Sex, Drugs and HIV/AIDS in Prison

Janet Weston

L0052097 Three protestors stand on a pavement, one in the act of Credit: Wellcome Library, London. Wellcome Images Three protestors stand on a pavement, one in the act of throwing stands on a poster on the floor with the words 'fight aids'; also featuring a newspaper cutting relating to an article by Bernard Spilsbury; six condoms in their wrappers litter the poster which is an advertisement for Act up Manchester, a movement in support of education on HIV and AIDS within prisons. Black and white lithograph with blue. 19uu Published: [19--] Copyrighted work available under Creative Commons by-nc-nd 4.0, see

Wellcome Library, London

As I arrived at the Centre in March, David Cameron had recently made his widely-reported speech on the subject of prison reform. Prisons, as Cameron was at pains to point out, are rarely a popular topic for politicians. For historians, on the other hand, they’re probably more appealing. They can tell us about crime and punishment, daily life within institutions, and they offer fragments of life stories of the hundreds of thousands who pass between their gates.

But what can prisons tell us about health and medicine in the past? Healthcare in prisons – one of the Prime Minister’s goals for reform – will be the focus of my research over the next two years.

This is part of a large Wellcome Trust-funded project, ‘Prisoners, Medical Care, and Entitlement to Health in England and Ireland, 1850-2000′, which is led by Catherine Cox and Hilary Marland. This five year project will look at mental illness amongst both adults and juveniles in prison, the roles and responsibilities of prison doctors, the impact of political prisoners on prison medicine, the needs of women in prison, and more.

My strand, led by Virginia Berridge will explore how the prison services in England and Ireland responded to HIV/ AIDS. High rates of infection in prisons caused concern, as did the likelihood of high risk behaviours inside. Issues such as the provision of condoms and clean needles, encouraging or enforcing HIV testing, maintaining confidentiality, and providing appropriate care and support for those with HIV/AIDS were difficult to resolve.

At the School, the home of so much work on HIV/AIDS, potential sources are everywhere. Oral histories, along with a witness seminar to bring together some of the key figures in the story of HIV/AIDS in prisons, will be vital. This is rather different from my PhD, which took 1959 as its end-point – and addressed medical (mainly psychiatric) treatments for sexual offenders. Many of these efforts at treatment took place in prisons, though, and some of the dilemmas and obstacles to be found within the prison service remain the same.

‘Sex, Drugs and HIV/AIDS in Prison’ will, I hope, add a new dimension to the story of medical care for prisoners. Did the issues raised by HIV/AIDS act as a catalyst for change in prison medicine? How successfully was new policy implemented in practice? And, if this exceptional epidemic did encourage a greater acknowledgement of the human rights of prisoner-patients, or more imaginative attempts to address their present and future health, have these innovations endured?