COVID and people living with HIV in jails and prisons
Positively Aware: Scott Schoettes
Scott Schoettes @pozadvocate

People living with HIV who are taking their medications and, as a result, do not have a compromised immune system are likely not at increased risk, so it is more important than ever that everyone take their medications every day.

This is my second column for Positively Aware and my second column about COVID-19. I promise I am going to write about other topics in future columns, but because the COVID pandemic is so pervasive and consequential, I want to share information about how it affects people living with HIV in jails and prisons while still timely.

To assist in this—and in keeping with my plan to share the work of other advocates in this column—I interviewed Richard Saenz, a Lambda Legal Senior Staff Attorney focused on criminal justice issues and my co-author for the chapter on prison and jails in AIDS & the Law.

Scott:  We have heard about outbreaks and higher levels of COVID in jails and prisons; can you explain why people in jails and prisons are particularly vulnerable during this pandemic?

SARS-CoV-2, the virus that causes COVID-19, is a highly contagious virus transmitted primarily through respiratory droplets by people in close proximity to each other; currently, the best ways to prevent it are by meeting only outdoors, remaining at least 6 feet from others, wearing a face covering, and frequently washing one’s hands with soap and water. All of these ways of preventing transmission are harder to make happen in jails, prisons, or detention facilities, so once the virus finds its way into one of these places, it spreads quite easily. A recent study showed that the rate of infection in state and federal prisons is 5.5 times higher than in the public at large. 

COVID has been also been particularly problematic in senior living facilities for some of these same reasons but also because older people are more likely to suffer the most severe consequences of this virus; are there traits of jail and prison populations that place them at higher risk?

Yes, people in jails and prisons are more likely to have one of the pre-existing conditions that makes people more susceptible to COVID-19. The less-than-ideal medical care for chronic conditions like HIV while incarcerated increases the chances of contracting COVID-19 and suffering the worst consequences of it. After adjusting for age, people in prison are 3 times more likely to die of COVID-19 if they get it.

What are jail and prison officials doing to help reduce the risk of COVID transmission in jails and prisons?

Practices vary widely, particularly across state prisons and local jails. In addition to the prevention techniques mentioned above, the Centers for Disease Control and Prevention (CDC) recommends limiting the transfer of prisoners from other facilities, minimizing movement across housing facilities, and suspending programs (like work release) that involve moving people in and out of the correctional facility. One very effective way of protecting people is to release them, and tens of thousands of people across the United States have been released from jails. Congress has expanded the authority of the Federal Bureau of Prisons to release individuals to home confinement, resulting in home confinement or early release for over 1,000 federal prisoners with “extraordinary and compelling reasons.”

Have legal actions in court been successful in improving conditions or securing the release of more individuals?

Legal advocates have had some success in securing preliminary orders to improve conditions only to see those orders reversed by appellate courts. This has been a source of frustration. Showing that prison officials acted with the “deliberate indifference” required to state a legal claim in such situations is difficult, because it provides for a wide range of acceptable behavior on the part of prison officials. One bright spot has been the order secured by immigration advocates requiring the nationwide release of vulnerable individuals from ICE detention.  Many detainees have been released pursuant to this order, though it is also now on appeal.

Do you have suggestions for people in jail or prison who are living with HIV?

People living with HIV who are taking their medications and, as a result, do not have a compromised immune system are likely not at increased risk, so it is more important than ever that everyone take their medications every day. The other thing I would advise is to take advantage of every precaution made available: maintain your distance from others whenever possible; if face coverings are provided, wear them whenever you can; and whenever you have the opportunity, wash your hands. And, if you do get it despite taking all these precautions, try not to panic—the vast majority of people survive COVID-19.

Scott Schoettes lives openly with HIV and is the HIV Project Director at Lambda Legal, where he engages in impact litigation, public policy work, and education to protect, enhance, and advance the rights of everyone living with HIV.