HIV/AIDS Infection: Why Prison Romances Are Helping to Fuel the AIDS Pandemic

There is a lot of blame to go around for the AIDS epidemic. Some of the explanations are so outlandish as to fall within the realms of conspiracy theories. Others are more practical and based on empirical evidence. The explosion of the infection in the prison population straddles the two extremes. Yes, there are too many urban myths about “dropping the soap” but it is also a fact that this is one of the populations that has a very high prevalence of the disease. If you lock up men with no sexual contact for a long period of time, don’t get surprised when they turn to one another for gratification. This is what is known as the “Gay for the Stay” phenomenon.

Young men engage in what is in effect situational homosexuality. Some of them decide to continue with those relationships outside but some forget them once they are released, only to reactive them once they return. This type of homosexuality is only limited to a particular context and adds a new perspective on the complex spectrum of human sexuality. We are soon learning that even within the LGBTIQ community, there are very many shades of the same sexuality. The problem is that the prison facilities are stuck in the Victorian era where prisoners are not expected to have any kind of sexuality.

They for example, lack the right facilities and programs for ensuring that all inmates know their Sero-status and can protect themselves from new infections and reinfections. The assumption is that these young men can spend years in closed confinement with one another without sexual contact. Some can do it…but that does not mean that everybody does. At least some South American prisons are coming to the terms that human sexuality requires an outlet, even in prison. That is why they have allowed conjugal visits. In the USA, the story is very different. It is almost as if we are running experiments to see whether men who are deprived of sexual contact for long periods of time can become situationally gay.

HIV/AIDS Infection A Health Crisis in the Making

Haven’t we learnt the lessons of the early 1980s? Are we waiting for an explosion of AIDS cases before we can start to pay attention to what is happening in our prisons? These are questions that bother those that are curious and inquiring. The prison system does not seem particularly bothered. The results are there for all to see: Correctional facilities have become a hotbed of an HIV/AIDS infection that spreads out to the rest of the community when the inmates are released. Remember that these are people who have relationships on the out. Thinking that it is a gay problem is just not going to help. A friend of my sardonically remarked that the authorities will pay attention when white straight couples start dropping off like flies. Until then, the establishment can write this off as yet another example of the gays being punished for their wickedness.

The evidence suggests that most people who are HIV positive in prison, actually got the virus whilst on the out. It is just that the conditions of incarceration make it easier to transmit the virus. Many of these people are intravenous drug users with a history of transient lifestyles. It should therefore not be surprising if they are fertile ground for this virus which thrives in social deprivation. The USA is the incarceration capital of the world with up to 2 million people in prison at any given moment in time. The rates of AIDS infection both in terms of incidence and prevalence are significantly higher than those of the general population. The last count showed that a prison inmate was five times more likely to be HIV positive than a member of the public.

By 2010 there were over 20,000 people that had been diagnosed with AIDS in prison. The vast majority (over 90%) of these diagnoses were male. Even within the prison population itself, the societal divisions are prevalent. That is why African American males are five times as likely as their white counterparts to have AIDS. Indeed, African American men in prison are twice likely to be diagnosed with AIDS as their Hispanic counterparts. That may not be surprising when one considers the fact that African Americans represent a disproportionately high percentage of prison inmates. They are more likely to be incarcerated and given longer prison sentences than virtually any other social group.

Multiple Vulnerabilities

Overtly gay men in prison are very vulnerable to rape as they are perceived to be an easy target for situational homosexuals. Prison prostitution is a thriving business in the absence of any other productive activity that earns the prisoner (s) money to spend on a daily basis. Besides, sex can be used to called in favors or even to keep a bully quiet. The adage not to drop the soap has very real implications for many young people that appear to be vulnerable. The American prisons are particularly prone to these trends, partly because they pile up prisoners in crowded dormitories. That removes the notion of privacy or safety within a cell. It is surprising that the HIV/AIDS infection rates are not even higher within the prison population. The authorities have certainly done all in their power to create an environment that is inherently unhealthy.

I know that gay prison lovers are not about to win the miss popularity contest in this law and order environment. However, we must remember that these are people too and they do eventually get out of prison. If we allow them to get infected with a deadly virus that is transmittable; we should also hold on tight because it is definitely going to be a bumpy ride. The most frustrating thing is that there are prevention strategies that are being ignored. Testing and safety training should be a matter of course the moment someone is admitted to any custodial facility. We also need to remember that not treating a person with an AIDS infection makes them even more infectious and therefore a liability in terms of public health. It is far more sensible to ensure that they are getting the right ARVs to bring the viral loads down and reduce the risk of infection.

We also have to rethink the revolving door policy that seems to be the prevailing ethos for correctional facilities. Our aim should be to ensure that people who leave prison, are better people than they came in. That means that the prison would have done one of its core jobs of rehabilitating offenders. Of course we ought to punish those who break the law, but not in such a way as to make them even worse. One of the most startling statistics is that up to 90% of all inmates spend no more than 72 hours in the facility. How in the hell is anyone going to do an intervention in that time? What is the point of imprisoning someone for three days? This is an example of the failure of the criminal justice system.

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A Possible Way Forward

Then you have that old canard of stigma. Nobody wants to talk about prison gay sex because it is dirty, something that they do out of urgent need. The problem is that the HIV virus has no shame. It will infect those who hide and will most definitely make them sick if they do not get the right treatment. Something that we think is a gay problem may end up being a national problem. Looking back at the responses of the Reagan administration to the HIV epidemic, one cannot help but wonder whether the lessons of those harrowing times have been learnt. We want to avoid thinking about the increasing infection rates in a population that we consider to be the lowest of the low.

In my view the entire prison system should be overhauled. We should get away from the bigoted and overzealous desire to lock up people in the harshest conditions possible. Of course, that does not mean escaping the justice that some offenders richly deserve. Instead it means taking basic public health steps to ensure that custodial facilities do not become a risk for everyone. That risk will most certainly seep out to the rest of the public if we are not careful.

We know that the LGBTIQ community has never been a priority for the establishment. However, in this instance there is an intersection of communities. In our quest to marginalize gay people, we may actually be writing out own death warrants. HIV is not able to tell whether someone is gay or straight, black or white, rich or power etc. It will simply enter the bloodstream and start its nefarious activities. The gay prison romance is a serious story that demands a serious response from those that are a position to make decisions. Otherwise, you can anticipate nasty health crisis headlines coming out of places like Houston.