“Retention in care” on PrEP & ARVs IN PRISON.

Could the intentions be more obvious?

Before I start this post, I would like to acknowledge that there is a large variation of opinion among the general population as to the purpose of the incarceration of criminals and as to what rights they should forfeit upon imprisonment. I agree that there is necessarily a punitive aspect to incarceration; with some crimes, that is the only realistic outcome. However, I do not think that any individual, for any reason, ought to be allowed to forfeit their right to refuse medical treatments that they either do not want, do not understand, or are coerced into. That is a line we cannot cross.

I will also point out that this study in no way advertises the coercion of anyone into taking PrEP; however, the language and the continued promotion of this treatment has a coercive aspect that we ignore at our peril. Here’s the article summary.

If this isn’t the most one of the most accurate microcosms of the entire creepy authoritarian HIV AIDS story, I don’t know what to say. Check out this article about the administration of PrEP in the prison system:

PrEP Uptake, HIV Care Continuum Have Improved for Adults in Federal Custody

Is PrEP an implicit part of the punishment meted out with a prison sentence? One wonders.

Rates of HIV pre-exposure prophylaxis (PrEP) receipt, including initiation and continued treatment, have increased among adults in custody (AIC) in the US Federal Bureau of Prisons (FBOP), according to a study published in Emerging Infectious Diseases. The HIV care continuum was also shown to have improved in the previous 2 decades.

The number of acronyms is getting out of control—has anyone noticed that? It’s peculiar and seems to be adjacent to this bizarre modern contagion of completely reinventing language to obscure meaning. Let’s press on.

The CDC estimates that 13% of people living with HIV (PLWH) are undiagnosed, which makes ending the HIV epidemic difficult. HHS has launched a campaign to reduce the number of new infections of HIV by 2030 with the 4 pillars of diagnosis, treatment, prevention, and response.

Let me clear one thing up for the good people at the CDC. “Ending the ‘HIV’ epidemic” is highly unlikely to happen, since there is no evidence that “HIV” is contagious at all; in fact, there is plenty of evidence that a positive test is far more likely to be due to nonspecific antibody response to any of a myriad of conditions or to something genetically linked—the epidemiology is not only inconsistent with the epidemiology of AIDS, but with the epidemiology of a contagious agent at all. Furthermore, this language is deceptive, because it implies that all but 13% of “HIV positive” individuals are being treated, when it’s more like 60% that know their status that are on ARV treatment, meaning that only about one half of “HIV positive” individuals are “retained in care.” Also, what is up with the year 2030? Is the apocalypse nigh?

The rest of the article is just repetition of the same nonsense we’ve heard over and over again, so I won’t torture you with too many more quotes. Here is where we are reassured that these prisoners have total autonomy in their decision to be tested and to take medication. I hope their statements reflect the lived reality of these inmates. Emphasis is mine throughout.

Guidelines for treating AIC with HIV were established in 2004. All AIC are informed that HIV screening is part of their laboratory screening when they are entered into custody and can opt out if they prefer. If HIV is detected, treatment is started when the AIC is both willing and able to start therapy.

[…]

The rate of new HIV infections in custody is low, but prevention is a goal of the BFOP due to most AICs returning to their community.

I see now—inmates are being offered PrEP because they are going to be “returned to the community.” I’m sure there’s absolutely no potential for abuse here at all—this can’t possibly end with a scenario in which inmates are required to be tested and treated before “returning to their community,” or as a requirement of parole. We’re not there yet, so perhaps this is alarmism on my part. The following excerpt does nothing to assuage my fears.

PrEP is started in AICs approximately 30 days before they are released from custody to assess their response to treatment. All AIC taking PrEP are given a 90-day supply if they respond well to treatment. Uptake in AICs was encouraged by a multimodal strategy. A webinar was provided to discuss harm-reduction strategies with health care providers and a PrEP fact sheet was created to answer questions about how it should be prescribed. Strategies to increase uptake were also developed at individual FBOP institutions, including running clinics for AICs who will be released within 90 days.

When I first saw this article, I had assumed that this was about offering PrEP to inmates to prevent them from acquiring “HIV” while incarcerated, but that appears not to be the case, although the article does state that “Any AIC who requested PrEP could also receive it.” This particular study was focused on ensuring that soon to be released prisoners are strongly encouraged to be tested and then treated, no matter the result of their test. That’s how PrEP works. I hope to God that “retention in care” and “adherence” to a regimen of drugs that are intended to treat a condition that is absent in the patient (by somehow “preventing”—although there has been some concern even in the mainstream that PrEP might be “masking true positives”—more on that in an upcoming post) are not going to be included as conditions for parole, but I’m not optimistic. There are some quite sinister implications here.

And that’s all I have to say about that depressing story. As always, let me know what you think in the comments.

To support my work on Substack, please purchase my book for yourself or for a friend, and leave a review on Amazon. You can learn about efforts to ban my book here. You can also buy my new minibook Almost Cancelled.

If you’re a new reader and would like some background as to my views on HIV AIDS, including the “existence” question, please refer to this post and the links contained therein.