Acquired Immune Deficiency Snydrome (AIDS) has emerged as a major public health problem in the current decade. End-stage AIDS and its precursors, asymptomatic HIV (Human Immunodeficiency Virus) infection and ARC (AIDS-Related Complex), pose a particularly thorny management and health care challenge for the nation's prisons and jails. Correctional administrators must deal not only with the general public health concerns of education, confidentiality of testing, infection control, and medical treatment, but also with unique issues of offender housing, victimization, and access to support services (Hammett, 1989).The response in prisons and jails has mirrored -but lagged far behind-the community and medical developments surrounding this issue. Panic and fear have, in some jurisdictions, led to such measures as mandatory testing, segregation and isolation, and punitive treatment of offenders. Several court challenges are now in process. As new information on HIV infection and AIDS has become available, many states are revising policies so as not to create &dquo;leper colonies&dquo; within their prison walls.The thesis of this paper is that HIV infected inmates need not be treated as a distinct, homogeneous set of offenders, all requiring the same management approach. Instead, commonly understood principles and procedures of offender classification can form a rational basis for the multiple decisions being made about their risk level, their housing/supervision requirements, and their health, mental health, and program needs within the prison setting. (For an excellent overview of the entire AIDS/Prison question, see Hammett, 1988.) The general issues of offender classification and management are also beyond the scope of this article. (See Clements, 1981.) A brief overview of current practices will be illustrated by findings from a court case challenging segregated housing. The effects of those policies and alternatives based on classification principles will be discussed.
Current PracticePrison-based AIDS policies are undoubtedly influenced by the general stigma associated with its primary victims -homosexual or bisexual men, IV drug users, and Black and Hispanic persons. This stigma combined with the early concerns -and misinformation-about transmission and the potential epidemic nature of AIDS led to policies which appear to have ignored or minimized earlier rulings and standards affecting prisoner management.