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Management of the Seropositive Prisoner: Medical, Ethical, and Economic Perspectives

NCJ Number
137431
Author(s)
G Sutton; R S Chavez; J Clark; P Eales; A Hamb; B Heyman; G Johnson; N Kendig; K S Shepard
Date Published
1992
Length
16 pages
Annotation
A panel of clinicians working in correctional facilities discussed many of the significant issues influencing the management of inmates with HIV infection or AIDS.
Abstract
Because correctional facilities are the destination for large numbers of people at risk for HIV infection including intravenous drug users and prostitutes, the standards of patient care in the prisons must be exceedingly high if those HIV-seropositive inmates are to be managed appropriately during the early stages of the disease. The debate over mandatory testing in correctional facilities has been addressed by the courts and the National Commission on Correctional Health Care; the practice is no longer condoned. While the suggested strategy of placing HIV- positive inmates in segregated housing has also stirred controversy, there remains concern that placing these inmates in the mainstream population will result in an increased incidence of HIV infection, though this has not proven to be the case. Another major concern, transmission of HIV to corrections employees, also has not materialized; the incidence of sero-conversion is extremely low. Much of the panel discussion focused on the use of the drug zidovudine as the most efficacious treatment for HIV- positive inmates. Some officials expressed dissatisfaction with current methods of counseling HIV-positive inmates. There was a large measure of concurrence that peer participation in inmate HIV education can have a significant positive impact. The issues of women prisoners and HIV and the relationship between HIV disease and tuberculosis were also explored. Standards of treatment in the correctional environment are among the highest in the nation as proven expertise, protocols, and treatment strategies are focused on the high-risk populations. However, access to affordable and quality aftercare remains a major problem for HIV- positive inmates.

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