Leigh Hopper, A Killer in Texas Prisons: AIDS Takes Toll on Inmates, Costs, Austin American-Statesman, October 11, 1995.

ROSHARON -- 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 prisons.

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 Galveston, 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 grow.

For prisoners like Sherlock, life is hard at Ramsey II, 30 miles south of Houston. 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 die anyway.'''

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 in Galveston 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 units near Galveston.

''This is a known HIV farm. John Sealy (at Galveston) 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, New York, Florida and California -- 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 in Galveston and Texas Tech University in Lubbock 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 Galveston). UTMB has a superb infectious-diseases department; so, it makes sense to everyone to keep inmates closer.''

High-risk population

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 said.

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 prisons.

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.''

Mississippi, Vermont and the District of Columbia 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.''