Life isn't easy for African American men and women re-entering society after incarceration, but the prevalence of HIV in the Black community creates a new set of challenges. Many former inmates may find themselves at an increased risk of contracting HIV once they leave prison, and those who are already infected often have difficulty finding sufficient medical and emotional resources on the outside.
The barriers
for anyone leaving prison are great, says Lena Asmar, director of clinical and
support services for AIDS Action Committee of Massachusetts, an organization
that advocates for people with HIV and AIDS. Finding affordable housing and getting a job can be
frustrating. "All of that
coupled with HIV is huge," Asmar says.
Despite
urban legends exaggerating the presence of HIV/AIDS in prison, only about 1.5
percent of state and federal prisoners are HIV positive, according to the U.S.
Department of Justice. For men and
women who don't have HIV, there are inherent risks when they return to their
homes and communities.
While
it's true that many inmates engage in high-risk behavior--such as unprotected
sex, injection drug use, and tattooing--while in prison, it's wrong to assume
that former inmates play a huge role in the high HIV-infection rate in the
Black community. The data just
doesn't support that fact, says Joseph B. Richardson, Jr., Ph.D., an assistant
professor at the University of
Maryland's
Department of African-American studies. In fact, in many communities where the HIV-infection rate is high,
former inmates may have a higher risk of contracting HIV on the outside, Dr.
Richardson points out.
One of
the biggest mistakes a former inmate can make is assuming that a partner has
been celibate while he or she has been in prison. Men, in particular, often assume their partners were
faithful while they were incarcerated, says Dr. Richardson. However, that partner may have been engaging
in other relationships during that time, and new partners whom former inmates
meet "can possibly be engaging in unprotected, high-risk sex," Dr.
Richardson adds.
Precious
Jackson, a women's-health educator at the Los Angeles-based Center for Health
Justice, stresses how important it is for couples to communicate about sex, as
well as the risk of HIV after a partner has been released from prison--and
suggests that both parties get HIV tests. "You want to make sure that both of you are healthy," she
says.
For those
former inmates who have HIV, the greatest challenge may be maintaining their
health. The prison system is
responsible for inmates' care while they are incarcerated, says Edward
Harrison, president of the National Commission on Correctional Health Care, but
once inmates leave prison, they must find health-care coverage on their own.
Not doing so immediately could be harmful. "You need to take HIV medications with
regularity," Asmar says. "If you don't, they may not work."
Not
surprisingly, it can be difficult to find affordable medical coverage or
receive help from programs that provide HIV treatment for the uninsured, such
as AIDS Drug Assistance Programs (ADAPs), which often have waiting lists. In addition, the difficulty that a
former inmate may face finding a home and a job could also affect his or her
health. "What often makes
people's health decline after they get out of incarceration is not having
stability to take their medication," Asmar says.
If you
know someone with HIV who is scheduled to be released from prison, help him or
her obtain appropriate care and treatment by following Asmar's tips:
Find
an advocate:
Local AIDS service organizations, often called ASOs, can provide information
about programs and services that may offer financial help. They can also provide contact
information for other organizations that can help out with other needs, such as
housing and job placement.
Explore
local hospital offerings: Some hospitals have community health centers that provide services
for free or at a discount. "Look for one that does infectious-disease work
and has providers that are not judgmental and know about HIV," Asmar says.
Get
emotional assistance:
Former inmates often experience feelings of isolation after returning home from
prison. "People sometimes come out with no support. Sometimes their families have turned
their backs on them and don't want anything to do with them," Asmar
says. Look for HIV/AIDS support
groups that can find people who are experiencing some of the same fears and
frustrations.
The key
is for HIV-positive former inmates to start making connections so that they can
better handle the challenges that accompany living with HIV. "The problems of isolation and
stigma are huge," Asmar says.
