What is The Problem?


                                                     Mid-state correctional Facility

                                                                            photo by Crist Yager (Utica Observer-dispatch)


           In Oneida County, the rates of cumulative Acquired Immune Deficiency Syndrome (AIDS) were below the national average in every city. Table 1 shows that the emergence of new Human Immunodeficiency Virus (HIV) cases was also relatively low. I mapped the cumulative AIDS rate of Oneida County, and found that Utica greatly stood out: Why?

            To answer the question I examined many facts. What I found was a very high annual AIDS rate within the Oneida County prison system. At about 675 new cases of AIDS per every 100,000 prisoners, meaning that out of every new 100 prisoners, at least 1 has AIDS [1]. The numbers are not extreme, but once you consider that Oneida County consist of four correctional facility housing roughly 4,200 prisoners the numbers, begin to add up [2].

The average daily population of inmates in the United States increased from just fewer than 500,000 in 1980 to nearly 1.2 million in 1990. About 732,000 inmates serve a term of a year or longer [3]. Increase in the number of people being incarcerated can be attributed to the government’s “war on drugs,” which resulted in the mandatory sentencing for drug offenders. This contributes to the fact that large numbers of those persons passing through the prison system were or are intravenous drug users [3]. Inmates are generally poor, uneducated, and over-represented by minorities [4]. I concluded that based upon the lifestyles of most prisoners and this limited access to appropriate medical care, that during the period of confinement the opportunity to reach a group whose risk factor far exceeded rates of other population was greatest. Stats show that nearly 600,000 prisoners are released back in to the outside population each year. Of those 600,000 247,000 are HIV positive or already AIDS cases [1, 3]. 

            In a study of the New York City jails, inmates participated in focus sessions, in which they described the risk behaviors many participated in. Many female and male prisoners spoke openly about inmates and sexual encounters taking place in prison. Both explained situations of consensual sex in exchange for favors and privileges [5]. Many male inmates told of incidences of forced sexual acts, mostly in the showers of prisons [5-6]. Inmates expressed a lack of risk reduction devices, such as condoms and syringes [6]. Prison officials do not want to acknowledge that sexual interactions and drug use take place within the prison system, by not doing so; there is a general lack of risk reduction devices for many communicable diseases including AIDS.

            Currently, only 19 states have mandatory testing [7]. On top of that fact, only 6% of correctional facilities routinely examine incoming inmates [8]. In 2005, The New York Times published a series of articles called “Harsh Times.” In the series, Prison Health Services (PHS), the nation’s largest inmate medical provider was exposed for the amount of inadequate care. PHS cared for 10% of the total incarcerated persons or 237,000 inmates. During the investigation, many records of under qualified doctors and nurses were documented. Also incidences of patient mistreatment and withholding of medication were discovered. Despite these facts PHS began receiving contracts in New York State [8]. The lack of care by The New York State Department of Correction has lead to the spreading of AIDS within the prison community. As a community, we must identify and that there is a huge discrepancy for AIDS care within our community and work with local officials to solve the issue.



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