Six HIV positive prisoners in Fulton County, Georgia, turned the treatment tables on Sheriff Jacquelyn Barrett in April when a federal judge called her medical cuts penny-wise and pound-foolish. “People are required under the Constitution to get medical attention in jail,” ruled Judge Marvin Shoob. “Cost isn’t a factor.”

The suit claimed the county served the plaintiffs—who are mostly doing time for drug possession and credit-card theft—what amounted to a death sentence through subpar care. “It was a tragic comedy,” said the inmates’ lawyer, Stephen Bright, of Georgia’s Southern Center for Human Rights. “Name the problem, and it was happening: people too sick to stand in pill lines, people on triple-drug combos getting only two—it ran the gamut.”

An Atlanta Journal-Constitution editorial slammed Fulton County Jail’s “false economy,” noting that while $2 million would be saved if its 150 PWAs went untreated, medical bills for opportunistic infections would eventually cost several times more. The lawsuit also fingered officials for jeopardizing public health. “Prisoners develop resistant strains of HIV if they do not receive proper meds,” said Jackie Walker, AIDS info coordinator at the ACLU National Prison Project. “And ultimately, they do get out.”

Shoob ordered Barrett to stock the slammer with HIV meds and hire a consultant for proper administration. While prisoners often file suit over medical complaints, rulings rarely swing their way. “It’s very empowering for the clients to be able to hold the jail accountable,” Bright said.