Massachusetts Inmates Sue over New Rules on HIV Medication: HIV Patients Now Must Wait in Line

The process for distributing HIV medication in Massachusetts prisons is designed to save the state money by discouraging adherence with therapy regimens, charges a suit expected to be filed today in US District Court in Boston. The prison system and its medical provider, UMass Correctional Health, “can and have erected barriers to access in order to discourage adherence,” says the suit by five HIV-positive prisoners. HIV-positive inmates constitute 2 percent to 3 percent of the prison population, while antiretrovirals account for 20 percent of state spending on medications. Until February 2009, HIV pharmaceuticals were among the drugs in the prison system’s Keep On Person program, in which inmates store and take prescription medications in their cells. At that time, HIV medications were removed from the program and made available only in a medication line, requiring HIV-positive patients queue up at least once and perhaps several times per day. “The removal of HIV medications from the Keep on Person program is callous and extremely shortsighted, as patients who refuse or are unable to go to the med line, or who miss doses because of the chronic defects in the med line process, will become more sick,” says the suit. In response to a similar suit last year, lawyers for UMass said such changes in fact are made to increase compliance. For example, medical staff can ensure HIV-positive patients take their medication during a face-to-face encounter in the medication line. The change was “by no means fueled by discriminatory intentions,” the previous suit stated. Massachusetts’ previous HIV care regime included a case manager and allowed prisoners to hold a 30-day supply of antiretrovirals in a locked container in their cells, said Joel H. Thompson, a staff attorney for Prisoner’s Legal Services, the Boston advocacy organization representing the plaintiffs.