Most states have turned to for profit managed-care companies to provide some portion of their prisoner health care services. Two major corporations, Prison Health Services and Correctional Medical Services, provide prisoner medical services in 43 states and account for 25% of dollars spent on prisoner health care.
Full Answer
Should HIV treatment be made available to prisoners?
HIV treatment. Antiretroviral treatment has been provided to many HIV-positive prisoners in high-income countries for the last ten years. As a consequence, AIDS-related deaths in prisons in these countries have decreased dramatically (Centers for Disease Control and Prevention, 1999; Mackenzie et al., 1999; Maruschak, 2001; Babudieri et al., 2005).
Should I pay for HIV care?
· Abstract. The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV.
What is the HIV infection rate in prison?
However, access to HIV prevention, treatment and care programmes is often lacking in prisons and other closed settings. Few countries imple-ment comprehensive HIV prevention, treatment and care programmes in prisons. Many fail to link their programmes in prisons to the national AIDS, tuberculosis or public health programmes.
What is HIV surveillance in prison?
HIV/AIDS is a serious problem for prison populations across Europe and central Asia. The incarceration rates in some countries in eastern Europe are among the highest in the world. For example, the incarceration rate in the Russian Federation in 2008 was 629 persons per 100 000, second only to rates in the United States of America.
Do prisoners get treatment for HIV?
While state prisons provide routine HIV testing and treatment and a well-respected, federally funded program to link inmates to medical care on release, HIV care in the jails is “limited, haphazard and in many cases, non-existent,” concluded the Human Rights Watch report.
What happens if you have HIV in prison?
If untreated or mistreated, HIV can result in serious illness or even death. To prevent these things from happening, people living with HIV in prison should be aware of—and insist upon—their legal right to medical care. The U.S. Supreme Court has ruled that prison officials must provide medical treatment to prisoners.
Does the government pay for HIV treatment?
The Ryan White HIV/AIDS Program is a federal government program for people with HIV or AIDS who have trouble paying for care. The program fills gaps in care that aren't covered by private health insurance or other federal funding.
How much does it cost to treat an HIV patient?
The cost of antiretroviral therapy (ART) used to treat HIV is the cheapest in India, with first-line treatment costing the government Rs 5,000/person/year, and second-line therapy - for people with immunity against the first-line drugs - priced at Rs 29,000/person/year. About 26,000 people are on second-line treatment.
Do prisoners get condoms?
With the signing of Assembly Bill 999 – also known as the Prisoner Protections for Family and Community Health Act – California became the third state in the nation, in addition to Vermont and Mississippi, to provide condoms to prisoners.
What is the second most common type of disability reported by inmates in prison?
The most commonly reported type of disability among both state and federal prisoners was cognitive disability (23%), followed by ambulatory (12%) and vision (11%) disabilities.
Is PrEP free in the US?
The Ready, Set, PrEP program provides free PrEP HIV-prevention medications to thousands of people living in the United States, including tribal lands and territories, who qualify.
Why are prisons a high risk environment for HIV?
The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release.
What are the factors that contribute to the vulnerability of prisoners to HIV?
They include overcrowding, violence, gang activities, lack of protection for vulnerable or young prisoners, prison staff that lack training or may be corrupt, and poor medical and social services
Why are prisons growing?
In many parts of the world, the growth in prison populations (and often the resulting increase in overcrowding) has been the result of an intensification of the enforcement of drug laws in an effort to limit the supply and use of illegal drugs. As a result of the large number of prisoners convicted for drug-related offences, the demographic and epidemiological characteristics of the incarcerated population are significantly different today in many countries from what they were two decades ago. Consistent with the nature of the crimes for which they are convicted, incarcerated individuals have a high prevalence of drug dependence, mental illness and infectious diseases, including HIV [46].
What is a prisoner?
The term, "prison", is used to refer to all criminal justice and correctional facilities.
How to measure prison overcrowding?
The best proxy indicator is the official occupancy rate, i.e., the percentage of the actual number of prisoners in relation to the official maximum capacity of the prison system as a whole. Although states can easily manipulate these statistics by simply enlarging the official maximum capacity, some 60% of all countries in the world report an occupancy rate of more than 100%, which means that they hold more prisoners than the maximum capacity. In 16 countries, primarily in Africa, the occupancy rate exceeds 200% [44].
What is forgotten prisoners?
Forgotten prisoners: a global crisis of conditions in detention
Do prisons have higher HIV rates?
Within prison populations, certain groups have higher levels of infection. In particular, the prevalence of HIV and HCV infection among women tends to be higher than among men [18].
Where do HIV patients get their services?
Some patients receive services directly at the health center itself, while others are referred to an HIV specialist in the community. Major investments in the network of community health centers over the past several years have created more opportunities for HIV care delivery.
What is Medicare for HIV?
Medicare —Medicare is health insurance for people age 65 or older, people under 65 with certain disabilities, and people of all ages with End-Stage Renal Disease. Medicare coverage for eligible individuals includes outpatient care, prescription drugs, and inpatient hospital care. It covers all medically necessary treatment for a person with HIV. To learn more about Medicare coverage and choices, visit Medicare.gov.
What is Ryan White HIV?
The Ryan White HIV/AIDS Program —The Ryan White HIV/AIDS Program works with cities, states, and local community-based organizations to provide HIV-related services to more than half a million people living with HIV each year. The program is for those who do not have sufficient health care coverage or financial resources to cope with HIV disease. Ryan White fills gaps in care not covered by these other sources. The program is divided into several “parts” to meet the needs of different communities and populations, and includes support for an AIDS Drug Assistance Program (ADAP). To find a Ryan White clinic near you, use the HIV.gov HIV Services Locator.
What is the Indian Health Service?
American Indian and Alaska Native Programs —The Indian Health Service (IHS) provides health care services—including HIV services —for members and descendants of federally-recognized American Indian and Alaska Native Tribes. For more information, go to https://www.ihs.gov.
Why is it important to treat viral infections?
These things are important because with the proper care and treatment, you can reduce your viral load, protect your health, enjoy a long and healthy life, and reduce the potential of transmitting the virus to others. But you might have concerns about how to pay for this. There are resources that can help you pay for the care you need.
What is the federal program for women?
The Children’s Health Insurance Program (CHIP) provides free or low-cost health insurance coverage for children up to age 19. Each state has its own rules about who qualifies for CHIP.
What are the rights of prisoners?
Prisoners should have access to medical treatment and preventive measures without discrimination on the grounds of their legal situation. Health in prison is a right guaranteed in international law, as well as in international rules, guidelines, declarations and covenants.29 The right to health includes the right to medical treatment and to preventive measures as well as to standards of health care at least equivalent to those available in the community.30 Access to health services in prisons should be consistent with medical ethics, national standards, guidelines and control mechanisms. Similarly, prison staff need a safe workplace and have the right to proper protec-tion and adequate occupational health services.
What are the good practice recommendations for HIV?
The following good-practice recommendations focus on ensuring an enabling and non-discriminatory environment for the introduction and implementation of the comprehensive package of HIV interventions. In the absence of such conditions, implementation could be challenging and intervention could be less effective.
Why is HIV not being addressed in prison?
The failure to implement comprehensive programmes known to reduce the risk of HIV transmission in prisons and to promote the health of prisoners living with HIV is often related to lack of political will, concerns about security and mistaken assumptions that such programmes will encourage injecting drug use and unsafe sexual behaviour. In addition, many governments lack the resources and technology to meet the overwhelming need. This public health crisis requires urgent attention and action.
How many prisoners in Ukraine have HIV?
Studies in European countries have found great variations in rates of HIV infection among prisoners. An estimated 10 000 prisoners are living with HIV in Ukraine.
Why do people in prison have condoms?
condoms. Denying access to such measures places people in prisons at increased risk of HIV infection. It also places prisoners living with HIV at increased risk of declining health, coinfection with tuberculosis and hepatitis, and ultimately death.
Where are HIV prevention measures implemented?
Few HIV preventive measures. Some (pilot) HIV prevention (harm reduction) programmes have been introduced in prisons in eastern Europe and central Asia. However, most countries in eastern Europe and central Asia offer few adequate HIV preventive measures in prisons, although they have been shown to be effective elsewhere, ...
Where did HIV occur in Scotland?
Major HIV outbreaks occurred among prisoners in Glenochill, Scotland in 1993 and in the Alytus prison in Lithuania in 2002.
Is HIV a problem in Europe?
HIV/AIDS is a serious problem for prison populations across Europe and central Asia. The incarceration rates in some countries in eastern Europe are among the highest in the world. For example, the incarceration rate in the Russian Federation in 2008 was 629 persons per 100 000, second only to rates in the United States of America.
Do prisoners have the same rights?
People in prisons have the same right to health and health care, including preventive measures, as those outside, and their lives and health are connected to those outside in many ways. Protecting prisoners’ health protects general public health. HIV testing and counselling in prisons and other closed settings.
What is the rate of HIV in prison?
Jails are usually operated by counties. Prisons are state or federal institutions. The rate of HIV among prisoners is 5 to 7 times that of the general population. HIV rates are highest among African American prisoners.
How many people in prison in 2008 had HIV?
In 2008, there were about 20,449 people with HIV in state and federal prisons. The rate of HIV infection is higher among female inmates (1.9%) than among male inmates (1.7%).
What are the basic principles of HIV therapy?
The goals of therapy are the same (see Fact Sheet 404 ): reduce viral load as much as possible for as long as possible. restore or preserve the immune system. improve the patient's quality of life.
Why is it important to get a referral for AIDS?
Getting a referral to an AIDS services agency is very important. Prisoners may need help finding housing, employment, and support services.
What is the right of a prisoner?
In the United States, prisoners have a constitutional right to healthcare that meets community standards. The Supreme Court case "Estelle v. Gamble" established this right. Failure to provide care that meets these guidelines might be considered "cruel and unusual punishment.".
Do HIV inmates go to prison?
Several studies have found that most HIV-positive inmates are infected before they enter prison. HIV risk behaviors often continue inside the institution. These include injecting drug use, tattooing, body piercing, and consensual and nonconsensual sexual activities. The lack of sterile drug paraphernalia leads to needle sharing in prison. Needle sharing among soon-to-be released prisoners is high.
Can prisoners bring their own medications?
Even when an inmate provides good information, there can be a delay in getting their HIV medications. Prisoners cannot bring their own medications with them. This delay or interruption in treatment increases the risk of resistance (see Fact Sheet 405 ).
What should prisons do for HIV?
Prison systems should ensure that HIV-positive prisoners receive care, treatment and support equivalent to that available to people living with HIV in the community, including ART.
How does HIV affect prisons?
HIV hit prisons early and hit them hard. The rates of HIV infection among prisoners in many countries are significantly higher than those in the general popu-lation. HCV seroprevalence rates are even higher. While most of the prisoners living with HIV in prison contract their infection outside the institutions before imprisonment, the risk of being infected in prison, in particular through sharing of contaminated injecting equipment and unprotected sex, is great. Outbreaks of HIV infection have occurred in a number of prison systems, demonstrating how rapidly HIV can spread in prison unless effective action is taken to prevent transmission.
Should prisons provide care for HIV patients?
Prison authorities should ensure that prisoners receive care, support and treatment equivalent to that available to people living with HIV in the community, including ART.
What is the best method to detect HIV?
CDCRECOMMENDATION:The CDC recommends the use of an HIV-1/2 antigen/antibody combination immunoassay (fourth-generation) algorithm as the best method to accurately detect and diagnose an individual with early (< 6 months) or acute HIV infection.
When should a fourth generation HIV test be performed?
When the possibility of acute or early HIV infection is being considered , providers should perform fourth-generation HIV testing in addition to an HIV viral load test. Viral loads in this setting are generally very high (>100,000 cps/mL). These patients should be counseled concerning the substantial risk of transmission during the acute phase of infection. Antiretroviral therapy, which is recommended for all individuals with HIV-1 infection, should normally be offered to those with early HIV-1 infection. Genotypic drug resistance testing should be performed before initiation of ART to guide the selection of the regimen.
Can HIV-2 be tested?
Laboratory monitoring for HIV-2 RNA viral load is problematic since testing availability is limited. Most commercial laboratories do not offer testing for HIV-2 RNA viral load, and the few that do offer only qualitative testing. •Specialized labs(see below) are available to quantify HIV-2 plasma RNA viral load, but it should be noted that one-quarter to one-third of HIV-2-infected patients without ART will report viral loads below the limits of detection. • It should also be noted that no validated HIV-2 genotypic or phenotypic resistance assays are available for clinical care, that HIV-2 is intrinsically resistant to NNRTIs, and that several PIs lack ARV activity.
Can HIV be tested for cervical cancer?
Co-testing for cervical cancer ( Pap test and human papillomavirus [HPV] test) is not recommended for HIV-infected women <30 years of age. Baseline and routine Pap testing if normal: HIV-infected women 21–29 years old should have a baseline Pap test at the time of initial diagnosis with HIV.
Is HIV-2 a disease?
DISEASE PROGRESSION:HIV-2 is associated with lower viral load levels, slower rates of CD4 decline, and slower rates of clinical progression, as compared with HIV-1; 86–95% of people infected with HIV-2 are long-term nonprogressors. Recent data show that survival of persons with undetectable HIV-2 viral load is similar to that of the general population. Nonetheless, HIV-2 infection can cause immunosuppression, as well as AIDS characterized by the same signs, symptoms, and opportunistic infections that are seen with HIV-1. Furthermore, AIDS resulting from HIV-2 infection is often associated with much lower viral load levels than AIDS resulting from HIV-1 infection (>10,000 copies/mL in HIV-2 cases, as compared to sometimes millions of copies/mL in HIV-1 cases).
Do inmates get pre-test counseling?
All inmates tested for HIV infection should receive pre-test counseling from qualified health care personnel, in accordance with current BOP policy. Counseling should provide information on HIV transmission, methods for preventing the spread of the virus while in prison and upon release to the community, and the meaning of the test results.
Is HIV testing a priority for the BOP?
Testing of inmates for HIV infection must be a priority for the BOP :Almost one in seven persons living with HIV infection in the U.S. is unaware of being infected, and less than one-third of HIV-infected individuals in the U.S. have suppressed viral loads—a result commonly linked to undiagnosed HIV infection and failure to retain diagnosed patients in care.
How long can you be in prison for HIV?
Some states have a maximum sentence length up to life in prison, while others have maximum sentence lengths that are less than 10 years. However, only 9 states have laws that account for HIV prevention measures that reduce transmission risk, such as condom use, and antiretroviral therapy (ART).
Which states have modernized their HIV laws?
Since 2014, at least nine states have modernized or repealed their HIV criminal laws: California, Colorado, Illinois, Iowa, Michigan, Missouri, Nevada, North Carolina, and Virginia. Changes include removing HIV prevention issues from the criminal code and including them under disease control regulations, requiring intent to transmit, actual HIV transmission, or providing defenses for taking measures to prevent transmission such as viral suppression or being noninfectious, condom use, and partner PrEP use.
How many states require HIV disclosure?
In 21 states, laws require people with HIV who are aware of their status to disclose their status to sex partners, and 12 states require disclosure to needle-sharing partners. The maximum sentence length for violating an HIV-specific statute is also a matter of state law.
Why did many states implement HIV-specific criminal exposure laws?
During the early years of the HIV epidemic, many states implemented HIV-specific criminal exposure laws to discourage behavior that might lead to transmission, promote safer sex practices, and, in some cases, receive funds to support HIV prevention activities.
Do states have HIV laws?
For this analysis, only HIV-specific laws are captured for states with both HIV-specific laws and STD/communicable/infectious disease laws. Only HIV or STD/communicable/infectious disease laws are captured for states with both HIV or STD/communicable/infectious ...
Is HIV a criminal offense?
Criminalization of potential HIV exposure is largely a matter of state law, with some Federal legislation addressing criminalization in discrete areas, such as blood donation and prostitution. These laws vary as to what behaviors are criminalized or what behaviors result in additional penalties.
Paying For HIV Care
Private Insurance
- Job-Based and Individual Insurance—Many people have private health insurance through their employer (or a family member’s employer), or they have individual insurance they have purchased. Under the Affordable Care Act (ACA), most job-based and individual plans are required to offer new benefits and protections. For example, plans can’t drop you or deny you coverage just beca…
Federal Resources
- If you do not have private health insurance—or you need help because your insurance doesn’t pay for the HIV care and treatment you need—there are federal resources that may help you. Getting Help—Figuring out which programs and services you qualify for can be confusing. But don’t worry! There are case managers and benefits counselors who can help you. They know what services a…
Non-Federal Resources
- Patient Assistance Programs (PAPs) are programs administered by pharmaceutical companies to offer free or reduced-cost antiretroviral (ARV) medicines to low-income people living with HIV who are uninsured or underinsured, and who do not qualify for federal assistance programs such as Medicaid, Medicare, or AIDS Drug Assistance Programs. Each pharma...