January 17, 2007

Prison Ink: Can You Get HIV From a Tattoo?

Behind bars, a tattoo “needle” is a twist tie, paper clip or guitar string, slipped perhaps through the plastic casing of a Bic pen and heated up with the motor from a hair dryer or electric shaver. The same sharp point etches a gang symbol on one arm and a spiderweb on another; the ink is used again and again—and there’s a lot of blood.

Prison tattoos are as raw as they come (and known to spread hep B and maybe C), but the jury is still out on whether or not they’re a risk for HIV.

When Canadian officials canceled a $600,000 pilot anti-AIDS program last month providing “safe” tattooing in six prisons, the explanation was that it was a waste of taxpayers’ money. Neither supporters nor opponents had much hard science on their side.

The U.S. Centers for Disease Control (CDC) website states: “A risk of HIV transmission does exist if instruments contaminated with blood are either not sterilized or disinfected or are used inappropriately between clients.” And yet the CDC’s Jennifer Ruth told POZ.com, “The CDC can’t trace a single case of HIV transmission to a dirty tattoo needle.”

Proponents of Canada’s defunct safe-tattooing program say the potential risk is enough for concern. An estimated 45% of Canadian prisoners find a way to get tattoos in prison even though it's against the rules; the U.S. numbers are probably about the same. “Let’s just accept that these activities are going on and do our best to reduce the harm,” argues Leon Mar of the Canadian HIV/AIDS Legal Network.

Former U.S. prisoner Jason Farrell, an expert on harm reduction who runs the Positive Health Project, says, “The dangers don’t lie in the actual tattoo; it’s the hidden danger of blood splattering and not being able to create a sterile environment.”

A Georgia prison study on HIV transmission last year shed little light on this issue. In the study, 12 HIV positive inmates listed unsafe tattooing as their only risk factor. But this kind of “self-reporting” has its flaws. First-person accounts make for shaky data anyway, and in this case, prisoners may have good reason to lie: The alternative explanations for how they got HIV are less socially acceptable.

“People are more likely to admit to nonstigmatized behaviors like tattooing rather than IV drug use,” says Ian Williams, PhD, of the CDC’s Epidemiology Division of Viral Hepatitis. Likewise, many inmates would rather not admit to having had sex with men.

Who’s to say where a prisoner picks up the virus—without knowing more about HIV and life behind bars?

Not that science always dictates prevention policy inside or outside prison walls. While condoms were long ago proved to help stop the spread of HIV—and are distributed in prisons in Canada, Australia and many European countries—they’re still not allowed in a vast majority of U.S. prisons.