AIDS Seen as Real Threat in Crowded Jails of California

California’s county jails are convenient way stations for the AIDS virus as it makes its deadly way around the state.

They are overcrowded and their populations frequently include homosexuals and intravenous drug users, groups at the highest risk of contracting acquired immune deficiency syndrome.

But it is forbidden for inmates to possess condoms, one of the few accepted safeguards against the deadly virus. The only exception is conjugal visits, when wives may bring condoms.

State law forbids sexual contact behind bars and jail officials say that distributing condoms to inmates would constitute abetting a felony. They say watchful guards and security to prevent sexual contact are the only answer.

“They will tell you that there are no sex and drugs in jails,” scoffed Mark Madsen of the California Medical Assn. “I’d say look again. Look again at the realities of what happens when people are incarcerated.”

Madsen said jail officials should allow inmates condoms, even if they refuse to distribute them.

“When are we going to start doing the right things, instead of the politically correct things?” he said. “It’s time we get off our high horse about morality and save their lives.”

So far, only Vermont distributes condoms to prison inmates, although officials in at least three other states are studying the idea.

Numbers Unknown

New York City has begun offering condoms to homosexual inmates in a pilot program. Officials there estimate that half the inmates in the program are current or former intravenous drug users; about half of those are infected with the AIDS virus.

California jails have no testing program to determine how many inmates carry the virus. Requirements for confidentiality often keep even prison administrators from knowing which inmates are likely to contract the disease.

Most counties report few cases of inmates who have the actual disease. But the AIDS virus has a long incubation period--perhaps as long as six or seven years--and a person who has the virus can spread it through sex or through sharing intravenous needles.

AIDS cripples the body’s disease-fighting immune system, leaving its victims vulnerable to a variety of life-threatening infections and cancers.

AIDS is caused by a virus believed to be passed through blood and semen, but not through casual contact. Groups at highest risk of getting AIDS are male homosexuals, intravenous drug users and recipients of contaminated blood.

Most often transmitted through sexual contact, AIDS also can be transmitted by transfusions of blood or blood products, by sharing contaminated hypodermic needles, and by mother to child at or before birth.

As of June 1, AIDS had been diagnosed in 36,058 Americans, of whom 20,849 have died, according to the Centers for Disease Control in Atlanta. No one is known to have recovered from AIDS.

Dr. John H. Clark, chief physician for the Los Angeles County Sheriff’s Department, said there has been only one documented case of AIDS transmitted in a jail in the entire country, but the number of people in California jails with the disease no doubt will continue to rise.

“Our jails are in one of the country’s AIDS hot spots,” he said. “Considering the links between AIDS, prostitution and intravenous drug abuse, and considering the number of arrests we make in these areas, the threat is of obvious concern.”

Some groups that have studied the problem say the potential for spreading the virus behind bars is tremendous.

“From the information obtained by the task force, it appears that the entire jail population is at risk for exposure to the AIDS virus,” said a report issued in February by the Santa Clara County Task Force on AIDS.

The task force recommended that authorities distribute condoms to the county’s 2,500 inmates, but Sheriff Robert Winter balked.

“It’s my position that since any homosexual activity is prohibited in the jail, I’m certainly not going to do anything that would promote or encourage it,” he said.

Winter’s response is virtually universal among jail officials, who are faced with monitoring inmates’ behavior in jails that, across the state, averaged 28% above recommended capacity last year.

Lt. John Tenwolde of the San Diego Jail, for example, said that distributing condoms “could be tantamount to condoning sexual activity in the jail, and sodomy is a felony. That is not a step that is being considered.”

In San Mateo County, women inmates being discharged receive a kit that offers, in addition to condoms, containers of bleach and water and instructions on how to sterilize needles used to inject drugs.

Perhaps nowhere in the country has the battle against AIDS been more hard-fought or more open than in San Francisco.

Flat Refusal

But jail officials there have refused to even consider issuing condoms to inmates, although a recent program similar to the one in San Mateo County provides them to inmates being discharged.

A city Health Department official informally asked City Atty. Louise Renne’s office recently for an opinion on whether distributing condoms would indeed constitute a felony.

Mayor Dianne Feinstein was angered because the review was public knowledge before she knew about it, a Health Department source said, and department officials refused to return phone calls about the issue.

“It is not an easy question,” Renne said. “Because of the criminal implications, there’s no way we’re going to issue any kind of opinion before we check with the proper criminal authorities.”

While the legal dilemma simmers, many jails are taking the less controversial step of beginning education programs to teach inmates how to avoid the disease.

In the booking area of the San Francisco jail, posters warn of the dangers of sharing intravenous needles or unsterilized tattoo needles, as well as the prohibition against sexual contact, said Sgt. Richard Dyer, an information officer. A pamphlet is being prepared with more complete information, he said.

Educational Film

In the huge, crowded Los Angeles County Jail, a videotape on AIDS is shown two or three times a week, sheriff’s physician Clark said. The tape, made by inmates at New York’s Sing Sing Prison, shows the demise, over the course of a year or so, of a number of once-healthy inmates stricken with AIDS.

The Los Angeles jail also has printed literature available and includes AIDS topics in health education classes.

Booklets about AIDS also are distributed to inmates in Sacramento County, and other counties are preparing similar programs. Some jail officials say, however, that most inmates get the information they need through the news media.

“The media has reached criminals as well as people on the street,” said San Diego’s Tenwolde.

The Medical Assn.’s Madsen said that jails should do more to educate inmates about AIDS, taking advantage of the “captive audience,” going beyond the basic warnings and explaining the different levels of risk involved in different activities.

Education, he said, is something jail officials can control, while other possibilities, such as testing for the disease, are not.

‘Why Bother?’

Tests for AIDS antibodies would have to be given repeatedly and constantly rechecked to maintain the “purity” of a changing jail population, he said. Otherwise, “it amounts to immunizing every other kid against smallpox,” he said. “Why bother?”

Currently, county jails do not do blanket testing. State law requires written consent from an inmate for such testing, and most allow a test only if the inmate requests it or displays AIDS-like symptoms.

Inmates in Placer County, however, face mandatory AIDS tests if they are drug users with needle marks or describe themselves as homosexuals.