South Carolina is marking the end of a bygone prison era with its announcement this week it will end segregation of HIV-positive inmates. The state was the last to retain the policy, in the wake of evolving understanding about the transmission of HIV that has led to waning stigma and isolation of HIV-positive individuals.
HIV segregation has not only branded prisoners by a medical status that should be confidential under medical ethics and international law; it also resulted in disparate treatment for HIV-positive prisoners, and significantly limited opportunities for rehabilitation, according to a 2010 ACLU report on human rights violations in the last three states to maintain HIV segregation. In the wake of the report, Mississippi ended segregation of HIV inmates, and an Alabama court ruled its segregation a violation of the Americans with Disabilities Act in 2012.
In segregated systems, inmates sentenced to as little as 90 days ended up in maximum security prison with death row inmates because of their status, and others with longer sentences were placed in solitary confinement for weeks or months while they waited for a bed to open up in an HIV unit. Segregated HIV-positive inmates often spent more time in prison, because they were not given the option to participate in rehabilitative programs that enable early release, according to the ACLU report. They were also cut off from in-prison jobs, work release programs, religious services, and substance abuse programs.
This severe segregation derives from an era when scientific understanding was much more limited, and people believed that HIV could be transmitted through mere surface exposure. While prison concerns about the spread of HIV through illegal drug use, sexual activity, and tattooing are valid, HIV is just one of many diseases that may be spread in these ways, and research suggests that they may all be more effectively and humanely prevented through the distribution of condoms, needle exchange programs, substance abuse therapy, and training and counseling programs.