Miami Herald - September 5, 1998
Tony Pugh, Herald Washington Bureau

It's a ruse that allows the former drug dealer from Miami a strange measure of credibility and security from harassment. There's no honor in picking on a sick man at Coleman Federal Correctional Institution in Florida's Sumpter County.

Unless, of course, that man has AIDS.

"You've got ignorant individuals in here, and they can sabotage you if they know you've got HIV," said Fernandez, who spoke freely with a reporter about his case. "They'll burn up your room or stick a knife under your bed or plant some marijuana so the guards can find it and put you in the hole," he says. "It's a dirty business in here."

The difficulty of maintaining inmate confidentiality is a key reason that new federal prisoners and most state inmates are not tested for HIV, the virus that causes AIDS. But concern over the safety of correctional officers and the high rate of HIV and AIDS among inmates could be forcing a shift in that policy.

State takes step

Earlier this year, South Carolina became the first state since 1990 to adopt mandatory HIV testing for all inmates and new prisoners. And in August, the U.S. House of Representatives passed legislation that requires federal inmates serving at least six months to be tested for HIV within four months of entering prison. Currently, federal inmates are tested only when they leave prison.

If the legislation passes the Senate, the American Civil Liberties Union fears that more states will adopt similar laws without the financial commitment to the counseling and health services that would make the policy meaningful.

"Any time the federal government institutes a program of this nature, the states immediately perk up their ears," said Jackie Walker, AIDS specialist with the ACLU National Prison Project in Washington. "That's the real danger of this legislation. You'll get some politicians who'll stand up and say, `The feds do it, we should do it also.' "

In Illinois, that politician is state Rep. Cal Skinner. The Republican from Crystal Lake failed in 1994 and 1995 to pass a similar measure for state prisoners but continues to push the issue. "I am absolutely convinced the prison systems of the U.S. are breeding grounds for HIV," Skinner said. "It's an area in which our country has got blinders on."

Health precaution

The push for inmate testing also has gained favor as AIDS spreads among minorities; advocates see the tests as a health precaution, because many prisoners ultimately return to ethnic communities.

In South Carolina, for instance, 66 percent of the state's 21,000 inmates are black. James McLawhorn Jr., president of the Columbia, S.C., Urban League, said a mandatory test policy should be encouraged, as long as it's accompanied by proper treatment before and after release.

"I think that's a win-win for everybody," McLawhorn said. "People have to know they're infected and then have the support they need. There are some legal concerns, but when you have an epidemic, I think you need to try to protect the general population as well as protect" inmate rights.

The federal testing proposal originally was drafted to permit testing of prisoners and officers whose bodily fluids mixed through bloody fights or other encounters such as "gassing," the inmate practice of hurling blood, urine and feces at prison guards. Rep. Steve Buyer, R-Ind., later amended the bill to require compulsory testing. He said doing so provides inmates with early access to life-prolonging treatment.

Privacy problem

But AIDS activists and civil rights advocates say the uneven quality of prison medical care and concerns about inmate rights far outweigh any such benefits. "What happens when a guard calls you an AIDS-carrying S.O.B?" the ACLU's Walker asked. "Whether it's by a guard, an inmate or a health-care staffer, you can expect their confidentiality is going to be violated."

At the end of 1995, the last year for which accurate prison HIV and AIDS statistics are available, state and federal inmates made up nearly 3 percent of the nation's confirmed HIV cases while representing less than 0.5 percent of the total U.S. population.

The same figures showed that the rate of confirmed AIDS cases in prison was more than six times higher than that of the total U.S. population. And between 1991 and 1995, AIDS-related deaths in prison increased 94 percent to nearly one in every three. In the general public, the figure was about one in 10 over the same period.

In all, 24,226 prison inmates were known to be infected with HIV in 1995, while 5,099 had full-blown AIDS. Most of these inmates were in state correctional facilities, yet South Carolina is only the 17th state to adopt mandatory testing.
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