Category: HIV

Segregation and Stigma of HiIV Positive Prisoners

Human immune-deficiency virus

HIV (human immuno-deficiency virus) is a virus which damages a person’s immune system and weakens the ability of a person’s body to be able to fight infections (Haas, 1993). Segregation of HIV positive prisoners was a common practice during the first discovery of the disease, due to added pressure on prison officials to reduce the growing spread of HIV in prisons. The lack of education and understanding of the disease led to segregation and stigma of prisoners with this disease. General stigma of HIV positive prisoners occurs not only in prison but also amongst the public. This could be due to the media’s portrayal of HIV, creating fear amongst the population. Also, there was no cure for the disease at the time, people believed once you were infected with the disease then it meant certain death. The ethical implications of segregation of prisoners also have to be considered as some would argue it’s a violation of human rights. Through research that was carried out into the cause, unjust punishment and treatment of prisoners with HIV, a better understanding has been developed on the issue.

Segregation

To begin with, the spread of HIV is possible in many different ways from sexual intercourse to vertical transmission. However, statistics shows that around ‘74% of HIV infections have been spread from unprotected homosexual intercourse while 17% is from sharing of contaminated needles’ (Haas, 1993). This could therefore provide the basis for why many believe that compulsory segregation of HIV positive prisoners is necessary to avoid the spread of the disease. There has also been a steady growth in the spread of HIV by use of intravenous injections, this is due to there being a scarcity of needles therefore this results in the rapid spread of the disease. HIV is a disease that a person could have without knowing they are infected therefore it also poses a threat to the general public. This is because once an infected inmate is released, they could then go on into the population and spread the disease. This provides an issue for prison officials and has led to increasing pressure for changes to be made and policies put into place leading to the introduction of mandatory HIV testing for all prisoners and the segregation of HIV positive prisoners. However, these policies have faced fierce opposition from not only inmates but also from other in the public due it’s breach of human rights and constitutional rights (Haas, 1993). Prisoners also feel that there is a lack of privacy and by immediately being forced to submit to a blood test, their rights are being violated. Although, prison officials will argue that due to the increasing cases of infections mandatory testing is required to help reduce the spread of HIV and help control the infections. This is thought to be achieved by segregating the inmates (which was the only act done before the introduction of HAART) or now also administering treatments for the inmates in the form of HAART (Highly Active Anti-Retroviral Therapy) for example. The key issues that still exist is the breach of confidentiality of prisoners, by segregating HIV positive prisoners their condition is highlighted to all other inmates and prison guards. Segregation of inmates could also create the stigma towards the disease as other occupants in the prison might not understand the disease and how it’s spread. Prison officials also considered providing condoms for prisoners in order to help promote safe sexual relationships as well as providing bleach to help sterilise needles that were used by prisoners (Robinette et al., 1999). However, after 1985 there was large reduction in the number of prisons which still used segregation as an effective method to curtail the spread of HIV. This in part was due to the decrease in stigmatisation and hysteria surrounding the disease (Robinette et al., 1999). There are also perhaps four other factors as to why segregation of inmates has fallen out of favour; ‘avoiding stigmatisation, hazards of mass screening, problems with segregated housing and small chance of transmission through casual contact.’ (Robinette et al., 1999).

Stigmatisation

In addition, looking through the stigmatisation of seropositive inmates, it is clear that through segregated housing the inevitability of inferior health care for these inmates has occurred. This stems from the fact that healthcare professionals do not view them as adequate patients. Health care providers immediately place prisoners into two groups with there being the ‘good patients’ (patients who are HIV negative) and the so called ‘rubbish patients’(those who are HIV positive)( Robinette et al., 1999). This is because health care specialities want to deal with life threatening issues or acute illnesses which can lead to them using key skills learnt and putting it into practice. Thus, ensuring that they can improve the health of the individual and save lives. However, with a disease such as HIV death is inevitable therefore the medical professional will feel like their attributes aren’t being used efficiently as there is nothing they can do to save the life of the individual hence why HIV positive patients are seen as ‘rubbish patients’. The ‘good patients’ are those who have exhibit these acute illnesses ensuring the medical personnel can help bring the person back to full health. From this it’s clear to see that segregation of inmates can only further increase this stigmatisation from health care professionals and this is therefore detrimental to the infected prisoners as it leads to inadequate care for these prisoners. To add to this, mass segregation of inmates requires mass testing of all prisoners. The issue with this is that sometimes the test could produce a false positive or negative result which could have detrimental effects. Individuals who are deemed to be seropositive will immediately be isolated, however due to a false positive result these people may not be infected. This is the same for those who are shown to be seronegative while in fact they are infected. This leads to those infected being put into the general population creating an inaccurate and false sense of security for the prisoners who aren’t infected as they may now be more likely to partake in high HIV risk activities such as unprotected sexual intercourse and Intravenous injections. It is clear as to how hugely detrimental this can be as it can lead to the rapid spread of the HIV disease in those or are uninfected. The results of these tests are also affected by the time taken between the first exposure to HIV and the presence of antibodies as sufficient time has not been given for the specific virus to be detected (Robinette et al., 1999). There are also two other issues related to mass testing of all prisoners, these being the costs as well as underappreciation of the education of HIV to inmates and the dangers of HIV. This is because only those who are infected with HIV and have been isolated, or those who are known homosexuals or intravenous injection users are more likely to be targeted when it comes to the education on the disease. This therefore ignores the belief that all prisoners should be informed and have a good knowledge on the issue to curtail the spread of the disease. As previously stated segregation of seropositive prisoners is also spreading the false belief that HIV is a disease that can be contracted by casual contact and as we know this is not the case.

Conclusion

To conclude, in order to help tackle the issue of HIV in prisons several changes can be made. A key change being the huge importance of the education of prisoners as knowledge is power and it can help reduce stigma towards HIV whilst also helping to reduce its spread as if people know what causes the disease they can be more cautious. It is also evident that sexual intercourse will occur in prisons so therefore condoms could be provided for prisoners. This is already being used in countries such as Canada and France and there have been no negative effects. For example, in Canada prison officers were surveyed to see if the use of condoms in prisons has caused any issues. Out of these people, ‘82% of prison officers surveyed said that condom availability caused no problems at their prisons’ (Robinette et al., 1999). However, there are prison rules against sexual intercourse it is argued that this is inhumane, and prisoners are bound to break the rules so is it is a better choice to provide inmates with the tools to practice safe sexual intercourse. Correctional officers may see condoms as a way to promote sexual intercourse with inmates or a way to move contraband into prisons but the protection of people from the spread of a deadly virus should outweigh these negative aspects. In future, more can be done to not only tackle segregation of inmates but to also challenge the stigma of HIV that it creates.

Can Starbucks Cure the HIV/AIDS Epidemic in Africa?

(RED), an organization founded in 2006 by celebrity humanitarian Bono and activist Bobby Shriver has exploded all over the world with its partnerships with popular global brands, including Apple, Converse, Gap, Armani, and Starbucks. This brand, commonly known as (Product)RED, markets products in an attempt to raise funds and awareness for those living with HIV and AIDS in Africa. (RED) incentivizes customers to step up by providing individuals with the opportunity to make a positive impact, as a portion of all donations generated from (RED) campaigns go directly to the Global Fund to fight AIDS, Tuberculosis, and Malaria. Product(RED) claims that they are fighting to solve the issue at hand, but they do so in ways that perpetuate the causes of the epidemic. The citizen-consumer, mobilized through celebrity humanitarianism, drives commodity fetishism which allows businesses to capitalize on humanitarianism.

In 2008, Starbucks, one of the largest coffee companies in the world, began its partnership with (RED), launching its 60-second “What If” advertisement. This advertisement poses a series of hypothetical questions, such as “what if when we help someone else, we help ourselves?” This “someone else” refers to Africans diagnosed with HIV and AIDS. However, interesting enough, the advertisement never mentions that the fund go towards contributing to HIV and AIDS prevention, only mentioning that they will “help save lives in Africa”. Upbeat piano music plays in the background of the advertisement, juxtaposing the seriousness of the issue with the lighthearted tone of the campaign. The thought-provoking promotion asks its viewers “What if we are not separated from everyone else, but connected?… What if just part of our purpose here is not me, but we” in an effort to connect its viewers to the epidemic of HIV and AIDS in Africa. The company encourages its audience to take action through its claim that being a part of the solution is much easier than it’s believed to be. The advertisement, which presents solely words and no images, is straightforward in its message: for every exclusive (Starbucks)RED drink bought during the holiday season, five cents will be contributed to helping save lives in Africa. Proceeds from the sale of hand-crafted beverages and other unique (RED) Starbucks merchandise and menu items are donated directly to the Global Fund to help finance HIV/AIDS prevention, education and treatment programs1. Starbucks leads us to believe that through collective efforts, it becomes possible to make significant progress in the fight against HIV and AIDS in Africa. The Starbucks (RED) campaign, claims “You & Starbucks. It’s bigger than coffee”, putting the focus on the individual and how their consumer behaviors can engage themselves in one of the world’s most pressing global health issues: the HIV and AIDS outbreak in Africa.

The Starbucks (RED) campaign certainly creates a good impression on its viewers, using celebrity humanitarian to integrate business with social concerns and motivate consumers. Celebrity humanitarian, Bono, brought the situation in Africa to the public eye, evoking sympathy and encouraging people who may not have known about the situation otherwise to contribute. Celebrity humanitarians, by involving themselves in urgent matters plaguing society, often play a key role in gathering support towards a particular cause. This technique, though well-intentioned, has unintended consequences. Richey and Pontey explain how the (Product)RED campaign attempts to “bring Africa to the minds of the idle rich… [using] celebrity together with the negotiated representation of a distant ‘Africa’” to address the solutions to the global issue. Despite charitable contributions made, the rich patronize the poor. Through these methods of extracting donations by evoking pity, foreign aid results in the framing of the underlying assumption that poor Africans are helpless and dependent on the charity of the more developed, superior Western powers.

The advertisement succeeds in its purpose of gathering funds, but it convinces citizen-consumers that their efforts will directly address the serious problems, even when they have no knowledge of where these funds are allocated. The citizen-consumer strives to unite the forces of consumerism with humanitarian foreign aid through their purchase decisions. Citizen-consumers experience a sense of pleasure through buying the charity merchandise, believing they can become part of the solution without needing to sacrifice anything significant. Nevertheless, the ways in which these consumers involve themselves are in reality for their own interests and not in the interests of those they are trying to help. Consumers end up contributing because of the conveniency of making a donation, and most of the time, they don’t have a full understanding of the causes they are donating to. This promotes the idea that consumers can “help people in ways that let [them] keep living their lives as is, while shedding some of [their] personal guilt” with the assumption that “positive social consequences will occur automatically, as a happy by-product of selfishness”. Starbucks’s Product(RED) advertisement does not disclose the cause they are supporting, but urges individuals to purchase their goods with the idea that their choice of brands and purchases can alter their engagement in real world issues, making them responsible, and ethically engaged citizens.

Starbucks’s partnership with (RED) is a manifestation of commodity fetishism, a term first used by Marx that describes “the necessary masking of social relations under which commodities are produced from which capitalist commodity production gains much of its legitimacy”. Through its branding of (Product)RED goods, Starbucks attempts to make a profit while addressing a fatal disease that plagues the lives of Africans, promoting the idea of doing well by doing good. Starbucks and its partnership with (Product)RED seems to “promote status, capitalism, and conspicuous consumption in the name of ‘helping’” while not disclosing the specifics of their aid activities. Starbucks engages in this commodity fetishism as its primary motive behind its partnership with (RED) is to maximize profits through selling (RED) branded goods and convince its consumers that buying coffee can save lives. Companies tend to not address the causes that underlie the issues they are focused on while highlighting the severity of the issue and how they plan on going about their solution: through gaining profits. (RED) asserts that they have the capabilities to fix the circumstances, so long as they are provided with sufficient funds for their plan of action, the Global Fund. (RED) explains how the solution is highly conceivable: a 20 cent pill taken everyday can stop mothers from passing HIV to their babies. They urge individuals to question, “why not contribute to such a simple solution?”, but they never question: if the solution is so simple, and the epidemic is so preventable, then why does it exist in the first place? What is the source of this problem that allowed it to grow to be so extensive to the point where it affects so many people? The answer, in this case, is poverty. The extremely unstable economic conditions in Africa prompted this wide-spread epidemic that now requires large funding to fix. This is the real problem that should be addressed, but efforts to combat this problem are insufficient. The (RED) campaign is committed to giving back through their business endeavors, representing a belief of business being the “universal access card for making progress, helping people, and changing the world”. The idea that the market is the most effective mechanism for pursuing social change only maintains the existing power dynamic. How could we possibly be able to change the world by maintaining the same economic status quo between the rich and poor? By not addressing the roots of the disastrous condition, companies only perpetuate the circumstances that gave rise to the problem in the first place, allowing capitalism to prevail.

A critical flaw in the way these humanitarian efforts are carried out is their unrealistic emphasis on simple solutions to complex global issues. The (RED) campaign, focused on the contributions of the citizen-consumer for funding, paves the way for commodity fetishism, in which celebrity humanitarians play a huge role. Commodity fetishism attempts to link humanitarianism and consumerism, allowing the rich to continue to profit off of the suffering of Africans. Consumers should ignore profit-maximizing motives to produce effective solutions to properly assist those living with HIV and AIDS in Africa. Though Starbucks claims that their efforts are producing a great impact with 5 cents from every exclusive drink purchased being donated to the Global Fund, the company certainly profits with the vast majority of their charity merchandise sales going towards their revenue. Consumers, when making purchases in attempts to do good, need to understand the importance of the complexity of making a real difference in the state of affairs in Africa. If the root causes behind the HIV/AIDS epidemic are not addressed, companies will continue to offer inadequate solutions that allow the disease to persist throughout the population.