Mass incarceration & hiv (presentation)

Mass Incarceration, HIV & Impact on Black America Presented By Isaiah R. Wilson Director of External Affairs National Black Justice Coalition

Presentation Elements • Who is NBJC? • Social Determinant of Health • State of Black America’s Health & Wellness • HIV & Mass Incarceration • Public Policy Solutions

Who is NBJC? • Founded in 2003, NBJC is civil rights org dedicated to the empowerment of Black LGBTQ and same gender loving people, including people living with HIV/AIDS. • “Building Stronger Black Families” theme guides NBJC’s strategic plan and program development as the organization focuses on removing stigma and inequalities that contribute to the high rates of HIV and other health disparities in Black America, including the LGBTQ/SGL population.

• NBJC’s current work is focused on health & wellness interventions, public policy advocacy, and HBCU engagement with emphasis on cultural competency.

Determinants of Health & Determinants of Incarceration • Social Determinants of Health are conditions in the environments in which people are born, live, learn, work, play, worship, and age that affect a wide range of health, functioning, and quality-of-life outcomes and risks.

• A significant amount of the prison population are members of groups that suffer social, economic or racial/ethnic discrimination in the broader society: • • • •

Poverty • Homeless/under-housed Unemployment • People who use drugs Early school leaving/low-literacy • People with mental illness Members of groups that experience systematic discrimination

Social Determinants of Health for African Americans with HIV • • • • • • • • • • •

Racism Socioeconomic Status Mass Incarceration Social Location or “Place” Attitudes about Homosexuality Stigma Trauma Unknown HIV Status Underestimation of Personal Risk Access to Care and Treatment Media Influence Source: Bryant-Davis, T., Arline Bradley, S. L., Sadler, K. R., Duru, V. (2014). The Black Church & HIV: The Social Justice Imperative. Retrieved from http://cdn.theblackchurchandhiv.org/wp-content/uploads/2014/12/ActivityMalX.pdf

HIV/AIDS Epidemic

HIV Diagnoses in the United States for the Most-Affected Subpopulations, 2015

State of Black America

Poverty

Source – CDC, 2014

HIV

Criminal Justice System

Mass Incarceration in USA • The US is the global leader in incarceration rates.

• “War On Drugs” implemented punitive policies that lean on long incarceration terms vs rehabilitation efforts in jails & prisons.

• As incarceration rates soared so did imprisonment of those with an elevated risk of HIV and viral hepatitis infections, including substance users, many of whom suffer from mental illness.

• Current data suggest that the US prison population has an elevated incidence of HIV compared to the general population.

• One study suggest that 14% of all PLWH and 20% of AA LWH pass through a jail or prison each year.

War on Drugs

• In June 1971, President Nixon declared a “War on Drugs.”

• The “War on Drugs” dramatically increased the size of federal drug control agencies, and promoted mandatory sentencing.

Criminalization of Black America

Mass Incarceration and Black America (1920-2014) • Blacks are incarcerated for drug offenses at a rate 10 times greater than that of whites.

• One in three black men can expect to be incarcerated in his lifetime.

• Black American and Hispanics/Latinos comprised 58% of all prisoners.

Criminalization of HIV • Outdated laws that criminalize PLWH for not disclosing status to sexual partners.

• Studies show that a significant amount of Black PLWH are or have been incarcerated under these laws.

• Individuals charged with HIV-related charges were convicted in nearly all cases.

Impact of Mass Incarceration on HIV Rates • Most Incarcerated PLWH have access to care while in custody • Most incarcerated individuals are released from prison without access to care and no way to ensure adherence to treatment • These individuals seek to re-establish themselves in the community including their sexual identity • Without ARVs, viral loads skyrocket and they become more likely to transmit the virus to Black women • This continues to impact the spread of HIV in Black communities

Impact of Incarceration • The impact of incarceration on the family is devastating. • One of every 15 black children has an incarcerated parent, compared to one of every 110 white children. • Research has shown that children of incarcerated parents are six times more likely to be incarcerated themselves during their lifetimes.

State of HIV & Prisons OPPORTUNITIES • HIV screening at time of imprisonment can identify those with previously diagnosed infection.

• Those identified as HIV-positive in correctional facilities usually are offered some type of care during their incarceration to combat HIV infection.

CHALLENGES • Lack of resources for HIV testing & treatment in correctional facilities • Jail tends to keep inmates for shorter times and have less resources than prisons for HIV interventions. Also, no capacity for plans post release from jails.

• Impact of laws that criminalize HIV. • Inmate concerns about privacy & fear of stigma.

• Hard to access care outside of correctional facilities so many former incarnated individuals are not able to be linked to long-term care for HIV. • Failure to maintain management of HIV after release threatens both the individual and their communities or those they engage sexually.

Current Political Landscape • In 2016, violent crime rates remained near the bottom of a 30-year downward trend.

• Trump Admin committed to “Tough On Crime” policies impacting communities of color & PLWH. • DOJ Actions Under Sessions • Revert back to Private Prisons • Return to harshest charges and sentences for drug offenses.

• Reinstated policy making it easer for local and state law enforcement to benefit from civil asset forfeiture.

HOPE IN CONGRESS? • There continues to be a bipartisan group of lawmakers committed to criminal justice reform in Congress and dedicated to ending rate of mass incarceration in US.

Public Policy Solutions • End “War on Drugs” and continued increase of incarceration of Black & Brown people in US. • Incentivize correctional facilities to make HIV screening, access to treatment, and linkage to care post release key priorities for these institutions at every level of gov’t.

• Support passage of Stop AIDS in Prison Act (HR 1882) at federal level.

• Eliminate HIV criminalization laws at state-level and passage of REPEAL HIV Discrimination Act (HR 1739).

• Increase in HIV/AIDS resources and programs in federal programs directed at the most impacted communities including Black populations.