HIV in Prisons

To the Editor, New York Times:

We applaud your attention to HIV/AIDS in prisons (“A Warning About AIDS in Prisons,” July 24 editorial). As the CDC reported, sexual transmission of HIV does occur in prisons. Condom distribution is long overdue and would impede the spread of the virus and save lives.

However, HIV prevention in prisons should be accompanied by high quality treatment for those infected. The majority of HIV positive prisoners do not contract the virus in prison; they enter prison already infected (1). This is because both incarceration and HIV disproportionately affect poor, marginalized, and minority communities. As the New York Times reported in a 2005 series investigating the largest prison health contractor in the US, the conditions of inmate healthcare—and HIV care specifically—are often deplorable.

Incarcerated populations cycle quickly between prisons and communities, and an estimated 25% of HIV positive individuals in the US pass through a correctional facility each year (2). Prisons, therefore, present a tremendous opportunity for public health officials to implement HIV prevention, treatment, and education for the communities most affected by the epidemic.

a medical student
a law student
a medical student

New York City, July 26, 2006

1. Spaulding et al. HIV in correctional facilities: a review. Clinical Infectious Disease. 2002 Aug 1;35(3):305-12.
2. Ibid.

The New York Times did not publish these letters I wrote.

To the Editor:

In his February 9, 2006, article "Tough US Steps in Hunger Strike at Camp in Cuba," Mr. Golden fails to address the question that the hunger strikers raise: is it allowable to indefinitely confine a human being under domestic, international, or moral law?

On December 9, 2005, Human Rights Watch reported that the detentions in Cuba are illegal under both domestic and international law. The US has not assured that detainees have rights to fair and speedy trial. They are secretly detained. These conditions make them vulnerable to torture and other abuses.

Golden's article misrepresents the Guantanamo scenario as a question of how a prison should treat suicidal inmates. He cites the US assistant secretary of defense for health affairs: "There is a moral question. Do you allow a person to commit suicide? Or do you take steps to protect their health and preserve their life?" Mr. Golden forgets that there is a third option. The US can release the detainees or grant them rights and privileges accorded prisoners under national and international law.

February 9, 2006

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In response to the NYC transit workers' strike:

To the editor:

As a student at the public health school bearing his name, I urge Mayor Bloomberg to approve the transit union's demands immediately. The Mayor has an opportunity before him. He can spend the MTA surplus on robust pensions, affordable health benefits, and high wages. These items will translate directly into improved health for thousands of transit workers, their families, and their neighborhoods.

The need for pensions should especially concern Mr. Bloomberg. The health of America's most vulnerable, particularly the growing elderly population, is suffering as cost of living skyrockets in urban areas and the gap between rich and poor widens. He can act now to ensure that retiring New Yorkers have pensions that allow them to grow old with dignity, security, and health. If he does not, New York's healthcare system will certainly bear the costs of his mistakes in the future.

December 21, 2005

The Red Pony, by John Steinbeck

Jody rushed for the harness-room. For some time he had been riding the saddle on a sawhorse. He changed the stirrup length over and over, and could never get it just right. Sometimes, mounted on the sawhorse in the harness-room, with collars and hames and tugs hung all about him, Jody rode out beyond the room. He carried his rifle across the pommel. He saw the fields go flying by, and he heard the beat of the galloping hoofs (18).

He sat down in the green grass. The trilling water sounded in his ears. He looked over the farm buildings and across at the round hills, rich and yellow with grain. He could see Nellie feeding on the slope. As usual the water place eliminated time and distance. Jody saw a black, long-legged colt, butting against Nellie's flanks, demanding milk. And then he saw himself breaking a large colt to halter. All in a few moments the colt grew to be a magnificent animal, deep of chest, with a neck as high and arched as a sea-horse's neck, with a tail that tongued and rippled like black flame. This horse was terrible to everyone but Jody. In the schoolyard the boys begged rides, and Jody smilingly agreed. But no sooner were they mounted than the black demon pitched them off. Why, that was his name, Black Demon! For a moment the trilling water and the grass and the sunshine came back, and then...

Sometimes in the night the ranch people, safe in their beds, heard a roar of hoofs go by. They said, "It's Jody, on Demon. He's helping out the sheriff again." And then...

The golden dust filled the air in the arena at the Salinas Rodeo. The announcer called the roping contests. When Jody rode the black horse to the starting chute the other contestants shrugged and gave up first place, for it was well known that Jody and Demon could rope and throw and tie a steer a great deal quicker than any roping team of two men could. Jody was not a boy any more, and Demon was not a horse. The two together were one glorious individual. And then...

The President wrote a letter and asked them to help catch a bandit in Washington. Jody settled himself comfortably in the grass. The little stream of water whined into the mossy tub (64).

chalk, dj ilium.

barfy barfy poke my eye
out of a worm hole, filthy sty.
ibbidy bibbidy eight course stay
corset, bored yet? holiday.

on the eighth floor, the
night snow has a long way to
float to the sidewalk.

a red mitten on
the street. chill fingers search the
lint in her pocket.

chicken fried turkey.

3 o'clock sunset:
digging chocolate chips out
of the ice cream box.

moustache bits litter
the sink, a razor blade on
the edge. dad lives here.

the suburbs make minds
fret over what to keep and
what to throw away.

when she's not looking,
he stuffs the trash can with a
porcelain swan-shaped vase.

she takes the trash to
the curb. the swan, salvaged, swims
on the garage shelf.

every bevery beetle cat
make me a town, flip-flop flat.
hominy, grits, pudding pie
evil weevil red tongue-tied.

eighty bumblers numblers gnat
knitting kittens into a hat.
how many sofas piled to the sky
will heed hum numbers outward guy?

small fry.

saving lives...millions
at a time. one more greasy
shrimp roll down my throat.

romanced by her own
voice, how she wants to make out
with the microphone.

opening the post
office box: a rush of wind,
blackness, and no mail.

vibration in my
pocket, palpitation in
my chest, flip open.

fat and transparent,
tell him your woes. priest in a
confessional, closed.

polyester butt
sweat, 12 to 8 am. an
apple in the car.

once in june

once in june did fly spots splat and
umber ochre brown at bat.
if ever slipper awesome high, then
eighteen junebugs in my eye.

when i am old and bejowled,
where will you be?
not on the back steps,
spitting watermelon seeds with me.