Just*in Time: September 2014

Just*in Time
by Justin B. Terry-Smith

Hey Brother! XOXO
I have a couple of questions I hope you can answer about the American legal system as it relates to screening and treatment when it comes to living with HIV.

A friend/past dalliance of mine who is living with HIV is in Washington in jail. Word got out he is there, since April, on charges that were reportedly a set-up. However, that is not proven yet.

But it seems the story was released here to damage his business and reputation, by people who don’t like him. It was a well-kept secret; even the government and consular officials did not know. So now the cat is out of the bag, and I can ask questions.

Q: I hear he is getting his meds, but what are the consequences in prison for people with HIV, in the Washington area?

Canadian IML Brother

Photo by Don Harris  © Don Harris Photographics, LLC. All rights reserved
Photo by Don Harris © Don Harris Photographics, LLC. All rights reserved

I’m so glad to hear from you and I hope all is well. Let me start off by saying that it is really hard to tell someone how prisoners and/detainees are being treated because each state is very different, but I’m glad you asked about just one, and I’m guessing you are asking about Washington state since you are very close to it.

As far as I know there are no consequences for inmates who are living with HIV in prison, but there are challenges. The Centers for Disease Control and Prevention (CDC) (2014) states that inmates in jails and prisons across the United States are disproportionately affected by multiple health problems, including HIV as well as other sexually transmitted infections (STIs), tuberculosis (TB), and viral hepatitis.

I looked up treatment as far as the Washington State Prisons system and HIV treatment is concerned and I found some information from the U.S. Department of Health and Human Services (HHS) (2014). According to HHS, correctional facilities have two main methodologies for dispensing medications to those who are on ART.

The first method is called directly observed therapy, or DOT. This is where the inmate or prisoner goes to the medical unit or pharmacy for all HIV medication doses; dosing is observed by staff members.

The second method is called keep-on-person or KOP. KOP lets prisoners/inmates to keep their medications in their cells and take them independently. Monthly supplies are obtained at the medical unit or pharmacy.

Which method is better?

In 2001 Dr. Margaret Fischl et al conducted a study correlating DOT vs. KOP inmates, and found out that a higher percentage of DOT patients achieved undetectable viral loads compared with the KOP patients (eighty-five vs. fifty percent) over a forty-eight-week period.

According to the CDC (2011), before September 2007, the Washington State Department of Corrections (WADOC) only provided HIV testing to inmates on request. In September 2007, WADOC began routine HIV opt-in screening in which inmates were notified that HIV screening would be performed during the prison intake medical evaluation if they consented. In March 2010, WADOC switched to a routine opt-out HIV screening model in which inmates are notified that HIV screening will be performed unless they decline.

In my opinion I believe that all HIV-positive people, whether in prison or jail, deserve the respect of being able to get proper healthcare. I know a lot of people are asking, “Well, Justin, how do we pay for that?” I honestly don’t know. But I know if I were falsely or legally imprisoned (and since I’m a black male I believe that has a greater chance than happening to me than my white counterparts), it would be unfair for someone to deny me my HIV medication. There is nothing more wretched than watching someone die and having the means to stop it.

Justin B. Terry-Smith has been fighting the good fight since 1999. He’s garnered recognition and awards for his work, but he’s more concerned about looking for new ways to transform society for the better than resting on his laurels. He started up in gay rights and HIV activism in 2005, published an HIV-themed children’s book, I Have A Secret (Creative House Press) in 2011, and created his own award-winning video blog called, “Justin’s HIV Journal”: justinshivjournal.blogspot.com. Now, with this column, Justin has found a way to give voice to the issues that people write to him about. Visit his main Web site at www.justinbsmith.com. He welcomes your questions at [email protected].