For Megan McLemore, a longtime activist and attorney with the New York-based Human Rights Watch ( HRW ), the HIV epidemic in the United States is being fueled by the epidemic of mass incarceration.
But McLemore, a senior researcher in HRW's Health and Human Rights division, has contended that the criminal justice system is largely absent from local and national conversations about HIV prevention and treatment.
"If you look at the [National HIV/AIDS Strategy] for example, you'll see about housing and violence, for example, but you'll see very little about criminal justice," she said.
McLemore has focused her work on prisons and HIV/AIDS for several decades.
"I've always focused in my career on prisoner's rights and the rights of the most vulnerable people," McLemore added. "The HIV part came in when, in the '80s, I got involved as a volunteer in various community groups. Then I worked with some friends of mine who were working on a documentary on the global AIDS crisis in the late '90s and early 2000s. We really focused on the fact that the AIDS drugs were not getting to sub-Saharan Africa even though they were already in Europe and the United States. When I got to Human Rights Watch, they were looking for a consultant to work on HIV in prisons, so my background was right."
McLemore said that she began her work with prisoners when she was in law school. "This is a population that has been so marginalized that it is literally invisible," she said.
Her current work goes beyond focusing on long-term prisoners. Rather, she's most concerned with people who are cycling in and out of the jails on minor drug offenses, sex-work charges and other low-level offenses. De-criminalizing such offenses, according to McLemore and her colleagues, is essentially HIV prevention.
"They're going in and out of jail very regularly, and that interrupts their ability to adhere to HIV medication, and if they don't already have HIV, it raises somebody's risk of becoming HIV-positive," she said. "The instability that it causes in people's lives causes disruptions as they relate to housingthe evidence is vast how housing is key to HIV prevention."
Even an arrest can be significantly disruptive, McLemore added. "So we're looking at the entire spectrum, from an arrest, to cycling through the system and having a criminal record. We're trying to step back and look back at how the criminal justice system in the United States is influencing the epidemic. There's growing evidence that, at every stage, it's very harmful."
The work requires a multi-level approach to engage the different facets of the system, she said. "A few months ago I released a report on HIV services in Louisiana jails. So there's an entire document now that has Human Rights Watch recommendations having to do with keeping people out of jail in first place. So now I'm going to be deeply engaged in that report for the next few years with the Department of Public Corrections, with the Department of Public Health, with the Governor's Office. It's leading by leading and strategy by strategy."
HRW and partner organizations wrote a letter about the National HIV/AIDS Strategy's failure to address criminal justice issues. "I'm beating the same drum, but I'm beating it at different venues and different targets," McLemore said, adding that administration officials were at least responsive.
"We met with them and they agreed to look at them for the next version of the strategy. We continue to meet with CDC people and having ongoing discussions about it," she added. "The road to HIV prevention leads through the criminal justice system for all these vulnerable populations."
McLemore will be in Chicago Monday, June 6, speaking first at a brown-bag presentation, "35 Years on the Frontlines: Local, National and Global HIV/AIDS Prevention," at AIDS Foundation of Chicago ( AFC ), 200 W. Jackson St., 13th Floor, at noon.
Jim Pickett, director of advocacy for AFC will also speak along with Erik Glenn, executive director of Chicago Black Gay Men's Caucus. Kim Hunt, executive director of the Pride Action Tank, co-host of the event, will moderate. The program is free, but all guests must RSVP to Jackie Thaney at firstname.lastname@example.org . Guests should bring ID and allow time for security entrance procedures.