Despite a decade of scathing reports and government audits, the New York State Department of Correctional Services has failed to provide adequate H.I.V. prevention and health services, including condoms to all inmates, according to two new reports.
The state's AIDS Advisory Council, in one report, has concluded that prison health services, particularly for inmates with H.I.V., are so seriously deficient that authority for inmate health care should be transferred from the correction agency to the state's Department of Health. The panel report cited uneven, uncoordinated health services in many prisons, major shortages of health care staff and inadequate training.
And in a news conference yesterday, advocates for prisoners and people with AIDS intensified their call for condoms to be made available to all inmates. The advocates, led by the Latino Commission on AIDS, said a survey of 108 former inmates indicated that high levels of unsafe sex in prison posed a public health risk. More than 60 percent of the respondents said they had witnessed inmates having sex.
Of the 70,000 inmates in the state's 73 prisons, about 8,000 are estimated to be infected with H.I.V., the virus that causes AIDS. The state prison system has the highest rate of H.I.V. infection of any system in the country, about 1 percent of all H.I.V.-infected Americans.
A spokesman for the New York Department of Correctional Services, James B. Flateau, said yesterday that a sharp drop in AIDS-related deaths in the prisons over the last four years attested to the quality of care received by inmates. Mr. Flateau said the AIDS care budget in state prisons had increased by 66 percent since 1995, when Gov. George E. Pataki took office, contributing to an 85 percent decline in AIDS deaths during that time.
New York State prisons do not make condoms available except for conjugal visits. Advocates said yesterday that New York City and several other cities and states, including Washington, San Francisco, Vermont and Mississippi, had rules that ban sex in prisons, yet allow the distribution of condoms to inmates. The authorities at Rikers Island in New York City distributed 200,000 condoms last year, advocates said.
"They've been willing to accept the paradox that they can distribute condoms at the same time as keeping sexual activity illegal," said Steven Nesselroth, the director of the AIDS in Prison program for the Osborne Association, a group that focuses on criminal justice issues.
But Mr. Flateau said he did not anticipate a change in the condom prohibition. "We're not going to do that," he said, adding that condoms are a security threat because inmates and visitors can hide drugs and other contraband inside the condoms and in their body cavities.
He said the agency did acknowledge that some inmates have sex in prison. "We've never said they weren't, and those inmates risk giving themselves a death sentence and we have told them that," Mr. Flateau said.
Over the years, prison health services have been found inadequate by various groups and government agencies, including the New York City Bar Association, the Correctional Association of New York and the State Health Department, which twice has audited the corrections department.
The 17-member State AIDS Advisory Council first addressed the issue in 1989. The latest report was unanimously endorsed earlier this month by the council, which consists of appointees of the Governor and the Legislature. The panel includes doctors, lawyers, advocates and community service providers.
A spokeswoman for the State Health Department, Frances Tarlton, said yesterday that the correction agency had made strides in improving its health care services.
"We don't see any need for the health department to take over medical care in the state prisons," Ms. Tarlton said.