflict: Texan-born Mexican-Americans or undocumented Mexican immigrants mostly convicted of drug-trafficking, sale or possession; local African Americans from the underworld of Houston county or the Valley; and Caucasian men of all ages convicted of sex offenses. Living under one roof in a 300-man dormitory, the three populations keep their distances and seethe with anger and hatred for each other. Boundaries are established and are not to be crossed unless you wish to risk a violent repercussion or ostracism and the ignominy of being a lonesome loser.
The TV room is organized so that each table is designated to a Mexican regional group or gang or to an exclusively black contingency, with the sex offenders (SO)s or "cho-mos" (child molesters) sitting against one of three walls. The remaining wall is for the few Caucasian men who are not SOs and who adamantly want to be distinguished from them. There is very little verbal communication among the members of any of these groups and privately they deride and scorn each other.
The homophobia is evident immediately as any reference to gay or lesbian issues is associated with mockery or sardonicism. A recent admission to the unit was a middle-age male-to-female transgender person who was the subject of countless pejorative discussions in which the licentious attitude and misinformation of the inmates were evident.
The saddest was watching a black gay man publicly decry homosexuals and HIV-positive people with contemptuous remarks in order to be accepted by the African-American homies in his unit, manifesting a severe case of self-loathing and internalized homophobia. Later on, by serendipity I became aware of the fact that he had pill bottles of Truvada (tenofovir/FTC) and Ziagen (abacavir) anti-retroviral therapy in his locker, which he had accidentally left open.
My medical training has taught me how to recognize the pathognomonic signs of long-standing HIV disease, such as the hollow cheeks (due to loss of the cheek fat pad), the protuberant bellies due to truncal adiposity and the spindly extremities with prominent veins due to lipodystrophy, so I am quick to recognize those who manifest such stigmata and make an effort to befriend persons who are likely to be suffering from HIV.
What I encounter is an impervious wall of silence and denial and reluctance to broach the subject among those I approach. Being a physician automatically makes me a "rare bird," and for the most part I will only be approached if an inmate has a medical question about whether he is being treated appropriately by the prison medical team for an ailment.
The predicaments that I face on a daily basis usually surround whom I should associate with, as the members of each group are unforgiving and only bring you under their wing if you are going to be loyal to the segregation and apart-ism that rules the campus. I try to evaluate each person as an individual regardless of the crime they may have committed and to maintain the integrity and belief systems that were imparted to me during my formative years by my parents and mentors, yet not a day goes by that I do not pray to be removed from this hostile environment.
My incarceration has allowed me to re-establish a relationship with my Higher Power and to confront my addiction in such a way that I can repair and make the necessary amends towards which I strive on a daily basis with the goal of one day achieving a true, salutary and invigorating redemption.