Dead Man Walking

I was reading the New York Times this morning when I came across this article, which is directly related to the topic of my term paper: continued associations of HIV/AIDS with death. The article reveals the presence of institutionalized stigmatization of individuals living with HIV in the prison system in Alabama and South Carolina. Despite the fact that airborne methods of transmission were debunked in the early days of the disease– back in the ’80s, when so little else about HIV/AIDS was understood– HIV positive inmates are prevented from working with food and segregated from the rest of the general prison population, including at mealtimes. Prisoners with HIV are prevented from transferring to prisons closer to their families, and, until recently, were barred from prison church services. Perhaps most disturbingly (and most relevant to my paper, as well as to the topic of this blog), one HIV positive inmate reported that guards would call out “dead man walking” when he passed through the halls. This is despite the fact that, with current treatments for HIV (while there is no cure and no vaccine, there are effective treatments), a person can live a relatively normal, healthy life, and is more likely to die with HIV than from HIV. With proper treatment, the amount of virus in a person’s system can be reduced to nearly undetectable levels (meaning that it is difficult to spread the virus to another person), and the progression of the disease to AIDS can be all but halted. In other words, modern medicine has made it entirely unnecessary (and entirely unethical as well) to treat people with HIV any differently than people without the virus, even in a prison setting.

And yet, misconceptions about the disease persist. People (yes, even outside of the Alabama and South Carolina prison systems, though I wish I could say otherwise) still think of HIV as though it was the plague. This is not to downplay the seriousness of this disease– it is a very serious issue, especially in Africa, where treatments are not  generally available, and where the death toll is absolutely devastating. But in the United States, the rate of people dying from HIV has fallen sharply since the early days of the epidemic, and continues to fall, even as perceptions of HIV remain very much the same.  These unchanging perceptions, exemplified by the policies of the prison systems in the article, provide a fascinating insight into how we associate things with death, and the rigidity of those associations, even as other cultural circumstances change.

Rachael Cogbill