In our California prison system HIV, AIDS, and Hepatitis C is spreading. Should these inmates have access to condoms to keep themselves and their families safe?

HIV, Human Immunodeficiency Virus is a virus that destroys the immune systems helper T-cells, this then cause AIDS, Acquired Immune Deficiency Syndrome, which makes it harder for the body to fight infections. Patients then often dye from secondary infections like Pneumonia. Hepatitis C, which attacks the liver and is spread by any source of sharing, needles, razors, toothbrushes, unprotected sex, and from mother to child during child birth.

In my two years as a Phlebotomist at the California Mens Colony I watched the new diagnosis of AIDS and Hepatitis C among inmates, as they either tried to ignore or run from it. Because of the diagnosis of HIV and the extent and painful deterioration to the body from this diseases the inmates use suicide as a way out.

I personally started two inmates on their treatment for AIDS after just being diagnosed and came back to work from the weekend off and was informed of their suicides. I’ve seen the positive results of many inmates with Gonorrhea, Syphilis and Chlamydia. I’ve followed the before and after of prison tattooing (abscesses, AIDS, Hepatitis). My original shake off was, “oh well, these guys are criminals and they’ve lost their rights anyway.”

Well as time went on I started thinking about the families these inmates are always talking about. I would overhear and have conversations with these inmates about their families, how much they love them, and how excited they are to visit with them. If one is so excited to see ones family why jeopardize it with such risky behaviors?

In prison there aren’t a lot of choices of how these inmates choose to live once inside; rape and stupidity are two risk factors of just being an inmate. Rape is not always among the gay and transsexual inmates; it is also used as power over the weak inmates or even initiation of new arrivals, a way for payment on an outstanding debt.

I know that sex in prison is illegal, but so is drinking and driving. We just don’t have the manpower to make it stop. I’m sure California could rebuild its prisons so every inmate could have a private cell, but at whose expense, the taxpayers? This would cost billions to a state that can’t even maintain or balance a budget, and most would argue to add more patrols and officers on the outside to prevent all of the illegal activities, then in turn keep these men and woman out of prison to begin with.

California Men’s Colony is our local State Penitentiary, located just off California State Highway 1, on your way to visit the beautiful Morro Bay coastline. It houses 7,000 inmates and has been a prison since 1954. The California Men’s Colony houses level II and III inmates, (California Mens Colony 1) these are said to be the less violent of the inmates.

I did some local research through Public Health records available to the public and I found that the behavior of the inmates alone raises the HIV and Hepatitis C population in our county, a group of men who don’t value life, their own health, or even feel they are bound by laws are brought in to our county here and then become part of our population even though they can’t function in our population they are considered part of it.

In the Epidemiological Profile “HIV/AIDS in San Luis Obispo County” states the following: the Center for Disease Control estimates 40,000 new HIV infections per year in the United States and as of July 2002 it has become a reportable condition in California, before this only AIDS its self was reportable. The incarcerated population of San Luis Obispo County has greatly increased the number of HIV/AIDS cases in the county. Between 1999 and 2004 Cumulative Incidence Reports for San Luis Obispo County have rose 46 per 100,00.

San Luis Obispo County also breaks down these case by race as follows; African American represent 1.2% of the population in San Luis Obispo County but 27.1% of all AIDS cases are African American, the majority of these cases are occurring in the institutionalized population of San Luis Obispo County.

Here is a break down of the institutionalized population percentage rates; 26.2% White, 48.8% Black, 23.3% Hispanic and 1.8% Other”.

I have found that in the prison system, as a new or gang educated inmate you can choose your race to be “other” so you can’t be a racial target, but so you can also end up on a yard or in a cell with other inmates you need to get a “message too”, I didn’t understand it until I witnessed it first hand. There was a new inmate that I had drawn blood for, clearly a Hispanic gang member, he hated gays but ended up housed on that quad, with in an hour a young gay man was rushed into the facility Emergency Room with a knife wound to his heart it had pierced his Pulmonary Artery, and soon to follow was the so called ” non gang member” who had marked “other” on his inmate history, all because the young gay inmate on the know to be gay yard looked at the “non gang member”. This “other” category on the forms when inmates are being received or transported to other prisons needs to allow for a little more detail or to expand on the race of “other” and officers witnessing this information being filled in should be able to write a description of what they are seeing, does this inmate have known gang markings on his body, his demeanor, just because these inmates want to avoid enemy gang members doesn’t mean other inmates should suffer, the blacks, whites, gay, transgender, or straight.

These statistics are between The Mens Colony, Atascadero State Hospital, and the Boys School, all located in beautiful San Luis Obispo County California, so being surrounded by these three facilities, I do see the need for protected sex or even a safer environment for these inmates, also I don’t understand why the inmates aren’t in their own cells, yeah fine house them on the same yard but at least let them fell safe at night when they sleep, have one officer per every four to eight inmates don’t let these inmates run the prisons, we the people located in the counties near these facilities need to ask more questions of the state who is putting these “Rehabilitation” facilities in our counties, they are affecting the health of our public, especially if their families are relocating to our county to remain closer to a loved one that in in one of our local “Rehabilitation” facilities they are exposed and then we are exposed.

For males in the prison system the transmission of the HIV/AIDS infection is not transported as frequently the way you would think, the highest risk is Intravenous Drug Use, not male-to-male sex, but those who do both Intravenous Drug Use and Male to Male Sex are at higher risks for transmitting and catching the disease.

HIV/AIDS testing is provided in the California Mens Colony, the inmates get two free tests per year, they receive pre and post counseling from an Infection Control Nurse, but the inmates must always sign consent for this testing. In the laboratory as the Phlebotomist performing these tests, I had to follow strict guidelines to identify the patients requesting HIV testing, if I did not feel one hundred percent the inmate in front of me that I was about to draw was the person in the inmate identification photo, the inmate would have to get a new photo and come back another day. This I later found was to protect the prison its self from false accusations from inmates, but also from inmates trying to drastically change their appearances from when they were first processed into the prison system, these inmates could very easily say they did not consent to an HIV test or they could say it was against their will. The only time a forced HIV test was done was if the inmate was in a fight, caught having sex, beat up an officer or hold a conviction rape or molestation, those instances would not allow an inmate refusal of HIV testing, if an inmate did refuse they would have to be strapped down in 5 point restraints with a Sergeant and Captain present along with a Nurse and a video camera to record and witness no harm or wrong doing, in most cases myself and the Infection Control Nurse could convince the inmates otherwise, to just sit in the Laboratory Chair and willingly have the blood drawn with no restraints and what little dignity they had. This made it a little easier on us both to obtain a blood sample for testing. I now just drew inmates with hesitations of the test itself, the hidden fear that in their stupidity or in a rape they may have contracted HIV, even passed it on to their loved ones.

STDs also increase the risk of catching HIV/AIDS, Syphilis and Herpes are open sores, if the inmates have these they most certainly have had unprotected sex and aren’t showing signs of stopping. Syphilis and Herpes are STDs with opens sores, making them easier to spread and once these inmates have sex with an infected inmate the risk of contracting HIV/AIDS increases. Our incarcerated population in San Luis Obispo County accounts for the greatest number and increases in AIDS cases in the community.

The following information I ran across while researching the information about Inmates in the San Luis Obispo County Rehabilitation Facilities.

EXODUS On-Line announces:

“ HIV Prison Advocates Applaud Assembly Vote to Make Condoms Available in California State Prisons” June 6, 2005

Correct HELP, the largest provider of condoms to prisoners in the state of California, today applauded the passing of AB 1677, legislation in the California State Assembly that would allow health agencies and non-profit groups to distribute condoms in California. The bill now moves to Senate.

Assemblyman Paul Koretz (D- West Hollywood) author of AB 1677 states, “ our prisons are HIV infection factories and we are paying tens of millions of dollars every year for not making condoms available. In addition to $18 million spent annually by the Department of Corrections, once outside of prison the average cost of care for an HIV infected patient in Medi-Cal is $23,00 per year.”

“Condoms in prisons save money and save lives………”[Dr. Peter J. Katsufrakis (exodusnews.com)]

Incidents of violence in prisons including fighting where one inmate is bitten or cuts between more than one inmate are also risks for transmission, this transmission is among non-consenting inmates. The overcrowding of prisons increases the chances of fighting and cellmate rape. Tattooing in prisons does not allow for a sterile tattoo environment that most of us may have experienced but the inmates use what they have available to them.

“Tattooing is widely practiced in prisons and is usually performed without fresh or sterile instruments. It involves multiple skin punctures with recycled, sharpened, and altered implements such as staples, paperclips, and the plastic ink tubes from ballpoint pens. Prison wisdom holds that tattooing that causes blood to flow results in the best quality image and is least likely to become infected. Homemade pigment is delivered intradermally (at a sharp angle) rather that through direct puncture. Metal points connected to a battery or other electrical source are capable of producing vibration, increasing the number of skin punctures exponentially, thereby creating a better tattoo, but also increasing the probability of HIV transmission. Body piercing is becoming more popular in prison as in the outside community, and clean instruments for this practice are similarly unavailable.

These are all compelling facts I’m sure most of you were not aware of. I presented my information two ways to people in our community, I asked how they felt about inmates being issued condoms and then presented some infection facts and the families at risk and asked the question again. Every person I asked wished to remain anonymous. So listed are some responses to my questions.

“ I really don’t care either way, but if the option is there to protect themselves I think they should.” (Female Medical Office Manager)

“ Where I work I would be more concerned about contraband getting in easier, sex isn’t that big of an issue at the Boys School.” (Senior Officer at the Boys School)

“ Its just disgusting, if you really want my opinion they should all just be separated from each other, if you have HIV/AIDS you need to be away from the population, or just dead.” (Male mid 30s in the medical field)

“ Why should I really be concerned with something that doesn’t directly affect me?” (Naïve Female early 20s)

If it was just that easy to just separate these inmates into different groups, but then you run the risk of human rights activists getting involved, because segregation isn’t legal and it infringes on prisoners rights.

I also found out that inmates don’t have to disclose the fact that they have AIDS once incarcerated, it is eventually found and noted.

One patient that came in monthly for his testing did not want anyone to know he had AIDS. He was a “retired” LA gang member, from the old days, he commanded respect and you could tell he had authority over the other inmates at The Mens Colony. He once asked me if other inmates had access to medical records, I knew he knew the answer to this, I said,”No the medical records are handled by medical personnel only.”, I knew if any inmate wanted information they could get it. I asked why he wanted to know and he informed me if anyone found out (about his AIDS) he would be housed with the “fagots on C Quad”. I kept it to myself because if he was in the lab-testing monthly for his HIV suppression medications, he was already seeing an Infection Control Doctor (Other inmates already knew).

Another inmate who also was a “retired” gang member told me he was lucky he had dodged the disease so far, this inmate had contracted the Flesh Eating Virus from sharing needles while on the outside, he told me of being in a coma for six months and how his girlfriend used to help him shoot up by using the vein in his forehead, the sight of this inmates many skin grafts and concave abdomen turned my stomach, the first time I say it I didn’t eat that day, seeing this would scare anyone who was looking to start shooting drugs or those who are using, to stop. For me it just turned my stomach that someone would have an addiction that bad and it take The Flesh Eating Virus to consider quitting.

SFGate.com on Tuesday April 9, 2005 announces:

“Calif. Bills Target Inmate Rape, Condoms” (Don Thompson, Associated Press Writer)

One of the bills, which passed out of the Public Safety Committee 4-2, would allow nonprofit groups and health agencies to distribute condoms and other bodily fluid barriers in California prisons.

The bill’s sponsor, Assemblyman Paul Koretz, said, “Various studies put the incidence of homosexual activity in prison at between 30 percent and 60 percent of male inmates, while HIV infection is at least five times that of the outside population. The state spends $18 million annually treating HIV and AIDS in prison.

The second bill, which was advanced by the committee on a 5-1 vote, would require the Department of Corrections to take efforts to prevent prison rape.

People may wonder why the inmates at the California Mens Colony don’t just automatically get these condoms on entry, who will police the condom issuing, how many condoms will be handed out per inmate, and will the spread of STDs, HIV, and AIDS actually be stopped, who will be policing the fact that the issued condoms will not be used to secrete illegal drugs into the prison itself?

From my experience alone I know that because of retirement and increased Academy time to become a Correctional Officer the is a really large shortage of Officers in the Men’s Colony as it is now, who will be protecting these officers once this increased risk is introduced to the Men’s Colony?

One thing many of us don’t put in perspective are the families of these incarcerated criminals. These families get together on approved weekends and spouses are allowed conjugal visits, and yes they do have sex, but who is protecting this inmate’s wife and children? Not the inmate, and as a spouse most of these women actually believe that their spouse is not having sex or has even been raped while they do their time. The inmates pass these diseases to their wives and if their wife becomes pregnant from this person they just can’t live without, complications and these diseases are passed to the newborn.

Before choosing this subject I knew a little because I had a chance to work inside the Mens Colony, but one thing I did not know was all those who are fighting to pass through the Senate ways to actually issue condoms to the inmates incarcerated in the California Prisons. I tried to keep focus on the California Mens Colony because I know they do not issue condoms there yet. While employed at the California Men’s Colony I had the joy of working alongside some really great nurses. They informed me what they would educate the inmates about. One even said she counseled an inmate to use a baggie or some barrier to protect himself since he wasn’t going to stop having sex.

Yeah, it’s gross but you also have to consider these inmates are released into our community and yes some people in our community are having sex with these inmates, free staff that work for the prison system are having sex with these inmates and diseases caught while in prison are spreading. We need to protect the inmates in hopes of protecting our selves and the health of the residents in our county.