Officials of local jails and prisons, faced with increased worries about the transmission of AIDS, are beginning to set policies to protect inmates and employes from the disease.
Corrections officials in Maryland, Virginia and the District are in the final stages of deciding whether to isolate prisoners who are suspected of having been exposed to the acquired immune deficiency syndrome virus. Currently, there are no uniform rules for testing prisoners for exposure to AIDS.
The threat of AIDS behind bars is considerably greater than in the general population because many prisoners have been convicted of drug offenses. Persons who take illegal drugs by injection constitute a group at high risk of contracting AIDS.
"The jail issue is not a gay issue," said Jim Graham, director of the Whitman-Walker Clinic, a District health facility serving the homosexual community. "The incidence of AIDS in jails today is principally a result of IV intravenous drug abuse."
In the District, corrections officials say they will petition D.C. Superior Court this week to release one AIDS victim from their custody because they do not have the resources or staff to handle prisoners who have AIDS. The inmate is currently in a private room in a locked unit at D.C. General Hospital, where nurses have complained that a proper isolation environment does not exist.
"We don't have sinks in the rooms to wash our hands and we have to carry their feces and urine down the hall," said one of the unit's 12 nurses. "It's not that we mind taking care of these people, but we're worried that there's not the proper isolation."
Marilyn Stackhouse, a spokeswoman for the hospital, said its nursing director reviewed the unit's facilities and found them adequate. "There's not a problem with the isolation on the locked ward," she said.
Donald Soskin, health services administrator for the D.C. Department of Corrections, said the prisoner is one of two District inmates who have been diagnosed as having AIDS. The other died in the spring. Several other prisoners have been sent to D.C. General for tests, Soskin said. Others, who officials suspect have AIDS symptoms, are housed in the infirmaries at the D.C. Jail and the Lorton Reformatory, he said.
All prisoners entering the D.C. corrections system are given physical exams, but special blood tests that detect the presence of the AIDS virus are performed only on those who medical officers suspect have AIDS, Soskin said.
The city's policy on prisoners with AIDS, expected to be issued next month, is to include procedures for testing and isolating youth offenders as well as adults. Youths from at least two District facilities have undergone blood tests to check for exposure to the AIDS virus, according to corrections officials.
As is the case in many states, area prisoners diagnosed with AIDS currently are being transferred to hospitals for treatment. A more difficult problem, corrections officials say, is how to handle the growing number of prisoners who have been exposed to the virus or have AIDS-Related Complex (ARC), meaning that they have some of the symptoms of AIDS but do not have the disease.
Estimates from the federal Centers for Disease Control suggest that between 5 percent and 25 percent of persons exposed to the AIDS virus will develop the fatal disease.
"We are seeing more and more people all the time with a positive antibody test," said Dr. Robert Fry, medical director for the Virginia State Department of Corrections. "We will test anyone who has symptoms. It is a problem that is increasing and we have to develop the means to deal with it."
Maryland officials have not made final a policy on AIDS among prisoners, but a doctor who advises the state on health matters says that prisoners with AIDS will continue to be placed on a special hospital ward. Prisoners with ARC will be evaluated on a case-by-case basis, said Dr. Frank Polk of Johns Hopkins University.
In the District, officials of Teamsters Local 246, which represents the city's prison guards, are planning to meet this week to determine if protective clothing should be issued to guards, according to Ernie Jumalon, principal executive officer of the local. "If an inmate is attacked and bitten, that's a life-threatening situation" that guards must handle, he said.
While policies are being developed, corrections officials are conducting training sessions to educate employes about the disease.
Health educators from the Whitman-Walker Clinic recently instructed U.S. marshals, who escort federal prisoners, about AIDS transmission, and doctors from the D.C. Jail are holding seminars on AIDS during shift roll calls. In Virginia, brochures on the disease are being distributed to prisoners and guards.
The problem of AIDS among prisoners is under control, according to Soskin, but "there's certainly the potential for it becoming unmanageable. There's a measurable degree of anxiety and misconception."