prison health news
-better health care while you are in and when you get out-

Issue 1, March/April 2003

We are on the outside, but we
were inside before. We’ve been
where you are now and know
what it’s like....and survived it.
We are ex-offenders talking
about health issues and trying
to bring about a positive
change for all people who are in
prison now or ever have been
in the past. This newsletter is
about all of us.
We will be talking about health
issues. For example, what is
good nutrition? Where can you
get services and information on
the outside? We want to take
your health questions seriously
and break down complicated
health information so that it is
understandable.
We’re also here to help you
learn to get better health care
within your facility and talk
about how to ask your health
questions. Don’t get frustrated.
Be persistent. In prison, it’s
often hard to get what you
want, but with health information, it doesn’t have to be
impossible. Join us in our fight
for our right to health care and
health information.
Read on...

In this Issue:

Soul On Ice by Vincent Abner, Sr., Books Through Bars, Contexts Collection

Who We Are....

Dear Readers.....................................1

What Does It Mean
To Be Healthy?..................................2

Words to Live By...............................3

Stages of HIV: How HIV
Works In the Body..........................4-5
Hepatitis C:
What You Should Know.................6-7

Write An Article!................................7

Resources
for People in Prison..........................8

From,
John, Shahiid, Brunilda, Les, Al, Subscribe!.........................................8
Samuel, and Jen
page 1

What
Does It Mean To Be Healthy?
by Laura McTighe

Our ideas and concerns about health
are shaped by our families, our communities, our societies, and our personal experiences. All these things
help us decide when we need to see a
doctor, what medicines are okay to
take, and when we need to go to a
hospital.
Many people in prison have put in
sick call slips that weren’t answered or
have seen doctors that gave aspirin for
any complaint. Your experiences will
shape your ideas about the health care
in the prison you’re in.
You Are Your Best Advocate.
While everyone has different ideas
and concerns about health, one thing is
true: you are your own best
advocate, because only you know
what is going on with your body. In
coming issues, we will talk about what
you can do to advocate for
yourself in prison. For now, we
want to give you the basics about
health, so you can best take care of
yourself.
The Body Is Good At Healing Itself.
There are constantly germs in the
environment and in our bodies. But
the good news is that in the majority
of cases, the body fights off illness
very well. Many times, you can get
better without having to see a doctor
or take medicines, because your
immune system takes care of the
illness.
When You Get Sick…
What you notice most when you get
sick are symptoms. Symptoms are
things you can feel, like a rash or
fever. But you can feel the same
page 2 symptoms from

different causes. For instance, a rash
is a symptom that can be caused by a
side effect from a medication, by an
allergy, by a fungal infection like ringworm, or by a sexually transmitted
disease (S.T.D.) like syphilis. All of
these causes need different
treatments.
The Bottom line…
If a symptom is bothering you or gets
worse, you need to put in a sick call
slip. You always need to see a doctor
if you have one or more of the following symptoms:
* Fever over 102
* A “cold” that lasts more than 2
weeks
* Diarrhea (loose stools) or vomiting
for more than 1 day
* Chest pain
* Difficulty breathing
* Unintentional weight loss
* Fever/weight loss/cough at the same
time
* Blood in stool (poop)
* Penis discharge or change in vaginal
discharge that burns, itches or has a
bad odor
* Sharp pains in or around your
stomach
* One-sided weakness, or slurred
speech
* Extremely bad headache
* Fainting or becoming unconscious
These symptoms can be signs of serious health problems. If you are experiencing one or more of these symptoms, write the symptom on your sick
call slip.
Any doctor that sees one of these
symptoms should take it seriously and
see you immediately.

Words
to Live By...
by a former inmate living with HIV

Take care of yourself. Make your
health your top priority. Ask for what
you need, don’t wait for someone to
take care of you. Advocating for your
health is a constant job, especially in
prison or jail.
Become educated about the HIV
virus, your medical condition, medical treatments and prevention. Find
out where you can get HIV-related
information while you’re in prison and
get on that mailing list. If one place
doesn’t write you back, write them
again, but write other places as well.
See if the prison library has any good
information. Pay attention to the date
the information was published: AIDS
information changes quickly; information from the late 1990s or later is
more reliable.
Join a support group if there is
one. If not, see if it’s possible to start
one. Find someone else who is living
with HIV/AIDS in prison who you can
trust to talk to.
Get to know the doctor or nurse
who knows the most about HIV
where you are and ask a lot of questions. Don’t take medications if you
don’t know why you’re taking them.
Ask about side effects and what the
medication is supposed to do for you.
Ask the doctor or nurse to explain any
words that you don’t understand. Bring
articles you have that may be helpful.
Don’t miss any doses. See if there is
any way to keep your meds in your
cell and train yourself to stick to the
schedule, no matter how hard that is to
do in the prison or jail.
Don’t wait to deal with having the
virus. Get tested, and if you are HIV
positive, search for any information
that you can get your hands on.

Before you are released, try to
make arrangements to see an experienced HIV doctor on the outside as
soon as you get out. Try to get the
prison/jail medical department to mail
your records to your new doctor, or at
least write up a summary with your
diagnosis, symptoms, test results and
medications. Keep this with you at all
times if you can.
Don’t accept no for an answer. Be
persistent, but not too persistent.
Remember that you can get more if
you are nice to people that you need to
be nice to. Use proper prison channels
to complain if you have to.
Don’t get anyone else infected.
Learn how to prevent HIV and only do
the things that are safe. You can get
HIV by having vaginal, anal or oral
sex without a condom; you can also
get HIV by sharing needles, using
dirty needles, and getting prison tattoos with dirty needles.
Keep a positive attitude. Having
HIV doesn’t mean you are going to get
sick or die in prison or jail. HIV treatments have turned HIV into a longterm treatable disease like diabetes. If
you take care of yourself, you can live
for 30 years or more with current HIV
treatments. As new and better HIV
treatments become available, people
with HIV will continue to be able to
live longer, healthier lives.
This newsletter will teach you about
living healthy with HIV—like, how the
immune system works and how good
nutrition and exercise can keep people
with HIV’s bodies strong. We will give
you real advice that you can use while
you are in prison. Between issues,
write to some of the resources on the
back page so you can get the most
information possible.
page 3

The
Stages of HIV: How HIV Works
by Laura McTighe

Even after 10 years of being
infected with HIV, about 50% of
people have no symptoms of any kind
and have never been on treatment for
HIV.
Thinking about Stages of HIV
In this issue, we will talk about how
HIV progresses in the body over time.
Think of these stages as general guidelines. These stages do not guarantee
what is going to happen to every person, but can help them pick priorities
and figure out if they are getting the
right type of care and services.
There is no way to look into a crystal
ball and predict if or when someone
will get sick, because HIV progresses
differently in everyone. In fact, we
know lots of people who have gotten
sick from HIV, and are able to get
healthy again with HIV treatments.
Most people don’t need to go on
treatment right away just because they
have HIV. We will talk more about
HIV treatment in future issues, but
write to us if you have questions.
1. HIV Transmission
The virus is passed from one person
to another through blood-to-blood and
sexual contact, or from HIV-infected
women to babies before or during
birth, or through breast feeding. HIV
can enter the body through the anus or
rectum, the vagina, the penis, the
mouth, other mucous membranes
(eyes or inside of nose), cuts or sores,
or through a vein (intravenously). You
can get HIV by having vaginal, anal or
oral sex without a condom, sharing
needles, using dirty needles, and getting prison tattoos with dirty needles.
HIV is NOT transmitted through
casual, everyday contact like shaking
hands.
page 4

2. Acute Infection (Early Infection)
Right after someone is infected with
HIV, the virus multiplies quickly, and
spreads to all parts of the body. This
period is known as acute or early
infection. Acute means intense. The
immune system hasn’t kicked in yet to
bring HIV under control, so the
amount of HIV in the body is very
high. Some people will get severe flu
symptoms, including rash and fever.
3. Seroconversion
Soon after initial infection, the
immune system kicks in and begins
fighting HIV. This process is called
seroconversion. Sero means blood and
conversion means change. The blood
changes because the immune system
makes special HIV antibodies that recognize HIV and fight HIV. Antibodies
are things that the immune system
makes to fight a specific germ, which
means that HIV antibodies will only
work on HIV and your body will only
make these HIV-specific antibodies
once you have been exposed to HIV.
Most HIV tests only work after you
have seroconverted, because these
tests look for HIV antibodies not the
virus itself. It can take up to 6 months
for the body to make HIV antibodies,
so you need to wait and get tested a
full 6 months after doing something
that puts you at risk for HIV. During
these 6 months, you can infect other
people even though you won’t test
HIV positive. It is important to use
condoms and only use clean needles.
4. Chronic Infection
In almost all cases, the body is
unable to rid itself of HIV after acute
infection and keeps trying to fight it.
The infection becomes chronic, or
life-long. Over time, HIV damages the

in the Body

immune system and makes the body
less able to fight off germs and infections. Still, someone can have a chronic HIV infection for many years without getting sick, or even knowing that
they have HIV.
5. An AIDS Diagnosis
Medically, an AIDS diagnosis is
defined as having less than 200
T-cells or having an opportunistic
infection.
T-cells are part of the immune system; they lead the attack against infections like HIV. When a person has
fewer T-cells, their immune system is
weaker. When someone gets an AIDS
diagnosis, it doesn’t mean that their
immune system has stopped working
and they’re going to get sick. An
AIDS diagnosis is a warning sign, like
a car’s “service engine soon” light.
When this light goes on, the car isn’t
about to stop running; the car needs a
tune-up. An AIDS diagnosis tells
someone: keep an eye on your health
because you might be at risk for getting sicker, and you should start HIV
treatments or other treatments to keep
you from getting infections.

Opportunistic infections (OIs) are
infections that cause illness in people
with weak immune systems. OIs are
the illnesses of AIDS. If a person’s Tcells are below 200, they are at greater
risk for getting OIs. It is very rare for
people with more than 200 T-cells to
have OIs. Most of the time, people
with OIs have less than 100 T-cells,
and especially less than 50 T-cells. A
doctor can prescribe medications to
prevent someone from getting OIs if
their T-cells go below 200.
The best long-term way to prevent
OIs is to strengthen the immune system. For most people, HIV treatments
slow down the progress of HIV in the
body. Starting HIV treatments is a big
decision. Keep an eye out for articles
on Starting HIV Treatments, so you
can be informed and make the decision that is right for you.
Remember!
Everyone’s body is different so HIV
progresses differently in every person.
DON’T PANIC if you find out you
are HIV positive. Educate yourself
about HIV. You can live for decades if
you take care of yourself.

HIV in Prison, Books Through Bars, Contexts Collection. From the artist: “The illustration I did shows
a prisoner with HIV who is suffering from the disease and also having psychological
page 5
problems and his situation looks even more dire now that he is in prison.”

Hepatitis
C: What You Should Know
by John S. James

Hepatitis C is a serious liver disease
caused by a virus. About 2% of all
Americans are infected with hepatitis
C. In prison, hepatitis C rates are much
higher: between 12% and 35%
depending on the prison. Hepatitis C
damages the liver over time, so the
liver is no longer able to keep doing
all of its jobs in the body. Most people
with hepatitis C do not have any signs
of liver damage for 10 years or more.
What does the liver do?
Everything we breathe, eat or drink,
and every medication we take is
processed through the liver. The liver
filters everything we take into our bodies and takes out the things that can
make us sick (called toxins), and turns
all these toxins into bile, which breaks
down the fatty and fried foods we eat.
The liver also makes proteins to build
and keep muscles, stores vitamins and
minerals for when we need extra energy, and controls hormone levels.
Hepatitis C and the Liver
In the United States, at least 4 million
people have been exposed to hepatitis
C, and 2.7 million of them have developed chronic (long-term) liver disease.
Many people with chronic liver infection will have no symptoms of liver
disease or will progress very slowly.
About 15% of people with hepatitis C
will develop cirrhosis (serious liver
damage) over a period of 20 to 30
years. Without treatment, about 3% of
those infected will eventually die of
cancer caused by the virus.
No one knows why some people are
able to clear hepatitis C from their
bodies without treatment and others
develop chronic infection. There are
also questions on why liver disease
progresses faster in some
page 6
people than in others.

What we know: when more toxins
come into the body, the liver has to
work harder to filter out the toxins, so
liver disease progresses faster. For
example, drinking a lot of alcohol
makes hepatitis C liver disease worse.
We also know: HIV makes hepatitis
C worse. About 1/4 people with HIV
also have hepatitis C. Doctors recommend that everyone with HIV should
get tested for Hepatitis C. The treatment guidelines for hepatitis C and
HIV are different from the guidelines
for hepatitis C alone. Next issue, we
will focus on hepatitis C and HIV.
Who is at risk for hepatitis C?
Hepatitis C is passed from one person to another through blood-to-blood
contact. You can get hepatitis C by
sharing needles, getting prison tattoos
with dirty needles, sharing personal
items like a razor or toothbrush, and
having sex without a condom. Casual
contact cannot transmit hepatitis C.
There is no vaccine for hepatitis C.
(There are vaccines for hepatitis A and
hepatitis B, and many people with hepatitis C should get them.) If you have
once been infected with hepatitis C,
you can be infected again. You do not
develop an immunity to hepatitis C
because you have been infected once.
Tests and Treatments for hepatitis C
Everyone with hepatitis C should get
care from an experienced doctor . A
doctor can help you monitor how
strong your liver is and help you
decide if treatment is right for you.
There are several tests that can help
you determine how damaged your
liver is. Blood tests look at levels of
enzymes and other substances the liver
produces. Blood tests tell you how
inflamed your liver is, but they don’t
determine how much damage the virus

has done to your liver. A biopsy is the
best available tool for determining how
damaged your liver is. To do a biopsy, a
doctor puts a thin needle in your liver,
draws out some cells, and looks at them
under a microscope. Biopsies are serious
procedures and can be very painful. If
you need a biopsy, make sure you go to
an experienced doctor.
There are also tests that help determine
how well you will respond to treatment.
There are at least six main kinds of hepatitis C virus, called genotype 1 - genotype
6. The genotype is determined by a special blood test. Genotype 1 is the most
common in the USA, and is hard to treat.
Not everyone with Hepatitis C needs to
take medicines. Current treatment works
well about half of the time, and often has
unpleasant or dangerous side effects, like
flu symptoms, depression, and low counts
of red blood cells or white blood cells that
make you feel tired and weak.
Treatment for genotype 1 lasts 48 weeks,
usually with a combination of two medicines, interferon and ribavirin. Genotypes
2 and 3 require 24 weeks of treatment
with the same medicines. Treatment for
genotype 2 or 3 is more likely to be successful than treatment for genotype 1.
Hepatitis C treatments work best in people who have had hepatitis C for a shorter
time, who have a smaller amount of hepatitis C virus in their blood, or who do not
have liver cancer. People with advanced
liver disease often can’t be treated at all,
because doctors believe the medicines
might do more harm than good. This may
change as better medicines are found.
In the Future...
Scientists are making rapid progress, and
better medicines will become available in
the next several years. So those who can
wait for treatment may want to do so,
because treatments will improve soon.

write an article!

We have gotten lots of
requests for articles already, and
we know that everyone who
reads this newsletter will have
questions or his or her own
story to tell.
If you have advice for other
prisoners dealing with health
issues, write to us. We will feature you in “Words to Live By.”
If you have a question, write to
us. We will write you back and
may publish an article on your
question in Prison Health News.
If you want to write an article
on something you think is important for prisoners’ health, send it
and we will consider publishing
it in Prison Health News. You
can also write us first to discuss
ideas for articles.
If you want your name kept
confidential, you can sign your
article with your first name or
“anonymous.”
In coming issues, we will cover:
* Nutrition,
* Exercise,
* Getting Support While You Are
Incarcerated,
* How to Advocate for Yourself,
* HIV Treatments,
* Hepatitis C Treatments,
* Treatment strategies for HIV
and hepatitis C Co-infection,
* Depression,
* Getting Out,
* Staying Clean When You Get
Out,
* Welfare, Food Stamps, and
Medical Assistance,
* Housing,
and much more!
page 7

resources
for people in prison
If you need help while you are in, or when you get out, contact:
In Philadelphia, PA

Philadelphia FIGHT
1233 Locust Street, 5th Floor
Philadelphia PA 19107
(215) 985-4448--no collect calls
Contact: Laura McTighe

In New York City, NY

Women Prison Association
& Home Inc.
175 Remsen Street, 9th Floor
Brooklyn, NY 11201
(718) 797-0300--for collect calls from
New York Jails/Prisons
(718) 637-6818--no collect calls
Contact: Leah Bundy

In Miami, FL

In San Francisco, CA

Continuum Springboard
225 Golden Gate Avenue
San Francisco, CA 94102
(415) 823-0414 --no collect calls
(415) 823-0415--no collect calls
Contact: Helen Lin or
Charlie Wilson

In Houston, TX

Houston Montrose Clinic
215 Westheimer
Houston, TX 77006
(713) 830-3000--no collect calls
Contact: Chris Jimmerson
Every organization on this list provides case management, medical care
and support services for people when
they get out of prison. Most of these
organizations specialize in care for
people with HIV. Every organization
distributes Prison Health News.

Care Resource, Miami
225 N.E. 34th Street
Miami, FL 33137
(305) 573-5411--no collect calls
Contact: Pedro Torres
If you need resources in a city not listed here, write to us!
We will help you tack down anwers to your specific questions.
Write to us if you know a great organization that is missing from this list.

If you need information while you are in, contact:
National HCV Prison Coalition
Project Inform

Outreach and Education Department
205 13th Street, Suite 2001
San Francisco, CA 94103-2461

Hepatitis C Awareness Project
PO Box 41803
Eugene, OR 97404

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page 8

Edited By:
Laura McTighe,
John S. James,
Kimberly Rogers,
Katie Krauss,
John, Shahiid,
Brunilda, Les, Al,
Samuel, & Jen
We are grateful for
financial support from
Boehringer Ingelheim
and Orthobiotech

newsletter & information on hepatitis C
*free to prisoners

2400 NW 80th St. #148
Seattle, WA 98117

newsletter on prisoner rights&court rulings
*sample issue $1. unused stamps OK.

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If you would like to have Prison
Health News mailed to you, write to:

Prison Health News
c/o Philadelphia FIGHT
1233 Locust Street,
5th Floor
Philadelphia PA 19107

All subscriptions are free, and are
sent First Class.