Transitions Clinic Network (TCN) is a network of community health clinics that serve returning community members. TCN clinic programs are led by community health workers (CHWs) with lived experience of incarceration and reentry who support TCN patients with their healthcare and reentry. TCN hosts a monthly Frequently Asked Questions (FAQ) column. This column is a space where we answer questions about healthcare and empower individuals to prepare for healthy reentry. This month we are writing about HIV — how to prevent, identify, and treat.
What is HIV?
Human immunodeficiency virus (HIV) is a virus that attacks the immune system so the body cannot defend from other infections or diseases. This virus can be treated buy not cured. HIV is spread by certain body fluids, most commonly through unprotected sex, sharing needles or syringes, or childbirth. Some symptoms of HIV include fever, fatigue, swollen lymph nodes, diarrhea, and weight loss. If it is not treated, HIV can weaken the body and become acquired immunodeficiency syndrome (AIDS), which can be life-threatening.
MYTH: You can get HIV from kissing or holding hands.
FACT: You cannot get HIV from saliva, from touching skin surfaces, or from sharing objects like toilet seats. It is passed through blood, semen, vaginal fluids, rectal fluids, or breast milk.
MYTH: Only certain people get HIV.
FACT: HIV affects everyone. People of all genders and sexualities can get HIV.
MYTH: Medications can cure HIV.
FACT: HIV can be treated but not cured. Treatments will be required for life to stay healthy. Medications like PrEP and PEP can also help prevent you from getting HIV if you are high risk or exposed.
What are PrEP and PEP?
PrEP (Pre-exposure prophylaxis) is an HIV-prevention medication. It reduces the risk of getting HIV through unprotected sex by 99% and the risk of getting it through sharing drug-injection devices by 74%. Because HIV cannot be cured, stopping the spread of HIV is important to keep you and those around you safe. PEP (post-exposure prophylaxis) is a medication you can take immediately after exposure to HIV to reduce your chances of getting the virus. You must take it within 72 hours of exposure to HIV. It can reduce the risk of getting the virus by up to 80%. (All statistical information on HIV, PrEP, and PEP is from the Centers of Disease Control and Prevention.)
What services for HIV are available in prison?
You can get tested and treated for HIV through medical services at CDCR. All patients at CDCR are offered HIV testing to check for the virus (called “screening”). You can also request testing. You may want to get tested more often if you have shared needles
or had unprotected sex. If you are living with HIV, treatment is important and you can receive medications to treat HIV while inside. Medications (called ART — Antiretroviral Treatment) can help you stay healthy and prevent spreading HIV to others. Most people can get the virus under control in six months with consistent HIV medications.
Unfortunately, you cannot get PrEP or PEP in prison — you must wait until you get out to get this preventative care. However, here are other steps you can take inside to prevent HIV: use condoms during sex and new needles/syringes for drug injection when possible and avoid getting new tattoos or piercings while incarcerated.
What services for HIV are available in the community?
When you get out, you can get many services in the community, including testing, treatment (ART), and prevention (PEP, PrEP, and harm reduction supplies like syringes and condoms). Services will differ by health clinic in the community. Some clinics have HIV-specific programs with lots of medical and social services. Some clinics may have doctors who do PrEP/PEP but others may not. Make sure to ask for what you want to find out if the clinic can meet your specific needs.
If you want to be tested for HIV, you can ask:
“Can I get tested for HIV? I think I may have been exposed or I want to make sure I’m healthy.”
If you want to see a medical provider to get PrEP and PEP, you can ask:
“Do you have PrEP or PEP? I want to make sure I don’t get HIV. Would you be able to write me a prescription?”
If you are living with HIV and you need to start treatment, ask the doctor:
“I have HIV and need treatment. How can we begin that treatment?
If you are already on HIV treatment, ask the doctor:
“I have HIV and am already receiving treatment. How can I continue it?”
What should I know before I leave prison?
You will meet with health care staff at CDCR to plan for going home. You should also sign up for Medi-Cal insurance. You will get 30 days of medications when you get out, but make sure to make a medical appointment as soon as possible!
Remember, preventing HIV is key and you can take steps to prevent it. Talk openly with your sexual partners about health and use protection for intercourse, avoid sharing needles or syringes, and consider getting PrEP or PEP from a community provider upon release. Remember that your health can also impact the health of those around you, both inside and outside of prison, and your daily health choices helps keep you and your community healthy.
If you are living with HIV, find a doctor you can work well with and stick with your treatment! Know that you are not defined by your status. There are effective treatment options available that can help you live a full, happy and healthy life.
If you have healthcare-related questions about reentry, feel free to write us at: Transitions Clinic Network, 2403 Keith Street, San Francisco, CA 94124. Or call our Reentry Health Hotline today at (510) 606-6400 to speak with a CHW and to see if there’s a TCN program in your community of return. We accept collect calls from CDCR. We are open Monday to Friday, 9am-5pm.