February 2007 Issue Guide

CABWHP publishes issue guides with thorough analyses of health policy issues addressing mental, emotional and physical health. Our Issue Guides are distributed via mail to Policy Advisory Group members and to over 1,000 colleagues and organizational collaborators.

Black Women & HIV/AIDS:

Advocacy to Save Our Lives

"To compound the problem [of HIV infection rates in prison], spouses and significant others of inmates are exposed-generally unwittingly-when the inmates (now HIV+) are released from prison, thereby increasing HIV infection rates among certain populations, especially women of color."1 According to a U.S. Department of Justice 2001 study, 3.2% of female inmates are HIV positive and more African American women in prison are HIV positive than their white counterparts. We know that whether incarcerated or in the community, Black women are the fastest growing group of new HIV infections.2 Advocacy groups are calling for: (1) more prevention education and provision of barrier devices (e.g. condoms) to inmates; and (2) a thorough look at how HIV positive women are treated in prison. Women in prison are three times more likely to be HIV positive than incarcerated men and the proportion of inmates with HIV is much higher than the proportion of HIV infected persons in the general population.3

Late last year, Congresswoman Barbara Lee introduced a bill that directly affects the Black community and other communities of color: H.R. 6083, "The Justice for the Unprotected against Sexually Transmitted Infections among the Confined and Exposed" Act of 2006. Commonly known as the JUSTICE Act, this legislation would allow community organizations to provide condoms, information and counseling on the spread of AIDS and other STIs in federal correctional facilities.4 Legislation in California calling for distribution of condoms in prisons was vetoed by Gov. Arnold Schwarzenegger late last year. The legislation hoped to address HIV prevention in prisons by allowing distribution of condoms and other barrier devices such as dental dams, in hopes of decreasing transmission of diseases such as HIV, but also other STIs such as syphilis, hepatitis, gonorrhea, Human Papilloma Virus (HPV) and yeast infections.5 AB 1677, introduced by Assembly member Paul Koretz, would have mandated that prisoners be given sexual barrier devices and, implicitly, would have required an acknowledgment that sexual acts do occur among prisoners. The use of barrier devices is legal in prisons in Mississippi, Vermont, Canada, and some European and Latin American countries.6 Although rates of female-to-female transmission of HIV are low, legalizing usage of barrier devices in prison could provide protection from other reproductive tract infections.7 This type of legislation does not address, however, issues of sexual abuse by male guards, where, in most instances, female inmates do not have the power to negotiate use of a condom. However, such legislation would help save the lives of women in the general population who engage in sexual activity with formerly incarcerated men.

Human rights organizations claim that this type of legislation (H.R. 6083 and AB 1677) provides the opportunity to act as an example in HIV/AIDS prevention and human rights. Los Angeles and San Francisco county jails have long acknowledged that providing condoms is critical to protecting the lives and health of prisoners and their sex partners, and have distributed condoms for years. Indeed, San Francisco Sheriff Michael Hennessey has expressed his strong support for this type of legislation emphasizing both the government's legal obligation to protect prisoners from harm and the public health benefits to all Californians of preventing HIV transmission in prisoners. According to the California Department of Health Services, the vast majority of Californians also agree that distributing condoms in prison is important to prevent HIV.8

International human rights documents establish that prisoners are entitled to the same standard of HIV/AIDS information and services available in the outside world, including access to adequate measures to protect themselves from HIV/AIDS. Prisons in Mississippi and Vermont, and jails in New York, Philadelphia, Washington, D.C., San Francisco and Los Angeles, have taken measures to ensure the health and human rights of inmates by distributing condoms. Several countries throughout the world also distribute condoms to prisoners (including Canada, most countries in the European Union, and Australia). These jurisdictions have distributed condoms for years without violence or other incidents that might compromise security, demonstrating that denying condoms to prisoners cannot be justified on public safety grounds.9 Incarceration should not be an excuse to allow HIV/AIDS to spread despite the availability of inexpensive and effective HIV prevention measures.

A larger issue for the women who are already HIV positive and incarcerated is access to adequate medical care. Even for those women who get past the stigma and harassment resulting from their HIV status, there are often obstacles to getting the necessary healthcare. Many women living with HIV in prison are seen by doctors who are not specialists in HIV care. HIV positive women have difficulty adhering to complicated drug regimens while in prison, and receive little instruction on the possible side effects or how to continue their medication regimen. This places them at high risk for becoming resistant to the medication or discontinuing the medications altogether. Even in the best of circumstances, prison staff may be suspicious of claims of healthcare emergencies and incarcerated women must wait to be seen by a healthcare provider to address their health challenges, especially if prison staff are indifferent or abusive. According to some HIV advocates, HIV positive inmates have experienced retaliation from prison staff when they have repeatedly spoken out about not receiving medical care.10

The response to HIV infection in women prisoners must take into consideration the problems women encounter in correctional facilities and the abuse many women prisoners have experienced on the outside. Women in prison are marginalized due to race, gender, class, poor healthcare, domestic violence, physical and sexual abuse as children, teen pregnancy, drug use, sexual orientation, and status as a sex worker. All of these factors impact their power to protect themselves against this disease. Advocates are calling for legislation that addresses these issues, specific to women of color in prison.11

As a community, it is important to address the needs of women and men leaving prison. Many women and men leave prison in denial of their HIV status, and continue with behaviors that endanger their own health and that of others. Increasing HIV infection rates in women are linked to another reproductive health issue, intimate partner violence and intimidation.12 Many women in heterosexual relationships with men do not feel empowered to ask or demand that a condom be used. Coordinators of HIV programs for women report a common story: women feel that their male partners will not allow condom use, or open discussion of safe sex measures, without it turning into accusations of her infidelity, or worse. Many women experience physical abuse and partner rape, while trying to assert their right to be in control of their own bodies, health and reproductive rights.13

Worldwide campaigns in the fight to end the pandemic of AIDS in Africa, have now initiated programs to address the connection between women's inferior social, economic, and political status and soaring HIV infection rates. The Global AIDS Interfaith Alliance, which funds and implements programs for HIV prevention, healthcare, and education of people living with AIDS in Africa and the thousands of AIDS orphans left behind, has made the social status of women a core element of their prevention campaign.14 When Black women have the social, economic and political power to negotiate the relationships in our lives, our risk of becoming HIV positive will decrease dramatically. Advocates for incarcerated women are working to change the public's views and urge us all to stand up for the rights of all Black women, including those behind bars.

Upcoming Events

SAVE THE DATE!

CALIFORNIA BLACK WOMEN’S HEALTH PROJECT

Presents

Black Women & Sexual Violence:
Prevention, Advocacy & Healing

A TOWN HALL MEETING

When: Saturday, March 24, 2007
Where: Oakland, California (Location: TBD)
Time: 10 a.m. - Noon

Light Refreshments will be served!

For more info: 310 412-1828 x15 or adrienne@cabwhp.org

Let your voice be heard!

Special Research Initiative Stakeholder Meetings for the

California Breast Cancer Research Program

Your opportunity to tell the CBCRP how to invest $18 million for the Special Research Initiatives.

During March and April, the CBCRP will hold four in-person stakeholder meetings and two telephone/web conferences to:

  1. Review scientific highlights in environmental links to breast cancer and disparities
  2. Discuss and brainstorm promising research topics and/or approaches
  3. Learn about funding opportunities

In-Person Meetings
Ukiah: March 26th, 12-4pm
Fresno: April 5th, 12-4pm
Los Angeles: April 9th, 8am-12:30pm
San Francisco: April 11th, 8am-12:30pm

Phone/Web Conferences (if you are unable to attend an in-person meeting)
April 4th, 12-1:30pm
April 12th, 12-1:30pm

For more info: http://www.cabreastcancer.org/sri/stakeholderMeetings/


Contact by email for more info

REFERENCES

1 Medical News Today www.medicalnewstoday.com (quoting the AIDS Healthcare Foundation.)

2 Bureau of Justice Statistics, Women Offenders, Department of Justice, www.ojp.usdoj.gov

3 "HIV and Incarcerated Women" by Kelly Safreed Harmon from the Test Positive Aware Network, www.thebody.com

4 The bill can be found at: http://frwebgate.access.gpo.gov/cgi-bin/getdoc.cgi? dbname=109_cong_bills&docid=f:h6083ih.txt.pdf

5 AB 1677 www.leginfo.ca.gov

6 Medical News Today www.medicalnewstoday.com

7 "HIV and Incarcerated Women" by Kelly Safreed Harmon from the Test Positive Aware Network on www.thebody.com

8 Human Rights Watch, www.hrw.org

9 Human Rights Watch, www.hrw.org

10 "HIV and Incarcerated Women" by Kelly Safreed Harmon from the Test Positive Aware Network on www.thebody.com

11 "HIV and Incarcerated Women" by Kelly Safreed Harmon from the Test Positive Aware Network on www.thebody.com

12 Long Beach Child Abuse and Domestic Violence Prevention Council

13 Domestic Violence Fact Sheet, Sexual Assault Crisis Agency, Long Beach

14 Global AIDS Interfaith Alliance, San Francisco, CA www.thegaia.org