This article describes the plight of people living with HIV held in United States Immigration and Customs Enforcement (“ICE”) custody and argues that “ICE’s detention guidelines and stated goals are not conducive to managing the medical needs of those living with HIV or AIDS.” The author contends that the Department of Homeland Security (DHS) should establish enforcement mechanisms that ensure detention centers meet an acceptable level of care, and discusses various legal and policy solutions that have been proposed by advocates and implemented in non-immigration detention settings.
The author notes that there have been multiple incidences where detainees with HIV died of HIV-related causes because they failed to receive appropriate treatment and instead were offered Tylenol or aspirin in an ICE facility. Detainees with HIV often receive unequal treatment due to the lack of uniform guidelines for treatment of HIV in detention facilities. Because the guidelines for medical treatment of ICE detainees do not carry the force of law, there are few repercussions when detention centers fail to provide adequate medical care.
The author points out several arguments in support of existing ICE health care standards, including that many United States citizens lack access to health care, that American taxpayers should not be forced to pay for the medical care of individuals who are being deported, and that some detainees receive better health care in an ICE facility than they would in their home country. While litigants have seen “mixed results” when bringing claims for their poor treatment in detention facilities, the author believes that “advocacy strategies to improve access to AIDS care seem promising.” Possible solutions to the issue include the adoption of DHS medical standards as federal regulations or a proposal by Congress to adopt effective medical standards as federal regulations. The author also suggests that ICE could subcontract with local HIV service providers, offer discretionary medical releases, or release detainees with HIV into Alternative Detention Programs.