Is the War on Drugs an Obstacle to Eliminating HIV?
Mass incarceration, the use of solitary confinement, and the rise of private prisons across America all have devastating psychological and socioeconomic consequences on our country as a whole. But we might be able to blame America’s love affair with mass incarceration for an unexpected problem: the continued spread of HIV and other infectious diseases.
HIV infections in the United States have pretty much plateaued: about 45,000 per year. According to Chris Beyrer— the Desmond Tutu Professor of Public Health and Human Rights at Hopkins– this is due to the prison system. Also, our prison system actually creates a huge obstacle for eliminating HIV and these kinds of diseases on a global scale. So why? And how can we solve this?
It’s estimated that about 4 percent of all inmates in the United States have HIV and 15 percent have hepatitis C. In some US prison systems, inmates might have decent state-sponsored health care which would provide them antiviral drug regimens to help keep diseases at-bay. But this isn’t always the case. The larger problem lies, however, once an inmate gets out. Once released they might not have the same access to health coverage or treatment which would eventually lead to spreading the disease throughout the public population. And remember, about half of those released end up catching a new charge and going back to prison within 5 years. So this is a public health concern that can be directly traced back to mass incarceration.
So why focus on prisoners and how is the prison system to blame? Well the prison system is just how we’re seeing this problem manifest. The real culprit is the War on Drugs. HIV and Hepatitis C infections are far more common among minority and inner city communities where administrations have focused on incarceration as a solution to drug abuse. As a country we treat drug abuse as a criminal offense instead of a public health issue. So small time dealers and users get locked up instead of properly treated. Which in turn leads to the spread of infectious diseases.
So how can we fix this? Aside from ending the War on Drugs and completely decriminalizing drug possession– which is a very unrealistic goal at this point– there are a few short term solutions we can take. First of all, only 2 states in the entire country allow prisoners access to condoms. I know, prisoners having sex isn’t something anyone really wants to think about– but it happens. And denying prisoners access to condoms is arguably a human rights violation.
Another solution: needle exchanges. Needle exchanges are relatively cheap to maintain (probably way cheaper than chronic anti-viral drug regimens) and drastically slow the spread of HIV and Hepatitis C. The two easiest ways to contract HIV and Hepatitis C are unprotected sex and sharing used needles. Providing condoms to prisoners and funding public needle exchanges would address both routes for infection. So until we start to treat drug abuse as a public health issue, these are our best bets for eliminating HIV– or at least slowing it from spreading.