Prisons, human rights, HIV, and other cheery subjects

Dr Janet Weston, London School of Hygiene and Tropical Medicine


As eagle-eyed trend-spotters at Social History Society annual conferences may have noticed, there has been a lot of work on the history of prisons of late. A good portion of this can be attributed to the Wellcome Trust-funded project, ‘Prisoners, Medical Care and Entitlement to Health in England and Ireland, 1850-2000’, which has been up and running since 2015, and has generated research into mental illness, maternal health, diet, prison doctors, solitary confinement, political prisoners, and more.

I was lucky enough to be a part of this project, and spent two years finding out about the impact of HIV/AIDS on prisons in these two jurisdictions. As I quickly learned, prisons were often singled out in the first decade of the epidemic as ‘breeding grounds’ for HIV infection.

This was not simply about sex between men in prison – popular histories of HIV/AIDS tend to focus on its impact on gay men, and we forget that intravenous drug use was the most commonly recorded mode of HIV transmission in cities like Dublin and Edinburgh. In fact, prisons prompted anxiety because they seemed to bring together the worst of all possible worlds: sex between men, certainly, but this alongside addiction and drug use, unsanitary conditions, and a population that was perceived as impulsive and prone to taking risks.

This population, perhaps unsurprisingly, did not generate any particular sympathy. Calls for more efforts to prevent HIV transmission within prisons did not dwell upon prisoners; instead, they talked about the ‘heterosexual epidemic’ that would ensue, once those infected behind bars were released and returned to their wives and girlfriends.

A heterosexual epidemic in the UK or Ireland did not materialise; what did emerge, in the 1990s, was a powerful connection between HIV/AIDS and human rights. The epidemic, with its heavy toll upon marginalised communities and the stigma and discrimination that poured forth, is credited with demonstrating that infringements of human rights have real health outcomes. Talk of human rights and HIV/AIDS became common, and took statutory form in the UK 1995 Disability Discrimination Act. Talk of prisoners’ rights did not follow suit.

In my recent article for Cultural & Society History, I’ve tried to think about some of the reasons why this emphasis on HIV/AIDS human rights did not translate into the prison setting. HIV and AIDS in prisons remained a concern, and debate rumbles on today about the provision of condoms and clean syringes to enable those in prison to protect their health.

There were practical problems to be sure: those in prison had few rights that could actually be enforced. But perhaps more significantly, prisoners were not seen as rational actors who would fulfil the responsibilities that accompanied rights. Even worse, they remained mostly silenced and invisible, especially amidst the ‘tough on crime’ rhetoric of the 1990s. Human rights didn’t work: what was more effective in improving healthcare for those in prison, in the end, was the requirement for ‘equivalence of care’ between prison and its surrounding community.

I’ve left the ‘Prisons Project’ now, but am continuing to think about these questions of rights, this time in the context of mental incapacity. And there’s lots still to be said about the history of prisons – as is being shown by projects at the University of Leicester on MNS disorders in Guyana’s jails and the transnational relationships between penal colonies as well as PhD projects at the Universities of Hull and York on courtroom and prison museums.


Read more in the Cultural & Social History article

SHS members can access the journal via this website here.

Read more blog posts by CASH authors here.


About the Author: Dr Janet Weston is a social historian based at the London School of Hygiene & Tropical Medicine, with particular interests in health and law. Her first book, Medicine, the Penal System and Sexual Crimes in England, 1919-1960s, was published by Bloomsbury in 2018, and she has also written about HIV/AIDS policy, public engagement, and dementia. Her current research is a Wellcome Trust-funded study of the history of mental incapacity, and some thoughts on incapacity in England in the mid-twentieth century will be out in the July 2019 issue of Medical History.  Her article, ‘Sites of Sickness, sites of rights? HIV/AIDS and the limits of human rights in British prisons’ was published online by Cultural & Social History on 11 March 2019.

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