Jail is Not a Solution to Public Health Problems

By Allison Glass
Healthy and Free Tennessee, State Director

Right now, many communities in Tennessee are facing issues with drug use and addiction.  This is especially true in areas where people are dealing with extreme poverty and joblessness.  Substance use is an escape and a coping mechanism for people in our state who are truly struggling.  

We are also one of the states with the highest number of new HIV diagnoses. Southern states have the largest percentage of people living with the disease and the most people dying from it.  When this is coupled with the decision of Tennessee not to expand Medicaid and the fact that so many people are having a difficult time making ends meet and being able to pay for health care expenses, we are looking at a crisis.  

These are both serious challenges that demand strong public health responses and yet sadly, people are being criminalized rather than supported.  Jail is not a solution to public health problems, but increasingly Tennessee is relying on a carceral approach to these very real health concerns.    

In 2014, the Tennessee state legislature pushed and Governor Haslam signed a law that has led to the arrest and incarceration of women alleged to have used controlled substances during pregnancy.  It says that a pregnant woman or a new mother can be thrown into jail if she gives birth to a baby who was harmed as a result of exposure to narcotics.  Sponsors claimed it was aimed at encourage women to seek treatment, but in fact it pushes services even further out of reach.   

The pregnancy criminalization law has resulted in the arrest of more than 30 women across the state. It has torn mothers away from their young children and made them scared to seek care. If a pregnant woman or a new mom in Tennessee has a problem with drug use, she needs health care and support. She does not need handcuffs. Such a punitive policy causes far more harm than good.  It does not help promote the health of women or their babies.  

Fortunately, we have a chance to get rid of this harmful law during the 2016 session when it comes up for a sunset.  However, this is not only law on the Tennessee books where threats and punishment are taking the place of support and health care.

Tennessee is one of 32 states with criminal laws that punish people for exposing another person to HIV.  This includes instances where there is no actual transmission, a meaningful risk that transmission could occur or any intent to harm.  Most transmission occurs when a person does not know they are infected, a consequence of a lack of information, difficulty getting tested and the stigma that surrounds HIV and AIDS pushing people to avoid getting tested.  

Sadly, the laws criminalizing HIV and AIDS are not just laws or cases from years gone by.   This past July, Michael Johnson was sentenced by a Missouri court to 30 years under a law similar to Tennessee’s policy.  

Laws that are about fear and punishment do not help a pregnant woman who is using drugs to seek out treatment or to feel safe to talk with her health professional and they do not help to improve the public’s awareness about self-care and prevention or to ensure access to testing services.  These laws are the antithesis of any recommendations from health professionals or people trained to support people living with HIV and/or struggling with drug use.   That is why major medical associations oppose laws that criminalize people based on HIV status or drug use during pregnancy.  

In addition to going against evidence based, best practices these policies are also discriminatory.  In states with laws that punish women for alleged drug use during pregnancy, it is low-income women and women of color who are disproportionately tested and arrested.  Black, gay men and transgender people of color are harmed most by laws that criminalize HIV status.  

We know that these laws have been utilized in cases where women were in violent relationships.  While we absolutely must address violence against women living with HIV and AIDS and the intersection with sexual and domestic violence, laws that criminalize individuals based on their status simply are not the answer.  

We can do better than judging and jailing people. From Medicaid expansion and funding for treatment and prevention of HIV to increased access to affordable drug treatment options to improved availability of trauma informed care for survivors of violence there are effective, evidence based ways to address public health challenges facing our communities – policies and programs that will not criminalize people and damage and destroy individuals and families.    

Allison Glass is the State Director of Healthy and Free TN, a statewide coalition aimed at ensuring that each person is able to manage their sexual health and protecting reproductive freedom.  They are leading the campaign to get rid of the pregnancy criminalization law and in working in partnership to modernize the laws dealing with HIV/AIDS in Tennessee. 

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