Health Care for HIV-Infected Inmates Thrives in Prisons

Article excerpt

They may not be a nice place to work, but the nation's prisons are boasting a growing pharmacy business. Does anyone want to apply?

About one million people throughout the nation are incarcerated these days, and their number is increasing. And because many of that number will be in prison for many years, they bring a unique meaning to the concept of "long-term care."

Inmates are much more likely than the general population to be infected with HIV, and therefore the drug budget for prisoners is rapidly rising. How inmates in Texas are treated for HIV infection was explained by Steven L. Harris, a physician who is director of preventive medicine at the Texas Department of Criminal Justice and who oversees the provision of health care to prison inmates. He spoke at the annual conference of the American Society of Consultant Pharmacists, held in midNovember in Nashville.

Harris explained, first of all, that unlike the rest of the U.S. population, prison inmates have a legal right to receive health care that meets local community standards. That right entitles them to voluntary testing for HIV infection and to voluntary treatment for the disease.

Inmates, as a population, can be difficult to treat, Harris commented. In Texas, the average inmate age is 33 years old. About 95% are male, with 47% black, 28% white, and 25% Hispanic. More than half of this population have been in prison before. Most have no work skills, test at the seventh-grade level, and have an average I.Q. of 92. The average sentence is 20 years, of which a third is actually served.

About 63% of Texas' inmates are substance abusers or addicts using injected drugs, which explains the population's growing HIV infection rate of 2. …