America Living With AIDS

Report Number Four:
HIV Disease in Correctional Facilities
March 1991
1. The U.S. Public Health Service should develop guidelines for the prevention and treatment of
HIV disease in all federal, state and local correctional facilities. Immediate steps should be taken
to control the subsidiary epidemics of tuberculosis and sexually transmitted diseases. Particular
attention should be given to the specific needs of women and youth within all policies.
2. Given the dearth of anecdotal and research information on incarcerated women, incarcerated
youth and children born in custody, federal and state correctional officials should immediately
assess and address conditions of confinement, adequacy of health care delivery systems, HIV
education programs, and the availability of HIV testing and counseling, for these populations.
3. To combat the overwhelming effects which drug addiction, overcrowding and HIV disease are
having on the already severely inadequate health care services of correctional systems nationwide, a program such as the National Health Service Corps should be created to attract health
care providers to work in correctional systems.
4. The Department of Health and Human Services should issue a statement clarifying the federal
policies on prisoners' access to clinical trials and investigational new drugs. In addition, the
Food and Drug Administration, in conjunction with the Health Resources and Services Administration and the National Institutes of Health, should initiate an educational program directed
toward informing inmates and health care professionals working in correctional facilities of the
availability of investigational new drugs, expanded access programs, and applicable criteria for
eligibility of prisoners in prophylactic and therapeutic research protocols.
5. Meaningful drug treatment must be made available on demand inside and outside correctional
facilities. Access to family social services and nondirective reproductive counseling should also
be made available with special emphasis on the populations of incarcerated women, youth and
children born in custody.
6. Prison officials should ensure that both inmates and correctional staff have access to comprehensive HIV education and prevention programs. Particular attention should be paid to staff
training on confidentiality and educating inmates about the resources available in the prison
setting that may be employed to reduce the risk of infection.
7. The burden of determining and assuring standards of care has largely fallen to the courts, due,
in part, to the failure of the public health authorities to take a leadership role in assuring appropriate standards of health care and disease prevention for our incarcerated populations. Bar
associations and entities such as the Federal Judicial Center must, therefore, establish programs
to educate judges, judicial clerks, and court officers about HIV disease.

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