There are now some 60,000 incarcerated persons in France — i.e. 50 % more than in 1983. The rise in the prison population corresponds only too well to a general tendency in Europe: criminalization of poverty, a policy that in itself leads to a growing pauperization of the prison milieu. The latter phenomenon hits the inmates, who are confronted with alarming survival conditions (lack of hygiene, poorly balanced nutrition, and grimy, dilapidated buildings).
Such misery is not without repercussions on the health care policy followed in prisons. Undeniably, progress has been made: since 1994, prison health care structures have been linked to nearby hospitals, thus theoretically allowing access to health care equivalent to that in the outside world. This reform was indispensable — but is not sufficient: in fact, health care conditions in prison remain precarious. Treatments with antiretroviral products require close medical supervision, strict dosage and a stable environment. The three requirements together are difficult, if not impossible to respect under prevailing conditions in the prison system. How, indeed, can treatment schedules be reconciled with rigid meal schedules? How can inmates keep their HIV-positive status confidential while sharing 12 m2 with three cellmates, with medications delivered to the cell?
Consequently, lack of means and prison crowding directly affect the compliance of HIV positive prisoners. Added to the problems caused by prison organization itself, are obstacles imposed by work in prison: prisoners with HIV/AIDS have to hide their disease and their treatment if they want to obtain jobs. These jobs are hardly skill-enhancing (ah, the joys of making hangers…); they are underpaid (the SMIC or guaranteed minimum wage is not applied in prison) and insecure (no health or unemployment insurance), but for most prisoners they are the only source of income: the RMI (minimum subsistence allowance) stops 60 days after incarceration and the Allowance for Handicapped Adults (AAH) falls to 12% of its normal amount, i.e. slightly over 450 Francs per month.
Vitamins are not free any more than are nutritional supplements, fresh produce or cleaning and hygiene products. All these items that are indispensable to staying in good health have a price that prisoners with HIV/AIDS cannot afford. Therefore, it is urgent that public authorities extend the subsistence allowance system to the prison system and raise the AAH It is more than time to give up this myth of the prisoner who, provided with room and board, has no other needs to meet.
The only recourse for sick prisoners who see their health deteriorating is to apply for a pardon on medical grounds. However, the procedure for obtaining it is long and complex and it is almost never granted. It has now been 4 years since a report with recommendations for the reform of this system was requested.
– The Prisons Commission of Act Up-Paris was created in 1991 in order for incarcerated persons with HIV/AIDS to be given a voice within the relevant institutions.
Several Act Up militants on the Commission correspond with prisoners who request our help. We meet with the head doctors of medical units within the prison system of the Paris region and even beyond (Châteauroux and Orléans). We work in close collaboration with International Prison Watch as well as with other associations involved with the prison system (AC !, Aides, Génépi, the Judges Union, etc.). In addition to helping prisoners with administrative procedures and ensuring respect of their rights, following particular cases allows us to identify bottle necks and practical difficulties that incarcerated persons encounter in current prison conditions. Beyond that, Act Up-Paris addresses public authorities (Prison Administration, the General Directorate for Health and IGAS) and members of Parliament to call for improvements in the living conditions of prisoners and the development of an alternative to incarceration for people suffering from serious illnesses.
