Leigh Hopper, A Killer in
Prisons: AIDS Takes Toll on Inmates, Costs,
Austin American-Statesman, October
-- To visit Ramsey II, established in 1908 and one of Texas'
oldest prisons, is to glimpse the past. Inmates pick cotton, raise cattle
and practice throwing lassos.
Yet a large percentage of the men inside suffer from a very modern-day
problem: HIV infection and AIDS, the leading killer in Texas
Inmate Carl Sherlock, 33, has the virus; he says he got it from a
girlfriend between prison stays. Only 41/2 years into a 60-year sentence
for burglary of a habitation, the repeat offender likely will develop
full-blown AIDS before he walks free. Medical treatment for Texas
Department of Criminal Justice inmates is considered state of the art;
some tout it as a model for the nation's prison systems. Video cameras
link prisoners statewide with doctors in
and a new facility for chronically ill inmates has opened in Beaumont.
But care is costly and the number of HIV-infected inmates continues to
For prisoners like Sherlock, life is hard at Ramsey II, 30 miles south of
His complaints are many:
''If I get into it with an officer, ... they make certain slurs or remarks
about it. 'It doesn't matter anyway, your AIDS-infected (self) is gonna
His HIV status is no secret at the unit. ''When you go to chow ... they
give you a sack lunch to take back with you, a sandwich and a cake. Only
HIV people get those,'' Sherlock said. ''It's supposed to be part of a
5,000-calorie (a day) diet.''
Trips to the infectious-disease clinic or John Sealy Hospital
are feats of endurance, starting with breakfast at 2 a.m.
and ending about 20 hours later. A bus goes unit-to-unit, picking up
inmates who ride handcuffed in pairs. By the time every inmate has seen a
doctor, it's late in the day.
Prison spokesman Larry Todd says the Beaumont
facility will cut down on travel time for some inmates because chronically
ill patients can stay there between consecutive visits.
Sherlock is one of 1,855 Texas
inmates who have tested positive for the human immunodeficiency virus. Of
those, 446 have AIDS, out of a total prison population of 127,275.
Sherlock, who takes the drug AZT, multivitamins and caloric supplements,
is healthy enough to keep a job mopping floors. Yet inmates sicker than he
is walk the halls, looking ''real dried up and small.''
The 'HIV farm'
HIV-positive prisoners are scattered statewide, but many are clustered in
''This is a known HIV farm. John Sealy (at
has a lot of people special-assigned to this unit,'' Sherlock said. ''This
farm here isabout ... I would say 40 percent is HIV-positive. That's the
people who know about it.''
>From 1992 to mid-August this year, 309 Texas
prisoners died of AIDS. It beats cancer, heart disease, homicide, suicide
and execution as a cause of death. Nationwide, four states -- Texas,
-- had over half of the HIV-infected inmates in 1993, according to a
recent U.S. Bureau of Justice Statistics bulletin.
As in the free world, Texas
prisons are turning to managed care to keep astronomical costs down. In
September, the state prison system, theUniversity of Texas Medical Branch
and Texas Tech
formed a partnership to care for inmates. Texas
currently spends $1,930 per inmate per year on health care, not counting
additional costs for HIV/AIDS care and transportation. A new data
collection system will keep track of AIDS care costs in the future.
''We will be concentrating the sickest of the inmates in the southern
region here,'' said Dr. Michael Warren, director of the Department of
Criminal Justice's health services division. ''So it's easier on them and
everybody when they have to come (to
UTMB has a superb infectious-diseases department; so, it makes sense to
everyone to keep inmates closer.''
More than half the inmates with HIV/AIDS are injection drug users,
according to Department of Criminal Justice statistics. More than 27
percent are both injection drug users and gay or bisexual.
Among such a high-risk population, inmate-to-inmate transmission is a
concern. Prison officials say transmission of the virus within the system
is rare, but others strongly disagree.
''There's a little bit of data on that -- one or two documented cases.
It's very difficult to measure something like that,'' said Caroline
WolfHarlow, one of the writers on the Bureau of Justice Statistics'
''Bulletin on HIV in Prisons and Jails.'' Because of the virus' incubation
period, someone could be infected outside and show up positive inside, and
vice versa, she says.
Cal Skinner, an Illinois
state representative pushing for mandatory testing, believes the
transmission rate is cause for alarm.
''Because we don't have mandatory testing, we don't have a clue. We have
the biggest incubator of the AIDS disease outside the drug galleries,'' he
Released inmates unaware of their HIV status, he says, go home and infect
their wives and lovers. In August alone, 66 HIV-positive inmates were
released from Texas
Sex between inmates is common at Ramsey II, Sherlock says. ''In the
shower, you can't help but see it. It's right in front of you. ... This is
aworld of its own. There's gonna be sex, regardless of where you go.''
Stephen Donaldson of
Stop Prison Rape Inc., a New York
education and activist group, said, ''Condoms should be provided to
prisoners. We feel ... this is murder by government policy.''
and the District
provide condoms to prisoners, Donaldson says, ''and it hasn't caused a
problem in any of those systems.''
'A positive attitude'
Sherlock found out he was HIV-positive while undergoing a series of
operations to rebuild his lower lip, which was destroyed by a gunshot.
He kept it to himself for a year as he went through denial. In that denial
stage, a lot of people pass the virus on, but not him. ''On judgment day,
I may be guilty of a lot of things. That won't be one of them.
''I try to keep a positive attitude that something's gonna give and I
think it will,'' he said, talking about research giving him hope. ''A lot
of people give up mentally and they die. I can't. I've got my momma. My
mom keeps me going.''