In March of this year while in Los Angeles for the 14th Annual Retrovirus conference, I and several other members of the AIDS Treatment Activists Coalition (ATAC) were invited to give a talk on AIDS activism to inmates at the Los Angeles County Jail. I was a little apprehensive at first, as I’d never done anything like it before, but lately I’ve been feeling the need to go outside of my comfort zone, and so I accepted the invitation.

As we drove through the streets of downtown Los Angeles, hopped on the 110 for a few miles, and then rode through a dilapidated Chinatown, I started to second-guess my decision. Apprehension grew into a palpable fear as the twin towers of the County Jail loomed ever closer. The L.A. County Jail is the largest county jail system in the U.S., with close to 20,000 inmates at any given time, of whom 300 are known to be HIV-positive. Morris Jackson, Treatment Education and Prevention Specialist for the Center for Health Justice, was driving. During our ride we talked about some of the work the organization does at the jail, including transitional planning, referrals, counseling and testing, educational trainings, and condom distribution. I had no idea what to expect when we arrived at the jail, so I continued to pry Morris with questions as he drove, admitting that I was just a little nervous. He was finally able to soothe my nerves somewhat by informing me that he had never, in the year that he worked there, had a problem with any of the inmates.

As we entered the facility, the bars clanged shut behind us and the guard took our names and checked them against a list of approved visitors for the day. He held onto our ID and in return we were given a day pass that we clipped onto our shirts. We were told that if we lost the pass, the entire jail would go on lockdown and we would not be able to leave. Needless to say I checked more than once over the next few hours to ensure that my badge didn’t come off.

We headed down several long hallways and rode the service elevator up to the K-11 Unit. This is where inmates who identify as gay, bisexual or transgender can voluntarily choose to live in a segregated unit. It allows them to live with others who they identify and share similar circumstances with and, most importantly, it keeps them out of the general population. But it’s certainly no cakewalk. We stepped up into the observational booth and our arrival was announced over the microphone, inviting the inmates to join us for the presentation. I looked through the plexiglass out over three separate rooms, each one with rows upon rows of bunk beds, where dozens of men lived in each large room with a television and an adjoining shower area. No privacy here whatsoever. Many of these guys are in here on drug-related charges, and awaiting trial or transfer to another facility. Around 30% of those in the K-11 unit are infected with HIV—many do not find out they are HIV-positive until they end up in jail and choose to get tested.

Inmates were told that if they were talking or disruptive during the meeting, they would be sent back to the unit. Those who wanted to attend then lined up, and the thick steel door unlocked and swung open. They marched by, single-file, and we nodded and said hello, and many greeted us back. They proceeded to the room where the meeting was being held and lined up against the wall in the hallway near the door. As we walked by the inmates and entered the room before them, it suddenly struck me how I was completely out of my element and that I had entered another realm of reality—a reality that is a way of life for millions of people in this country.

Morris had told me earlier how incredibly ingenious some of these men and women are, crushing up blue pills to make eye-shadow, or carving tweezers out of a toothbrush. “Now if they could just take some of that energy and ingenuity and start to use it in a more constructive manner, they would be able to do something with their lives,” he said with a glimmer in his eye, and I could see he really meant it. It was obvious to me that he and the other people who he works with really care about the inmates and that they definitely have a passion for this work. “I’m really lucky in the sense that I have a job that I look forward to going to every day. I work with some incredible people, and I feel as though I’m able to make a difference in some of these guys’ lives.”

I was introduced to the group of about 50–60 men by Cathy Olufs, Education Director for the Center for Health Justice, who wrote the activist section for this year’s Positively Aware Annual HIV Drug Guide, and who along with Morris is also a member of ATAC. “Now, you all know that magazine Positively Aware that we bring in here for you guys?” Many of them uttered in agreement and nodded their heads. “Well, this is the editor of the magazine.” At that moment at least a dozen of them, as if on cue, held up the magazine. It was a moment that I will never forget. In that instant, I felt as though I was exactly where I needed to be and doing what I was supposed to be doing. The apprehension that I had experienced earlier suddenly dissipated.

Morris told the group that once they are sent to jail, people on the outside tend to forget about them, or don’t even think about them at all. When I stood up to talk, I began with, “You know what? I do think about you guys. I think about you every single day. I get letters from you all the time, and I read every one of them. I don’t have enough time to answer you personally, but if you request it, I’ll make sure we add you to the mailing list, or send you information.” I talked a bit about my own personal journey, and about the choices we make in life. I told them that no matter what circumstances we may find ourselves in, that we always are presented with a choice. As I spoke, it quickly dawned on me that had the circumstances in my life perhaps been a little different, or I’d chosen a different path, I could just as easily be sitting there alongside them listening to someone else give a talk about AIDS activism.

Nita Costello of Houston and Orlando Roman of New York City, fellow activist members from ATAC, engaged the group as well, making them laugh, sharing their own personal stories, and talking about how they came to be involved in AIDS activism. The inmates listened intently and seemed eager to learn as much as they could about HIV prevention, treatment, and advocacy. Their informed questions about drug interactions, adherence, HIV transmission, and resistance shattered many of the personal beliefs and stereotypes that up until then I had held about incarcerated individuals. You know—lazy, undeserving, uneducated. These guys were anything but those things.

Our time was up much too quickly, and the inmates were told they had to leave and go back to the cell. Many of them came up to shake our hands and thank us personally. They seemed genuinely appreciative that we had given of our time and come to talk with them. It seemed so little to give, and I received so much in return.

Prison prevention Today the debate on whether to allow condoms in prisons rages on. In 2006, Governor Arnold Schwarzenegger of California vetoed a bill that would have allowed condom distribution in state prisons. (However, a new bill is being introduced, AB1334, and is supported by a number of prison rights groups.) A recent Illinois House bill allowing condom distribution in state prisons was voted down six to five. But to me, the question of whether or not we should allow access to condoms in prisons seems moot. “Lock them up and throw away the key” is no longer an option in the age of AIDS. We have a moral and ethical responsibility to educate and empower all members of our society, regardless of who or where they are, and to provide them with the tools necessary to make safer and smarter choices—so they can protect not only themselves, but their partners and families as well. And until we offer comprehensive and non-judgmental prevention and education programs to all populations affected by the epidemic, we will never be able to stem the increasing rates of infection that continue to devastate our communities. It is as though we are handing down a sure death sentence. And their blood is on our hands.—Jeff Berry

About Center for Health Justice With their newly-coined motto “Prisoner Health is Public Health,” Center for Health Justice (CHJ) is a tiny agency doing big things around issues of incarceration and HIV/AIDS in California and beyond. CHJ was founded in 2000 under the name of CorrectHELP (The Corrections HIV Education and Law Project) by a coalition of AIDS activists, civil rights attorneys, and formerly incarcerated individuals who were concerned about the numerous unmet health needs of HIV-positive prisoners in California. Since its infancy, the agency’s staff and supporters have worked tirelessly to achieve their mission—to reduce the spread of HIV in prisons and jails, advocate for HIV-positive inmates, and reduce the recidivism rate for individuals affected or infected by HIV. In early 2006, the Board of Directors voted to change the agency name from CorrectHELP to Center for Health Justice in an effort to better reflect their current work in the jails and prisons in California, which in addition to HIV prevention and treatment education services (including condom distribution in Los Angeles and San Francisco County Jails), now also includes educational programs on hepatitis C and STDs, women-specific empowerment programs, and a new public policy department focusing on broader issues relating to HIV in correctional settings. CHJ staff members are reflective of the communities they serve: nearly half are persons living with HIV/AIDS and several have previous incarceration experience. Under the leadership of a bright new executive director, Vincent Jones, a former staffer for U.S. Senator Barbara Boxer, Center for Health Justice is poised to move HIV and incarceration issues in the U.S. to the forefront in the coming years. CHJ operates an inmate hotline that accepts collect calls (323-822-3838) and is accessible to incarcerated persons around the country. For more information on Center for Health Justice or their programs, please visit their website at www.healthjustice.net or call (323) 822-3830.