Jails across across the country have long since stopped putting inmates with the AIDS virus in separate housing. Here's why one state refuses to change its ways.
During the earliest and scariest years of the AIDS crisis, prisons across America commonly housed HIV-positive inmates separately from their HIV-negative counterparts. That practice has largely disappeared, however, as science and society have changed. The evolution of antiretroviral medicines has drastically reduced the likelihood of disease transmission, and in recent years, 48 states and the Federal Bureau of Prisons have sent their segregation policies packing.
Alabama and South Carolina, however, have hung on. Prisons officials from both states continue to insist that keeping HIV-positive patients separate not only prevents HIV transmission, but also makes disease treatment cheaper and easier. In South Carolina, for example, all HIV-positive inmates are housed in one maximum security prison, making it simpler to administer HIV care on the state's spaghetti-thin healthcare budget.
Prisoners with HIV have fought back, however, insisting that while conditions for inmates with the virus are certainly separate, they are far from equal.
Beverly Jacobs, 43, experienced this firsthand. While imprisoned for credit card fraud, she spent 16 months in the Julia Tutwiler Prison in Wetumpka, Alabama. She sought entrance to a religious dorm, but officials denied her a space because she is HIV positive, she said. She was also rejected from a support dorm for people recovering from substance abuse, thereby missing out on critical services. And she was turned away from a work-release program that could have helped her gain valuable skills.
Her clothing was washed separately from that of HIV-negative inmates, destined for a bin marked with thick letters: "AIDS." Her linens often came back dirty. "I still have nightmares about that prison," said Jacobs.
In 2011, the American Civil Liberties Union sued to end the practice in Alabama, and a decision is expected by Christmas. Lawyers are arguing that Jacobs' experience was the rule, not the exception, and that the policy violates the Americans with Disabilities Act by excluding inmates with HIV from a host of rehabilitative and vocational programs.
By housing HIV-positive inmates in one facility, the state says it can deliver first-rate care at a fraction of the cost.
It is also, they argue, unnecessary: Prisoners with far more contagious diseases, like hepatitis B and C, are not kept segregated. And since the advent of potent antiretrovirals, there has been no data, they say, to show that HIV-negative prisoners are more likely to contract the virus when housed with HIV-positive ones.
"These policies no longer make any sense," said Kathie Hiers, CEO of AIDS Alabama, which is able to serve about half of the state's approximately 15,000 people living with HIV. "To treat folks as lepers were treated in biblical days is ridiculous."
If the ACLU wins, one state -- South Carolina, rarely one to cower under pressure from outside entities -- will be left as the lone defender of the practice.