DOJ Civil Rights Division Insanity Will Lead to More Prisoners Contracting AIDS

[tyme]

Alright.  I'm in healthcare, and yeah, I agree that HIV/HepC/TB/never-get-overs-of-the-day are all *really* bad things.

HOWEVER.

I will never agree to mandatory testing for everyone. 

Do you have any other ideas for dramatically reducing the HIV (or Hep) infection rate, or is that just a necessary evil to if we want to keep our liberty?

9/11 only killed a few thousand Americans, one time, and look at what we're doing in Afghanistan and Iraq, not to mention internally to our own country (fly recently?), because of it.  Terrorist attacks have immediate casualties while HIV/Hep/TB are delayed, but even if terrorists managed to set off a dirty bomb in Manhattan, that would be a one-time equivalent -- at most -- of a few years of HIV infections.

There wouldn't even have to be an attack of the magnitude of a dirty bomb.  Suppose terrorists started planting bombs in movie theatres and killed a few thousand that way.  Any bet we'd be under quasi-martial law in large cities?

Let's compare: martial law in response to a smaller threat, or blood tests in response to a larger threat.  People just aren't as frightened about HIV and Hep, because they're "gay" or "drug user" diseases, compared with terrorist attacks.  Would our response to terrorist attacks be any different if they disproportionately targeted gay bars or slums dominated by drug users?

[Headless Thompson Gunner]

9/11 only killed a few thousand Americans, one time, and look at what we're doing in Afghanistan and Iraq, not to mention internally to our own country (fly recently?), because of it.

The difference is that it's government's proper place to defend against foreign attack, while it's none of government's damn business what kind of medical services we choose for ourselves.

[Viking]

This debate has occurred before, when AIDS first become news.  Up till then, STDs were tracked down by questioning those who came down with them and going after their sexual partners.  But, not with AIDS.

Wait, what? AIDS carriers are excempt (either by law or by practice) from laws regarding tracking seriously harmful diseases?

[MicroBalrog]

You are not asking the proper question in the proper context, which is, "Why should HIV+ prisoners be stigmatized?"

Fine.

Someone ends up in prison. They are raped, or bitten by a violent inmate. They get AIDS. They need to be stigmatized, why?

[MechAg94]

Fine.

Someone ends up in prison. They are raped, or bitten by a violent inmate. They get AIDS. They need to be stigmatized, why?

Isn't stigmatizing sort of in their own head?  I believe they were essentially quarantining them. 
If they had quarantined them earlier, that person might not have contracted AIDS. 

[MechAg94]

In the US at least, HIV still has a bit of "gay disase" stigma attached to it and that no "good" person would ever have or worry about having HIV.

It still is because one of the highest infection rates continues to be in the gay community last time I saw numbers and still largely due to behavior. 

[MicroBalrog]

Let's compare: martial law in response to a smaller threat, or blood tests in response to a larger threat.  People just aren't as frightened about HIV and Hep, because they're "gay" or "drug user" diseases, compared with terrorist attacks.  Would our response to terrorist attacks be any different if they disproportionately targeted gay bars or slums dominated by drug users?

What does this have to do with the price of tea in China?

When AIDS was new, people were rather scared of it, historically, and some got so scared that they advocated some pretty crazy stuff to deal with it.

Today, people just realize how un-dangerous it is.

I mean, sure, AIDS is very bad if you have it, but do  you know how low the likelihood of an individual person is to become infected? Do you realize that AIDS deaths are in decline in absolute numbers? [dropped below 16,000 total in 2002]


People's bodies, and their sexuality, are the final fortress of their privacy. If we can invade that, then the entire concept of individual freedoms is pointless. To do that over HIV means that there's no threat, no matter how tiny, you won't do it over.

[roo_ster]

Fine.

Someone ends up in prison. They are raped, or bitten by a violent inmate. They get AIDS. They need to be stigmatized, why?

They're in prison and have been convicted of a crime?  IOW, whatever stigma being HIV+ has is dwarfed by the stigma of being a convict.

[Angel Eyes]

They're in prison and have been convicted of a crime?  IOW, whatever stigma being HIV+ has is dwarfed by the stigma of being a convict.

Being a convict is not necessarily a stigma, depending on the neighborhood.

[BrokenPaw]

Being a convict is not necessarily a stigma, depending on the neighborhood.

That plus because the perception is that HIV is a "gay" disease, the presumption may be that anyone singled out for having HIV is gay, and that may very well be stigmatic, even for (or perhaps especially for) one who is not.

[Tallpine]

I'm in favor of mandatory testing.

For prisoners, or for everyone 

If the latter, how ya gonna do that? 

SWAT raids...? 

[Angel Eyes]

For prisoners, or for everyone 

Mandatory testing of prison inmates for HIV, hepatitis, and TB strikes me as a reasonable safety measure, given the close living conditions inside.

Mandatory testing of the general public is fascism.  IMHO, of course.

[roo_ster]

Mandatory testing of prison inmates for HIV, hepatitis, and TB strikes me as a reasonable safety measure, given the close living conditions inside.

Mandatory testing of the general public is fascism.  IMHO, of course.

I agree with this. 

We owe the other prisoners, not infected with a deadly disease, a reasonable assurance that they will not contract a deadly disease while wards of the state.

[Perd Hapley]

Why should people who have a deadly disease be stigmatized?

Remember: you can contracT HIV by being bitten by an HIV-positive person. Or raped. Or even born with it.

Why should a person who has been born with HIV be stigmatized? Is it his/her fault somehow?

You mean why would people who have a deadly communicable disease be stigmatized?  Because they have a deadly communicable disease, that's why.  Whether they bear some moral culpability is not really at issue.  They may be the nicest and otherwise wholesome people at the church picnic, but the presence of blood-born pathogens tends to put a damper on things.   

[Perd Hapley]

But being tested won't hurt you. 

You've no need to worry about Big Brother, if you've nothing to hide.

[MicroBalrog]

You mean why would people who have a deadly communicable disease be stigmatized?  Because they have a deadly communicable disease, that's why.  Whether they bear some moral culpability is not really at issue.  They may be the nicest and otherwise wholesome people at the church picnic, but the presence of blood-born pathogens tends to put a damper on things.   

Uh. You're not really likely to contract HIV from another person unless you... bite them? have sex with them? I'm out, really.

[mtnbkr]

FWIW, there are a lot of avenues for getting HIV tested these days.  I've had two this year in the process of buying life insurance (two policies).  My wife had one this year (life insurance again, only one policy) and another when she was pregnant with our first child.  She might have had one when she was pregnant with Thing 2, but I don't recall hearing.

Being solidly middle-class white and married, we're not exactly part of any risk group, yet that's 4 tests between the two of us in the past 8 years.

Chris

[Perd Hapley]

Uh. You're not really likely to contract HIV from another person unless you... bite them? have sex with them? I'm out, really.

Your point?   

[vaskidmark]

I agree with this. 

We owe the other prisoners, not infected with a deadly disease, a reasonable assurance that they will not contract a deadly disease while wards of the state.

Again, we need to go back to the rules governing health care as it is provided in prisons.  Generally speaking you cannot isolate/segregate an inmate just because s/he has disease X - unless disease X will spread by merely being in the presence of the inmate.  That's why active TB cases are segregated in the infirmary until they either submit to treatment and become non-communicable or die.  And yes, inmates have the right to refuse medical treatment.  Sure, you can try for a court order to force it on them, but outside of MH issues it becomes more difficult.

Prisoners who are X-positive and who behave in a manner that subjects staff/other inmates to the possibility of having X spread to them - fighting, spitting, throwing bodily fluids, biting, etc. - can be segregated because of their behavior -- but mot merely because they are X-positive.

And even if their behavior is such that they pose a transmission risk, the administration cannot hang a big red "I HAVE X"  sign around their neck or on the front of their cell.  Go read and thank HIPAA for that.  Best you can get is a policy that anybody that fights, spits, throws bodily fluids, bites, etc. and the person on the receiving end can/must be tested for a specified list of communicable diseases.  Even if Inmate X does it three times a day, and has been tested daily for the last year, he gets a new test every time because doing otherwise would disclose his personal medical information.

Go look at how your free-world healthcare system deals with bodily-fluids exposures.  Actually read the form you sign almost every time you access health care.

stay safe.

[MicroBalrog]

Your point?   

That AIDS isn't really a communicable disease like, say, Ebola or the Black Death is. There's no point in stigmatizing those who have it and treating them like lepers.

[Perd Hapley]

I'm simply pointing out that there is a stigma attached to having a deadly communicable disease (dcd).  If you have a dcd, and people know that you have said dcd, you expect them to treat you differently than those without dcd, at least in some way.  Even you would acknowledge this. 

I'm not saying they should wear a scarlet letter or yell "Unclean!" as they go down the street.    As usual, you treat an observation as a policy proposal. 

[seeker_two]

It's not a matter of stigmitization or being a "gay" disease....it's a matter of managing health care in a closed, controlled environment. And, having worked in prison environments, I'd be OK with segregating prisoners for most communicable diseases on a temporary or permanent (as needed) basis.

Getting adequate correctional officer coverage for these units....THAT'S the real problem...

[kgbsquirrel]

Mandatory testing of prison inmates for HIV, hepatitis, and TB strikes me as a reasonable safety measure, given the close living conditions inside.

Mandatory testing of the general public is fascism.  IMHO, of course.

I agree with this. I think perhaps though that a mass misrepresentation is at work here. The words we use to describe something affect the way we think and perceive an issue. For instance I has a Staff Sergeant who changed one of the rules of firearms handling to read "...anything you do not wish to kill" instead of "destroy." The word in this case is segregation. This word is closely tied with abuses of people by government over arbitrary causes (color of skin). This words brings into effect incorrect and disingenuous connotations for this discussion. An appropriate word that should be used, however, is quarantine. This word accurately depicts what is truly going on; those with diseases that are shown to be lethal are being separated from the existing population that do not have those diseases and this being done after definitive proof has been presented that keeping those two populations in close quarters (prison) has lead to a spread of that disease. The method of transmission is moot in this case as it has been shown that in these conditions fluid born transmission is just as problematic. I did have some qualms about forced quarantine regarding some previous discussions but as these are persons already being confined justly those discussions likewise also do not have merit in this case. In this case it is certainly proper and humane to attempt to stem the spread of communicable lethal diseases regardless of type, also I have yet to see any argument made to indicate that these quarantined prisoners are receiving any lesser treatment than those from which they have been separated. If you would readily quarantine those with typhus, TB, measles, or a myriad of lesser diseases, why would you not quarantine those with proven lethal illness that has been shown to spread in such a population? A society, ladies and gentlemen, is measured by the treatment of it's prisoners, how do you wish to be judged?

[freakazoid]

Mandatory testing of prison inmates for HIV, hepatitis, and TB strikes me as a reasonable safety measure, given the close living conditions inside.

Mandatory testing of the general public is fascism.  IMHO, of course.

I agree. I know in boot camp we all had to get tested, I know of one person in my boot camp division who found out he had Syphilis and was able to get treatment.

[Jamisjockey]

Again, we need to go back to the rules governing health care as it is provided in prisons.  Generally speaking you cannot isolate/segregate an inmate just because s/he has disease X - unless disease X will spread by merely being in the presence of the inmate.  That's why active TB cases are segregated in the infirmary until they either submit to treatment and become non-communicable or die.  And yes, inmates have the right to refuse medical treatment.  Sure, you can try for a court order to force it on them, but outside of MH issues it becomes more difficult.

Prisoners who are X-positive and who behave in a manner that subjects staff/other inmates to the possibility of having X spread to them - fighting, spitting, throwing bodily fluids, biting, etc. - can be segregated because of their behavior -- but mot merely because they are X-positive.

And even if their behavior is such that they pose a transmission risk, the administration cannot hang a big red "I HAVE X"  sign around their neck or on the front of their cell.  Go read and thank HIPAA for that.  Best you can get is a policy that anybody that fights, spits, throws bodily fluids, bites, etc. and the person on the receiving end can/must be tested for a specified list of communicable diseases.  Even if Inmate X does it three times a day, and has been tested daily for the last year, he gets a new test every time because doing otherwise would disclose his personal medical information.

Go look at how your free-world healthcare system deals with bodily-fluids exposures.  Actually read the form you sign almost every time you access health care.

stay safe.

One gives up their freedom when they commit acts against the public trust.  Conversly, a prisoner shouldn't have to worry about being raped by an aids infected inmate. Nothing like serving out a relatively minor offense and being sentanced to death with a communicable disease.