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NY Prisons- HIV & HCV- New Health Dept Oversight
 
 
  New York's prisons provide, among other things, medical care to nearly 60,000 people. Yet the prisons operate the only health care system in New York that's not monitored by the state Health Department.
 
The result is medical care that, while improving, is still deficient in many ways, as a report by the Correctional Association of New York detailed earlier this year.
 
That could be readily fixed, of course. The Health Department could, and should, be given authority to exert more influence in prisons and jails, just as it does over all other hospitals and clinics in New York. All it would take is passage of a bill under consideration in the Legislature.
 
An important first step across what Assemblyman Richard Gottfried, D-Manhattan, calls the barrier between public health and the prison system came last week as Governor Paterson wisely signed a law that will require Health Department oversight of treatment of prison inmates with HIV and hepatitis C.
 
New York has the largest number of HIV-positive prison inmates, an estimated 4,000, of any prison system in the country. That's 20 percent of infected inmates nationwide. New York also has an estimated 8,400 inmates infected with hepatitis C. That, at least, is the toll that we know about.
 
The Correctional Association report noted that fewer than half of the HIV-positive inmates and only about 70 percent of those with hepatitis C have been identified. The number of inmates being treated for these diseases varies among the state's 70 correctional facilities, even though the inmate population is much the same, demographically, from one to another. Such an inconsistency in treatment, we expect, will change under the Health Department's oversight.
 
Even more could change, in fact, if the Legislature and the governor were to extend regulation of medical care in New York's prisons beyond their two most serious health problems.
 
There's little to the arguments against such legislation. Mr. Gottfried and Sen. Thomas Duane, D-Manhattan, say the fiscal impact of their bills would be minimal. Conversely, there's a fiscal benefit to be reaped from improving medical care in prisons before inmates' health deteriorates further or they re-enter society -- as almost all eventually will.
 
New York already stands apart, boldly and proudly, from other states for addressing the problems posed by HIV and hepatitis C in its prisons. A state government with its share, and then some, of embarrassments could distinguish itself by requiring that health care in prisons and jails meet professional standards, as required by its constitution.
 
From
Women In Prison Project
Fact Sheet
 
HIV/AIDS
 
· Experiences that often lead women to become involved in criminalized behavior - drug abuse,1 sex work, poverty, unemployment, and domestic violence and trauma2 - are also experiences that put women at risk for HIV and Hepatitis C infection.2
 
· At year-end 2005, New York State had 4,000 inmates (350 women and 3,650 men) living with HIV, down from 7,000 in 1999.4
 
· New York has the largest number of HIV-infected incarcerated people5 and second largest number of HIV-positive incarcerated women of all prison systems in the country.6
 
· 12.2% of women in New York's prisons are HIV positive - a rate of infection more than double the rate for male inmates (6%)7 and 80 times higher than the rate in the general public (.15%).8
 
· As rates of HIV are disproportionately high among African-American and Latina women in the general public, HIV disproportionately impacts incarcerated women of color.9
 
· New York has the largest number of HIV positive jail inmates in the country - 1,359 in 1999.10
 
· A 1999 New York City Department of Health study found that more than 18% of women entering the city jail system were living with HIV compared to 7.6% of men. This study also found that African American women accounted for over 21% of HIV positive cases; almost 14% were Latina and about 12% were Caucasian.11
 
· The number of AIDS-related deaths in New York's prisons dropped about 94% from 1994 (244) to 2006 (14).12
 
Hepatitis C
 
· Hepatitis C (HCV) is a viral disease that attacks the liver. People infected with HIV are often co-infected with HCV: approximately 30% of all people living with HIV in the general public are co-infected with HCV.13 Effective HIV prevention must also include a focus on HCV.
 
· The New York State Department of Correctional Services (DOCS) estimates that more than 15% of HIV positive inmates are known to be co-infected with HCV.14 People who are co-infected with HIV and HCV sometimes experience an accelerated progression of HCV.15
 
· An estimated 22.1% of women and 12.8% of men in New York State prisons are infected with HCV.16
 
· The rate of HCV infection among New York's women prisoners is more than 14 times higher than the HCV infection rate in the general public (1.6%).17
 
· HCV is especially prevalent among women incarcerated for crimes related to sex work and drug addiction.18
 
· Because HIV and HCV have shared routes of infection (blood), the U.S. Department of Health and Human Services and the Infectious Disease Society of America recommend screening all people with HIV for HCV.19
 
Identification of HIV and HCV in Prison
 
· DOCS has only identified an estimated 45% of its HIV positive population and 70% of its HCV-infected population, leaving hundreds of incarcerated individuals without appropriate monitoring or treatment.20
 
· Just under 62% of HIV positive women at Bedford Hills, Albion, Taconic and Bayview correctional facilities were receiving HIV medication in 2005-2006. Only 4% of women with HCV at these facilities were on treatment for HCV.21 (Note: not all people with HCV are appropriate candidates for treatment.)22
 
 
 
 
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