The US Department of Homeland Security (DHS) should upgrade its care and treatment of immigrant detainees with HIV, Human Rights Watch said in a report released today. The organization charged that the agency has failed to meet its obligations to and respect the rights of its detainees with HIV. It fails to monitor the appropriate treatment of detainees with HIV, or even how many have HIV, and has substandard policies and procedures for providing life-saving care.
There are nearly 30,000 immigrants detained in hundreds of prisons, jails, and immigration detention centers throughout the United States.
"The US government has no idea how many of these immigrants have HIV or AIDS, how many need treatment, and how many are receiving the care that is necessary," said Megan McLemore of Human Rights Watch’s HIV/AIDS program.
The 71-page report, “Chronic Indifference: HIV/AIDS Services for Immigrants Detained by the United States", documents the experiences of HIV-positive detainees in immigration custody whose HIV treatment was denied, delayed, or interrupted, resulting in serious risk and often damage to their health. The investigation included interviews with current and former detainees, DHS and detention facility officials, and an independent medical review of treatment provided. Detention facilities which housed immigrants with HIV infection failed to consistently deliver anti-retroviral medications, conduct necessary laboratory tests, ensure continuity of care, and ensure confidentiality or protection from discrimination.
Contrary to international human rights obligations, constitutional protections, and best practice advisories, the Department of Homeland Security’s detention guidelines for HIV/AIDS care fail to meet both national and international standards for appropriate care, and the agency does little to enforce their own minimal standards.
“Although the US government ‘outsources’ much of its immigration detention to local jails and facilities across the country, it cannot evade its responsibility to protect the well-being, health and lives of HIV-positive immigrants,” said McLemore.
The report highlights the death of Victoria Arellano, a 23-year-old HIV-positive transgendered detainee who died in July 2007 after eight weeks in an immigration detention facility in San Pedro, California. Arellano was reportedly denied treatment and became gravely ill. Detainees in her housing unit repeatedly called to guards that she needed medical care, but she was left suffering in her bunk as her condition worsened. Finally taken to the facility clinic, she was taunted and ridiculed by staff. She told her cellmates before she died, “It was a nightmare.”
“The Department of Homeland Security needs to upgrade their policies and more closely monitor and ensure effective treatment for immigrants living with HIV or AIDS,” said McLemore. “Otherwise these individuals will continue to suffer, and even die, in the care of the US government.”
Additional examples highlighted in the report:
Charles B., a Lawful Permanent Resident from Jamaica, became resistant to 13 leading AIDS drugs during more than four years in immigration custody;
Anna F., a 61-year-old woman born in Germany, failed to receive medically indicated treatment to prevent pneumonia;
Peter R., a pharmacist by profession, received a complete dosage of AIDS medication in immigration custody only 65 percent of the time, leaving him at risk of developing resistance to the drugs he depends on for survival.
Jean P., fleeing violent persecution in Haiti, has an AIDS-related condition that left him blind in one eye, yet this condition is inadequately monitored in immigration detention;
Gloria M., an AIDS counselor in Chicago, was told by jail officials that “the state won’t pay” for her HIV medications.