HIV-infected prisoners: what mental health services are constitutionally mandated?

State and federal correctional facilities currently have approximately 23,000 inmates who are infected with human immunodeficiency virus (HIV). These inmates suffer from the same mental health disorders as uninfected inmates but are additionally subject to mental health problems uniquely related to their HIV infection. Many prison systems are struggling to provide minimal mental health care to uninfected inmates. How will prisoners address the additional mental health needs of the staggering number of inmates being diagnosed with AIDS and HIV? This article describes the type of mental health services that are constitutionally mandated and discusses whether and how prisons will have to respond to the distinct mental health issues related to HIV infection.     

Inmate sues the Correctional Service of Canada

This article summarizes a lawsuit commenced recently in the Ontario Superior Court of Justice by an HIV-positive inmate in the federal penitentiary system against the Correctional Service of Canada (CSC). This action is an important part of the ongoing struggle to hold government and public officials accountable for failing to address the HIV/AIDS crisis in prisons. The suit contends that CSC must be held liable for the seroconversion of an inmate while in CSC's care and custody, and that it must also be held liable for the alleged negligent provision of medical care to HIV-positive inmates.     

Commons committee recommends significant increase in funding for AIDS strategy

A House of Commons committee says that current funding for the Canadian Strategy on HIV/AIDS should be more than doubled. It calls for designated funding for inmates and First Nations and Inuit peoples, and for HIV vaccine research. Finally, it says that more federal government departments need to become involved in the response to AIDS.     

Chinese scholars call for AIDS rules based on respect for individual rights

In June 2002, the UN Theme Group on HIV/AIDS in China published a comprehensive situation analysis and needs assessment of the HIV/AIDS epidemic in the People's Republic of China (PRC). The report, entitled "HIV/AIDS: China's Titanic Peril", also describes and analyzes current HIV/AIDS legislation and policies. It notes that "laws and regulations that are based on fear and prejudice have contributed to fuelling the epidemic instead of curbing it." The report observes that the targets and goals established in China's five-year Plan of Action (2001-2005) are not consistent with the commitments endorsed in June 2001 at the United Nations General Assembly Special Session on HIV/AIDS. It states that the Plan "continues to present HIV/AIDS as a medical problem, and fails to understand the epidemic as a broader development issue." Even where laws could assist, enforcement remains a huge challenge. For example, in 1998 the National People's Congress passed a law prohibiting commercial blood donations for medical purposes. Nonetheless, the illicit and unregulated blood trade, which has rapidly accelerated the spread of HIV infection in China, has continued. When the alarm was sounded by Dr. Wan Yanhai, coordinator of the AIZHI (AIDS) Action Project, the government response was to arrest him. In the following article, Nick Young, editor of China Development Brief, reviews the findings of three studies commissioned by the United Nations Development Programme (UNDP) on the role of the law in response to HIV/AIDS.     

Barcelona 2002: law, ethics, and human rights. Juggling individual and collective concerns with respect to HIV/AIDS policies

Efforts to prevent the spread of HIV infection sometimes give rise to tensions between individual and collective rights. This article, based on a presentation by Nelson Varas-Díaz (abstract TuOrG1171), explores these tensions in the context of the laws and policies of eight Latin American countries: Costa Rica, Dominican Republic, Ecuador, Guatemala, Honduras, Nicaragua, Panama, and Puerto Rico. The article describes five elements of the response to HIV/AIDS in which tensions between individual and collective rights have surfaced: the participation of people living with HIV/AIDS on national commissions; the ability of HIV-positive persons to access antiretroviral medications; HIV-antibody testing practices; the confidentiality of health information; and the rights and duties of people living with HIV/AIDS. The article concludes that the success of programs designed to prevent the spread of HIV infection depends on the ability of societies and governments to balance the tensions between individual and collective rights.     

Barcelona 2002: law, ethics, and human rights. HIV testing for peacekeeping forces: legal and human rights issues

In 2001, the United Nations Security Council established an Expert Panel to study the issue of whether the UN should institute HIV testing of peacekeeping personnel. This article, based on a 9 July 2002 presentation to the XIV International AIDS Conference (abstract TuOrG1173), reports on the findings of a paper prepared for the Expert Panel by the Canadian HIV/AIDS Legal Network. The paper examined whether it is permissible for the UN to implement mandatory HIV testing of its peacekeeping personnel, and whether HIV-positive UN peacekeeping personnel should be excluded or restricted from service on the basis of their HIV status or HIV disease progression. The article describes some of the court cases in which these issues have been considered; discusses the importance of analyzing such issues in the context of a human rights-based approach to the pandemic; and formulates a series of key principles for guiding UN decision-making. The article concludes that a policy of mandatory HIV testing for all UN peacekeeping personnel cannot be justified on the basis that it is required in order to assess their physical and mental capacity for service; that HIV-positive peacekeeping personnel cannot be excluded from service based on their HIV status alone, but only on their ability to perform their duties; and that the UN cannot resort to mandatory HIV testing for all UN peacekeeping personnel to protect the health and safety of HIV-negative personnel unless it can demonstrate that alternatives to such a policy would not reduce the risk sufficiently. In the end, the Expert Panel unanimously rejected mandatory testing and instead endorsed voluntary HIV counselling and testing for UN peacekeeping personnel.     

THE POLITICS,AND PLACE,OF GENDER IN RESEARCH ON CRIME*

The study of gender and crime has grown exponentially over the past 40 years, but in some fundamental respects, it remains underdeveloped. Few scholars have considered both the similarities and the differences in the predictors of offending among males and females and the implication of this for middle‐range theories. Victimization has been put forth as a major explanatory factor for female offending; yet the study of female victimization has been ghettoized because it has failed to address the ways in which it is related to the larger literature of victimization. Female inmates have always been characterized as having special needs, but the basic necessities (housing and employment) inmates require once they are released from prison are in fact gender neutral. These bodies of research all have suggested that the salience of gender varies in different contexts and is intermixed with other forms of stratification. As such, we would do well to attend to those situations and relational processes that foreground gender and focus our efforts on where gender‐based paradigms are important and can have a real impact.     

Nigeria: HIV-positive woman launches suit after being denied treatment

A 39-year-old woman who was denied treatment at a hospital in Lagos simply because she is HIV-positive is fighting back through the courts. The Center for the Right to Health has filed a lawsuit on her behalf, seeking damages as well as an injection to prevent further discrimination against people with HIV/AIDS who seek treatment.     

Possible solutions for preventing inmate sexual Assault: Examining wardens’ beliefs

Inmate sexual assault has long been a problem within the American correctional system. Prison sex researchers have prescribed various remedies and solutions for dealing with this issue. However, few of these studies have examined wardens’ beliefs regarding possible remedies for inmate sexual assault. Using data collected from 226 wardens in 2001, this study examines the beliefs that wardens hold concerning the effectiveness of institutional policies and procedures, staff training, and increased supervision by staff on sexual assault among inmates. On average, wardens feel these possible solutions would reduce inmate sexual coercion. Multiple regression analyses reveal that race, education, percentage of inmates sexually assaulted and known by the warden, and percentage of inmates having consensual sex are statistically significant variables associated with these remedies. Support for this project was provided by a grant from the College of Justice and Safety, Eastern Kentucky University.     

Canada refuses to issue a visa to an HIV-positive worker on antiretroviral drugs

Citizenship and Immigration Canada has denied an application for a visa from an HIV-positive man even though he is in good health. The man was seeking to fill a two-year work term in Canada. The case raises concerns about Canada's immigration policies for people with HIV and about the ability of organizations working in AIDS to hire HIV-positive foreign workers.     

Activism and Radicalism in Prison: Measurement and Correlates in a Large Sample of Inmates in Texas

There is considerable speculation that prison plays a role in radicalization. Many individuals involved in acts of political extremism have spent time in prison, adding credibility to such claims. Despite these assertions, there is little empirical evidence regarding the prison-radicalization link because access to prisons is challenging and there are few valid scales of extremism. Studies that do examine a potential link have small sample sizes or select on extremist case studies. The current study draws on interviews conducted with 802 male prison inmates in Texas the week before their release to the community. Inmates were administered the Activism and Radicalism Intention Scale, one of the few validated scales in the extremism literature. A series of structural equation models revealed several important findings. First, we found that the psychometric properties of the modified two factor model of activism and radicalism intentions were largely acceptable among prison inmates, including subgroupings of Latino, white, black, and gang and non-gang-involved inmates. Second, our findings revealed that there was more activism than radicalism intentions among prison inmates, although levels of both were comparable to non-institutional populations. Activism and radicalism intentions were positively related, although this correlation was weaker than in prior studies. Activism should not be substituted for radicalism. Third, our exploratory analysis of concurrent validity identified few multivariate correlates. Group identification—namely, racial and religious groups—was related to both scales, but in opposite directions. Age was negatively, while street-to-prison gang importation was positively, related to radicalism intention. We outline the implications of these findings for research, policy, and practice on activism, radicalization, and prison.     

Official incidents of inmate-on-inmate misconduct at a women’s prison: using importation and deprivation theories to compare perpetrators to victims

Importation and deprivation theories have long been used to explain prison misconduct and victimization among male inmates. However, the key variables from these theories have rarely been tested on female inmates. In addition, many of these existing studies use combined samples of males and females, while ignoring female-only samples of prisoners. Using data from official misconduct reports collected from 2007 to 2012 from a large women’s prison in Ohio, the current study sought to compare the characteristics of perpetrators of inmate-on-inmate misconduct to their victims. Findings reveal that variables from both importation (age, race, and current violent offender status) and deprivation (mental health status and prior violent disciplinary reports) theories were significant in predicting perpetrator vs. victim likelihood. Policy implications and suggestions for future research are discussed.     

HIV/AIDS and human rights revisited

In their article, Sofia Gruskin and Daniel Tarantola demonstrate how, as the number of people living with HIV and with AIDS continues to grow in nations with different economies, social structures, and legal systems, HIV/AIDS-related human rights issues are not only becoming more apparent, but also increasingly diverse. In the 1980s, the relationship of HIV/AIDS to human rights was only understood as it involved people with HIV or AIDS and the discrimination to which they were subjected. The concerns included mandatory HIV testing; restrictions on international travel; barriers to employment and housing, access to education, medical care, or health insurance; and the many issues raised by named reporting, partner notification, and confidentiality. Almost 20 years into the epidemic, these issues remain serious and most often have not been resolved. In the 1990s, however, there was increased understanding of the importance of human rights as a factor in determining people's vulnerability to HIV infection and their consequent risk of acquiring HIV infection and their chances of accessing appropriate care and support. And most recently, human rights have also come to be understood to be directly relevant to every element of the risk/vulnerability paradigm. Gruskin and Tarantola identify three situations and three levels of governmental obligations that should be considered when identifying the specific needs and related rights of individuals in the context of HIV/AIDS. They conclude that policymakers, program managers, and service providers must become more comfortable using human rights norms and standards to guide and limit government action in all matters affecting the response to HIV/AIDS; and that those involved in HIV/AIDS advocacy must become more familiar with the practicalities of using international human rights law when they strive to hold governments accountable.     

HIV/AIDS in prisons: recent developments

In a report released on 20 November 2002, entitled Action on HIV/AIDS in Prisons: Too Little, Too Late--A Report Card, the Canadian HIV/AIDS Legal Network concluded that despite repeated studies and nearly ten years of recommendations for urgent and pragmatic action, the response of Canadian governments to HIV/AIDS, HCV, and injection drug use in prisons remains inadequate. Only a few weeks later, the House of Commons Special Committee on Non-Medical Use of Drugs released its report, which contained a number of recommendations to the Correctional Service of Canada. Although the Committee avoided talking about needle exchange programs in prisons, it did recommend them! Meanwhile, in Ireland, not even condoms or bleach are provided.     

Too Close for Comfort: Exploring Gender Differences in Inmate Attitudes Toward Homosexuality in Prison

Since the inception of the Prison Rape Elimination Act in 2003, there has been increased interest in not only sexual victimization among incarcerated populations, but all aspects of prison sexuality. Correctional policies have focused on the homosexual population in attempts to protect these individuals from victimization and in attempts to decrease sexual relationships between inmates. While recent research has focused on the prevalence of homosexual behavior and the prevalence of sexual victimization among incarcerated populations, there has been little research on inmate attitudes toward homosexuality and same-sex sexual encounters in prison. The present study adds to the literature base by examining gender differences in attitudes toward inmate homosexuality among a sample of male and female inmates in a large Southern prison system. Findings revealed that male inmates, older inmates, and heterosexual inmates had significantly more negative attitudes toward homosexual inmates. Implications based on these findings are discussed.     

Examining the characteristics of male sexual assault targets in a Southern maximum-security prison

Studies concerning inmate-on-inmate sexual assaults within male correctional facilities are sparse in the sociological and correctional literatures. Only a few studies have specifically examined the characteristics of male inmate sexual assault targets. The current research sought to address this gap by providing an examination of factors related to victimization likelihood. Using data gathered in March 2000 from 142 inmates (18% return rate) in one Southern maximum-security prison, the authors examined demographic and behavioral characteristics of male inmate sexual targets. Based on inmates' self-reports of sexual victimization--threatened and/or forced sexual assault encounters--correlates of victimization were identified. Approximately 18% of the inmates reported inmate-on-inmate sexual threats, and 8.5% reported that they had been sexually assaulted by another inmate while incarcerated.     

A Woman's Life Before Serving Life: Examining the Negative Pre-Incarceration Life Events of Female Life-Sentenced Inmates

Despite the increase in the number of females incarcerated, there is a paucity of research concerning female life-sentenced inmates in the United States. Using a nationally representative data set containing the largest known sample of this population, the present research examines the pre-incarceration traumatic experiences of female life-sentenced inmates. The results indicate that these women are more likely to experience traumatic events, in particular abuse, than either male life-sentenced inmates or female inmates in general. Logistic regression analyses reveal a significant association between abuse and a life sentence in both gender-specific models.     

Issues in Female Inmate Health: Results From a Southeastern State

The current study examines health care services and perceptions of those services by former inmates of a women's prison in 1 southeastern state. The results indicate that many women enter prison with health issues, including hypertension, HIV/AIDS, depression, anxiety, and drug addictions, and use health services while incarcerated. Women in this study expressed overall dissatisfaction with those health services and did not perceive that their health improved while incarcerated or that they received better health care in prison than on the outside. This exploratory study points to the need for further empirical investigation into the issue of health care for the incarcerated female. The generalizability of the study's findings is possibly limited by the fact that respondents were former female inmates. Also, results from 1 southeastern state may not be generalizable to other geographic locations.     

Gender-related differences in correctional officers' perceptions and attitudes

Prior research on women correctional officers in institutions housing men inmates in the United States has assessed the impact of the women's presence on men colleagues and inmates. Although these studies disclosed much about male orientations, they revealed little about the adaptation of women to this traditionally masculine occupation. The present study addressed the differences between men and women jail correctional officers' job-related perceptions and attitudes. A broad range of analyses detected few substantive perceptual and attitudinal gender differences. These data suggest that the institutional context may be more important than gender in shaping the perceptions and attitudes of men and women correctional officers.     

Kenya: AIDS-law sensitization results in schooling for orphans

In a landmark victory for children living with HIV/AIDS, in January 2004 the Kenyan High Court approved an agreement between the government and the Nyumbani Children's Home whereby the Ministry of Education will admit HIV-positive children to government schools. Prior to the agreement, government practice was to refuse admission of children from the Nyumbani Children's Home, Kenya's oldest and largest AIDS orphanage, on grounds such as that the school was full to capacity or that the applicant had failed to produce a birth certificate. This was in spite of the fact that Kenya's schools are already overcrowded and that births are often unregistered.