On January 25, 2003, a frigid day inside Limestone Correctional Facility in Capshaw, Alabama, large pieces of ceiling fell from overhead—and a prisoner with AIDS fought for breath. An X-ray revealing large lesions on both lungs, indicating possible metastatic lung cancer, had been virtually ignored for two months. A nurse told correctional officers he could stop breathing at any time and to drive the patient to a hospital—not the one nearby but another two hours away. The officers said they had no medical training and suggested an ambulance, but she replied, “He’ll be fine.” Within half an hour, the patient was dead in the van’s backseat.

HIV health care for Alabama prisoners is in critical condition. In four years, 41 HIV positive male prisoners have died at Limestone—a staggering rate among approximately 250 HIVers. Many deaths have been from PCP pneumonia or wasting. One prisoner—who was treated only by adding white bread to his meals, no medication or supplements—begged his doctor for more food, crying. He died at 39, weighing just 74 pounds.

Only Alabama segregates prisoners with HIV both in programs and housing, which means they cannot participate in work release or other activities to earn money or reduced sentences. The state’s positive men are all housed together, whether they are serving time on bad checks or murder. Since Limestone’s HIVers filed a lawsuit for better medical care and living conditions, the Department of Corrections has made minor changes—for example, moving them from a dilapidated warehouse to a dormitory with cells, and replacing the company that had been providing medical care. But the system is far from healed: Last fall, three people died within a month.

The case is set for trial early this year. Alabama’s women prisoners have also filed a lawsuit for humane medical care, to be tried in June. But legal victories will likely be limited— federal courts have already upheld the state’s segregation of HIVers—so support from community AIDS activists is essential. Visit www.schr.org to learn more about HIV in Alabama prisons; join the national PrisonPoz Listserv at www.hcvinprison.org. Become an advocate in your state.


Lisa Zahren is an investigator at Atlanta’s Southern Center for Human Rights, which represents Alabama’s prisoners with HIV.