POZ gets a lot of mail from prisoners with HIV. Every day the letters arrive, sometimes in stacks. They are easily recognized because the envelopes are usually stamped with warnings—“INMATE MAIL”—from prison officials and the handwriting is careful and intense.

Most detail inhumane conditions and treatment policies the writer has witnessed or experienced firsthand (AZT monotherapy, anyone? No, of course it doesn’t matter if you skip doses of your protease!). Others request legal help, and a large number are about difficulties in getting their hands on POZ. Many prison officials bar POZ because it empowers those under their watch, exposing inmates to information about the appropriate standards of care they deserve—and should insist upon.

The authorities usually claim POZ is pornographic. My favorites are those systems that specifically prohibit “male homosexual” material and use that as an excuse. Yet when we put former Playmate Rebekka Armstrong on our cover last June, she was banned as well.

In Florida and Virginia, POZ’s pro bono counsel Dan Johnston has been able to get prison policies banning POZ revised. Elsewhere, prisoners still go to great lengths to get their hands on POZ by having them sent to loved ones outside the prison. People who are in desperate need—truly, honest-to-God desperate need—still must struggle to get credible information about AIDS.

It is not easy to address prison issues. Journalists are seldom allowed access inside these facilities, whereas those who work for change within the system are as fearful of retaliation for speaking publicly as the prisoners themselves.

But we can no longer let our discouragement preclude action. The need for education and improved treatment in prisons has been shamefully neglected.  Prison work is the loneliest field of AIDS activism; prisoners with HIV barely register on the lowest scale of the American caste system. Only pennies from the billions of dollars raised for AIDS service organizations go to prison work; only a handful of community organizations have programs for prisoners.

Education programs for inmates can be uniquely effective.  Entering prison is often when someone “hits bottom,” when the opportunity is greatest to educate, rehabilitate, treat addictions and change destructive patterns.  

The question is whether the 90 percent of inmates with HIV who eventually return to the outside come out healthier and equipped with the tools to fight the epidemic, or return full of prison-created resistant strains of virus and brimming with an angry fury born of institutionalized abuse and neglect.

David Rothenberg founded the Fortune Society, a non-profit group that offers AIDS programs, counseling and job training to ex-offenders. In talking recently about the group’s founding, 30 years ago, he spoke almost wistfully: “Back then we were allowed to care and we felt obligated to challenge each other.”

It made me think of the early and mid 1980s, when we were compelled to care and obligated to challenge the system in order to survive. That compulsion and obligation has dissipated and, in regard to AIDS and prisons, probably wasn’t there in the first place.

Do you remember when you were afraid to ask about an old friend you hadn’t seen in a while for fear the news would come back that he had died? Do you remember obsessing over every bruise, pimple and blemish, convinced that KS had finally descended upon your house?

In those days, it was so easy to be driven by compassion and to demand the same of everyone. Anger at politicians, the media and drug companies fueled our activism. But in the way that Greenwich Village and the Castro District were the epicenters of the epidemic back in those early days, when we felt so ignored and dismissed, so is the prison system today.

The list of those ignoring the plight of prisoners with HIV is a long one, but sadly it now includes much of the generation of activists whose outrage when they were ignored birthed the activism that has kept so many of us alive.

We railed against those who could have helped back then, but who chose to do nothing. How will history judge us, we who stormed the NIH, transformed the FDA and shut down the New York Stock Exchange, but are absent when it comes to AIDS in prisons?

As my health has improved, I have felt freer than at any time in my life.  Yet, as I and others feel greater freedom, the epidemic is steadily moving deeper into the least free parts of our society.  Our passion, money and commitment must go behind those bars and stand with our infected and neglected brothers and sisters. To fail to join this fight is to allow history to record our activism as selfish, our indifference a function of privilege, and our claims to compassion a fraud.