[Congressional Record Volume 155, Number 46 (Tuesday, March 17, 2009)]
[House]
[Pages H3459-H3463]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                    STOP AIDS IN PRISON ACT OF 2009

  Ms. WATERS. Mr. Speaker, I move to suspend the rules and pass the 
bill (H.R. 1429) to provide for an effective HIV/AIDS program in 
Federal prisons.
  The Clerk read the title of the bill.
  The text of the bill is as follows:

                               H.R. 1429

       Be it enacted by the Senate and House of Representatives of 
     the United States of America in Congress assembled,

     SECTION 1. SHORT TITLE.

       This Act may be cited as the ``Stop AIDS in Prison Act of 
     2009''.

     SEC. 2. COMPREHENSIVE HIV/AIDS POLICY.

       (a) In General.--The Bureau of Prisons (hereinafter in this 
     Act referred to as the ``Bureau'') shall develop a 
     comprehensive policy to provide HIV testing, treatment, and 
     prevention for inmates within the correctional setting and 
     upon reentry.
       (b) Purpose.--The purposes of this policy shall be as 
     follows:
       (1) To stop the spread of HIV/AIDS among inmates.
       (2) To protect prison guards and other personnel from HIV/
     AIDS infection.
       (3) To provide comprehensive medical treatment to inmates 
     who are living with HIV/AIDS.
       (4) To promote HIV/AIDS awareness and prevention among 
     inmates.
       (5) To encourage inmates to take personal responsibility 
     for their health.
       (6) To reduce the risk that inmates will transmit HIV/AIDS 
     to other persons in the community following their release 
     from prison.
       (c) Consultation.--The Bureau shall consult with 
     appropriate officials of the Department of Health and Human 
     Services, the Office of National Drug Control Policy, and the 
     Centers for Disease Control regarding the development of this 
     policy.
       (d) Time Limit.--The Bureau shall draft appropriate 
     regulations to implement this policy not later than 1 year 
     after the date of the enactment of this Act.

     SEC. 3. REQUIREMENTS FOR POLICY.

       The policy created under section 2 shall do the following:
       (1) Testing and counseling upon intake.--
       (A) Medical personnel shall provide routine HIV testing to 
     all inmates as a part of a comprehensive medical examination 
     immediately following admission to a facility. (Medical 
     personnel need not provide routine HIV testing to an inmate 
     who is transferred to a facility from another facility if the 
     inmate's medical records are transferred with the inmate and 
     indicate that the inmate has been tested previously.)
       (B) To all inmates admitted to a facility prior to the 
     effective date of this policy, medical personnel shall 
     provide routine HIV testing within no more than 6 months. HIV 
     testing for these inmates may be performed in conjunction 
     with other health services provided to these inmates by 
     medical personnel.
       (C) All HIV tests under this paragraph shall comply with 
     paragraph (9).
       (2) Pre-test and post-test counseling.--Medical personnel 
     shall provide confidential pre-test and post-test counseling 
     to all inmates who are tested for HIV. Counseling may be 
     included with other general health counseling provided to 
     inmates by medical personnel.
       (3) HIV/AIDS prevention education.--
       (A) Medical personnel shall improve HIV/AIDS awareness 
     through frequent educational programs for all inmates. HIV/
     AIDS educational programs may be provided by community based 
     organizations, local health departments, and inmate peer 
     educators. These HIV/AIDS educational programs shall include 
     information on modes of transmission, including transmission 
     through tattooing, sexual contact, and intravenous drug use; 
     prevention methods; treatment; and disease progression. HIV/
     AIDS educational programs shall be culturally sensitive, 
     conducted in a variety of languages, and present 
     scientifically accurate information in a clear and 
     understandable manner.
       (B) HIV/AIDS educational materials shall be made available 
     to all inmates at orientation, at health care clinics, at 
     regular educational programs, and prior to release. Both 
     written and audio-visual materials shall be made available to 
     all inmates. These materials shall be culturally sensitive, 
     written for low literacy levels, and available in a variety 
     of languages.
       (4) HIV testing upon request.--
       (A) Medical personnel shall allow inmates to obtain HIV 
     tests upon request once per year or whenever an inmate has a 
     reason to believe the inmate may have been exposed to HIV. 
     Medical personnel shall, both orally and in writing, inform 
     inmates, during orientation and periodically throughout 
     incarceration, of their right to obtain HIV tests.
       (B) Medical personnel shall encourage inmates to request 
     HIV tests if the inmate is sexually active, has been raped, 
     uses intravenous drugs, receives a tattoo, or if the inmate 
     is concerned that the inmate may have been exposed to HIV/
     AIDS.
       (C) An inmate's request for an HIV test shall not be 
     considered an indication that the inmate has put him/herself 
     at risk of infection and/or committed a violation of prison 
     rules.
       (5) HIV testing of pregnant woman.--
       (A) Medical personnel shall provide routine HIV testing to 
     all inmates who become pregnant.
       (B) All HIV tests under this paragraph shall comply with 
     paragraph (9).
       (6) Comprehensive treatment.--
       (A) Medical personnel shall provide all inmates who test 
     positive for HIV--
       (i) timely, comprehensive medical treatment;
       (ii) confidential counseling on managing their medical 
     condition and preventing its transmission to other persons; 
     and
       (iii) voluntary partner notification services.
       (B) Medical care provided under this paragraph shall be 
     consistent with current Department of Health and Human 
     Services guidelines and standard medical practice. Medical 
     personnel shall discuss treatment options, the importance of 
     adherence to antiretroviral therapy, and the side effects of 
     medications with inmates receiving treatment.
       (C) Medical and pharmacy personnel shall ensure that the 
     facility formulary contains all Food and Drug Administration-
     approved medications necessary to provide comprehensive 
     treatment for inmates living with HIV/AIDS, and that the 
     facility maintains adequate supplies of such medications to 
     meet inmates' medical needs. Medical and pharmacy personnel 
     shall also develop and implement automatic renewal systems 
     for these medications to prevent interruptions in care.
       (D) Correctional staff and medical and pharmacy personnel 
     shall develop and implement distribution procedures to ensure 
     timely and confidential access to medications.
       (7) Protection of confidentiality.--
       (A) Medical personnel shall develop and implement 
     procedures to ensure the confidentiality of inmate tests, 
     diagnoses, and treatment. Medical personnel and correctional 
     staff shall receive regular training on the implementation of 
     these procedures. Penalties for violations of inmate 
     confidentiality by medical personnel or correctional staff 
     shall be specified and strictly enforced.
       (B) HIV testing, counseling, and treatment shall be 
     provided in a confidential setting where other routine health 
     services are provided and in a manner that allows the inmate 
     to request and obtain these services as routine medical 
     services.

[[Page H3460]]

       (8) Testing, counseling, and referral prior to reentry.--
       (A) Medical personnel shall provide routine HIV testing to 
     all inmates no more than 3 months prior to their release and 
     reentry into the community. (Inmates who are already known to 
     be infected need not be tested again.) This requirement may 
     be waived if an inmate's release occurs without sufficient 
     notice to the Bureau to allow medical personnel to perform a 
     routine HIV test and notify the inmate of the results.
       (B) All HIV tests under this paragraph shall comply with 
     paragraph (9).
       (C) To all inmates who test positive for HIV and all 
     inmates who already are known to have HIV/AIDS, medical 
     personnel shall provide--
       (i) confidential prerelease counseling on managing their 
     medical condition in the community, accessing appropriate 
     treatment and services in the community, and preventing the 
     transmission of their condition to family members and other 
     persons in the community;
       (ii) referrals to appropriate health care providers and 
     social service agencies in the community that meet the 
     inmate's individual needs, including voluntary partner 
     notification services and prevention counseling services for 
     people living with HIV/AIDS; and
       (iii) a 30-day supply of any medically necessary 
     medications the inmate is currently receiving.
       (9) Opt-out provision.--Inmates shall have the right to 
     refuse routine HIV testing. Inmates shall be informed both 
     orally and in writing of this right. Oral and written 
     disclosure of this right may be included with other general 
     health information and counseling provided to inmates by 
     medical personnel. If an inmate refuses a routine test for 
     HIV, medical personnel shall make a note of the inmate's 
     refusal in the inmate's confidential medical records. 
     However, the inmate's refusal shall not be considered a 
     violation of prison rules or result in disciplinary action.
       (10) Exclusion of tests performed under section 4014(b) 
     from the definition of routine hiv testing.--HIV testing of 
     an inmate under section 4014(b) of title 18, United States 
     Code, is not routine HIV testing for the purposes of 
     paragraph (9). Medical personnel shall document the reason 
     for testing under section 4014(b) of title 18, United States 
     Code, in the inmate's confidential medical records.
       (11) Timely notification of test results.--Medical 
     personnel shall provide timely notification to inmates of the 
     results of HIV tests.

     SEC. 4. CHANGES IN EXISTING LAW.

       (a) Screening in General.--Section 4014(a) of title 18, 
     United States Code, is amended--
       (1) by striking ``for a period of 6 months or more'';
       (2) by striking ``, as appropriate,''; and
       (3) by striking ``if such individual is determined to be at 
     risk for infection with such virus in accordance with the 
     guidelines issued by the Bureau of Prisons relating to 
     infectious disease management'' and inserting ``unless the 
     individual declines. The Attorney General shall also cause 
     such individual to be so tested before release unless the 
     individual declines.''.
       (b) Inadmissibility of HIV Test Results in Civil and 
     Criminal Proceedings.--Section 4014(d) of title 18, United 
     States Code, is amended by inserting ``or under the Stop AIDS 
     in Prison Act of 2009'' after ``under this section''.
       (c) Screening as Part of Routine Screening.--Section 
     4014(e) of title 18, United States Code, is amended by adding 
     at the end the following: ``Such rules shall also provide 
     that the initial test under this section be performed as part 
     of the routine health screening conducted at intake.''.

     SEC. 5. REPORTING REQUIREMENTS.

       (a) Report on Hepatitis and Other Diseases.--Not later than 
     1 year after the date of the enactment of this Act, the 
     Bureau shall provide a report to the Congress on Bureau 
     policies and procedures to provide testing, treatment, and 
     prevention education programs for Hepatitis and other 
     diseases transmitted through sexual activity and intravenous 
     drug use. The Bureau shall consult with appropriate officials 
     of the Department of Health and Human Services, the Office of 
     National Drug Control Policy, and the Centers for Disease 
     Control regarding the development of this report.
       (b) Annual Reports.--
       (1) Generally.--Not later than 2 years after the date of 
     the enactment of this Act, and then annually thereafter, the 
     Bureau shall report to Congress on the incidence among 
     inmates of diseases transmitted through sexual activity and 
     intravenous drug use.
       (2) Matters pertaining to various diseases.--Reports under 
     paragraph (1) shall discuss--
       (A) the incidence among inmates of HIV/AIDS, Hepatitis, and 
     other diseases transmitted through sexual activity and 
     intravenous drug use; and
       (B) updates on Bureau testing, treatment, and prevention 
     education programs for these diseases.
       (3) Matters pertaining to hiv/aids only.--Reports under 
     paragraph (1) shall also include--
       (A) the number of inmates who tested positive for HIV upon 
     intake;
       (B) the number of inmates who tested positive prior to 
     reentry;
       (C) the number of inmates who were not tested prior to 
     reentry because they were released without sufficient notice;
       (D) the number of inmates who opted-out of taking the test;
       (E) the number of inmates who were tested under section 
     4014(b) of title 18, United States Code; and
       (F) the number of inmates under treatment for HIV/AIDS.
       (4) Consultation.--The Bureau shall consult with 
     appropriate officials of the Department of Health and Human 
     Services, the Office of National Drug Control Policy, and the 
     Centers for Disease Control regarding the development of 
     reports under paragraph (1).

     SEC. 6. APPROPRIATIONS.

       There are authorized to be appropriated such sums as may be 
     necessary to carry out this Act.

  The SPEAKER pro tempore. Pursuant to the rule, the gentlewoman from 
California (Ms. Waters) and the gentleman from California (Mr. Issa) 
each will control 20 minutes.
  The Chair recognizes the gentlewoman from California.


                             General Leave

  Ms. WATERS. Mr. Speaker, I ask unanimous consent that all Members may 
have 5 legislative days to revise and extend their remarks and include 
extraneous material on the bill under consideration.
  The SPEAKER pro tempore. Is there objection to the request of the 
gentlewoman from California?
  There was no objection.
  Ms. WATERS. Mr. Speaker, I yield myself such time as I may consume.
  Mr. Speaker, I would like to thank my friends, John Conyers, the 
chairman of the House Judiciary Committee, Mr. Lamar Smith, ranking 
member of the House Judiciary Committee, and Mr. Bobby Scott, chairman 
of the Judiciary Subcommittee on Crime, Terrorism and Homeland 
Security. Their staffs worked closely with my staff in a bipartisan 
manner when we drafted this bill 2 years ago, introduced it as H.R. 
1943, reported it favorably and passed it on suspension. And they have 
been strong supporters of it ever since.
  More than a quarter century has passed since AIDS was first 
discovered, yet the AIDS virus continues to infect and kill thousands 
of Americans every year. Last year, the Centers for Disease Control and 
Prevention, CDC, released new estimates of HIV infection which proves 
that the HIV/AIDS epidemic is even worse than we thought. The new 
estimates indicate that approximately 56,300 new infections occurred in 
the United States in 2006. This figure is approximately 40 percent 
higher than CDC's previous estimates of 40,000 new infections every 
year.
  Here in our Nation's capital, health officials just announced that 
the HIV infection rate has reached 3 percent. That is 2,984 residents 
per every 100,000 over the age of 15, or 15,120 right here in our 
capital. This is a rate that exceeds the 1 percent threshold for a 
severe epidemic, and compares to severely impacted nations in West 
Africa. This announcement made the headlines in Sunday's Washington 
Post.
  We need to take the threat of HIV/AIDS seriously, and we need to 
confront it in every institution in our society. That includes our 
Nation's prison system.
  In 2005, the Department of Justice reported that the rate of 
confirmed AIDS cases in prisons is three times higher than in the 
general population. The Department of Justice also reported that 2 
percent of State prison inmates and 1.1 percent of Federal prison 
inmates were known to be living with HIV/AIDS in 2003. However, the 
actual rate of HIV infection in our Nation's prisons is still unknown 
because prison officials do not consistently test prisoners.
  In January of this year, the Journal of the National Medical 
Association published an article by Dr. Nina Harawa and Dr. Adaora 
Adimora on ``Incarceration, African Americans and HIV: Advancing a 
Research Agenda.'' The article confirmed that individuals at high risk 
for incarceration also tend to be at high risk for HIV infections. 
Incarcerated populations have a high prevalence of characteristics 
associated with HIV infection. These characteristics include low 
socioeconomic status, drug use, multiple sex partners, and histories of 
sexual abuse and assault.
  Mr. Speaker, I reserve the balance of my time.
  Mr. ISSA. Mr. Speaker, I yield myself such time as I may consume.
  The Stop AIDS in Prison Act of 2009 requires the Federal Bureau of 
Prisons

[[Page H3461]]

to develop comprehensive policy to provide HIV testing, treatment, and 
prevention for inmates in Federal prisons. This legislation will combat 
and prevent the continued spread of HIV and AIDS among prison 
populations and the community at large.
  Mr. Speaker, there are about 200,000 prisoners in the Federal prison 
system, but the incidence of HIV and AIDS in the prison system is 
difficult to measure because not all prisoners are routinely tested.
  Mr. Speaker, there is no doubt that the prison population, like the 
population of America as a whole, includes prisoners who are HIV 
positive and do not know it. In 2006, a report by the U.S. Department 
of Justice estimated that over 1 percent of Federal inmates were known 
to be infected with HIV. The United Nations Joint Program on HIV/AIDS 
and the U.S. Centers for Disease Control and Prevention have 
historically defined an HIV epidemic as occurring when the overall 
percentage of disease among residents of a specific geographic area 
exceeds 1 percent. That means that the percentage of prisoners who 
carry the HIV/AIDS virus may have reached epidemic proportions.
  The occurrence of HIV and AIDS cases in Federal prisons is at least 
three times higher among prison inmates than it is among the United 
States population as a whole.
  H.R. 1429 requires routine testing of all Federal prison inmates upon 
entry and prior to release. For all existing inmates, testing will be 
required within 6 months of enactment. This reasonable requirement will 
enable prison officials to reduce HIV/AIDS among inmates and provide 
counseling, prevention, and health care services for inmates who are 
infected with the disease.
  For those prisoners tested when they enter prison, testing will 
ensure that they receive adequate treatment, education, and prevention 
services while incarcerated. Similarly, it is important that prisoners 
are tested shortly before release into the community so adequate 
services can be coordinated for the prisoners after release. That in 
turn will protect the community that they then reside in.
  I believe in thorough punishment for criminal offenders because the 
public deserves to be protected; but we have a duty to treat prisoners 
humanely and to prevent the spread of HIV/AIDS, not just within the 
prison populations, but to the populations they return to.
  Mr. Speaker, I would like to thank my colleagues on the Judiciary 
Committee and particularly Congresswoman Waters for her work on this 
legislation. She has led the way, she has pushed hard, and she, with 
Ranking Member Lamar Smith, bring this bill today with broad bipartisan 
support. As was said earlier, this bill passed by suspension in the 
last Congress, and we would hope that it passes early and is signed 
into law at the earliest possible date. H.R. 1429 remains an important 
piece of legislation yet undone by this Congress from the previous 
Congress.
  I reserve the balance of my time.
  Ms. WATERS. Mr. Speaker, Dr. Harawa's and Dr. Adimora's article also 
pointed out that incarceration could provide a window of opportunity 
for reaching at-risk individuals and providing them testing, treatment, 
and prevention services for HIV and AIDS. Unfortunately, these services 
are not consistently available in the correctional system.

                              {time}  1345

  HIV testing is not required upon entry and prior to release from 
Federal prisons, nor is testing required in most State prisons.
  Treatment for HIV/AIDS in the correctional system is often limited by 
lack of expertise among prison health providers and inadequate access 
to HIV pharmaceuticals.
  Finally, HIV prevention programs are not available in a consistent or 
complete fashion throughout the entire correctional system. That is why 
we need to pass the Stop AIDS in Prison Act today. The Stop AIDS in 
Prison Act requires the Federal Bureau of Prisons to develop a 
comprehensive policy to provide HIV testing, treatment, and prevention 
for inmates in Federal prisons.
  This bill requires the Bureau of Prisons to test all prison inmates 
for HIV upon entering prison and again prior to release from prison 
unless the inmate absolutely opts out of taking the test. Inmates who 
test positive will be given comprehensive treatment during their 
incarceration and referrals to services in the community prior to 
release. All inmates, regardless of their test results, will be given 
HIV prevention education.
  We are honored to have the support of many of the prominent HIV/AIDS 
advocacy organizations for the Stop AIDS in Prison Act. These include; 
AIDS Action, The AIDS Institute, the National Minority AIDS Council, 
the AIDS Healthcare Foundation, the HIV Medicine Association, the 
Latino Commission on AIDS, AIDS Project Los Angeles, Bienestar, a 
Latino community service and advocacy organization, and the AmASSI 
National Health and Cultural Centers, another community service and 
advocacy organization. The Board of Supervisors of the County of Los 
Angeles, which has been severely impacted by HIV/AIDS, has also 
expressed support for this bill.
  In conclusion, the Stop AIDS in Prison Act will help stop the spread 
of HIV/AIDS among prison inmates, encourage them to take personal 
responsibility for their health, and reduce the risk that they will 
transmit HIV/AIDS to other persons in the community following their 
release from prison.
  I would like to thank my colleagues who have been involved, 
especially my colleague from California who is on the floor today in 
support of this legislation.
  I would urge all of my colleagues to support this important 
legislation.
  Mr. Speaker, I reserve the balance of my time.
  Mr. ISSA. Mr. Speaker, I yield myself such time as I may consume.
  I think the gentlelady made such a good point that, in fact, we have 
an obligation to recognize that individuals will return to our 
community, and they need to return healthier than they came in. So the 
requirements in this bill, both for testing on the way in and testing 
on the way out of prison, are so important.
  Mr. Speaker, under Governor Pete Wilson, I had the honor to serve on 
his prison board for the Prison Work Program. What I discovered in 
prison is exactly what the gentlelady from California is alluding to, 
that we often incarcerate without doing the other things that should be 
done--education programs, work programs, drug and alcohol detoxing 
programs, and, yes, recognizing that good physical and mental health 
are essential, that we have to make sure that people who are being 
prepared to leave prison are being prepared to not return to prison.
  So I join with the gentlelady in support of this effort, like so many 
others that she has championed over the years.
  Mr. Speaker, I reserve the balance of my time.
  Ms. WATERS. Mr. Speaker, may I inquire as to how much time I have 
remaining.
  The SPEAKER pro tempore. The gentlewoman has 13\1/2\ minutes 
remaining.
  Ms. WATERS. Mr. Speaker, I yield 3 minutes to the gentlelady from 
California, the Chair of the Congressional Black Caucus, Barbara Lee.
  Ms. LEE of California. I thank the gentlelady for yielding. But also, 
let me thank you for making sure that we stayed on point as it relates 
to HIV/AIDS. And I have to just stop and take a minute and help recall 
some of this history.
  Actually, when I was first elected in 1998, you were chairing the 
Congressional Black Caucus at that point. And you recognized what this 
HIV/AIDS epidemic was doing in our country, especially in the African 
American community.
  I remember you called a meeting--I think you gave us maybe 2 or 3 
days, but the seriousness of this warranted that. People came from all 
over the country. And we talked about what we needed to do, and we 
sounded the alarm.
  Under your leadership, we developed the Minority AIDS Initiative. And 
I must say, you insisted then that it be comprehensive, and it must be 
complete, and it must be funded. I believe at that point we were able 
to get maybe $150, $157 million; drop in the bucket, maybe, but yes, it 
was a major step in the right direction. We are still trying to get up 
to $650 million for the Minority AIDS Initiative.
  But having said that, let me just say, in terms of the comprehensive 
nature

[[Page H3462]]

of what we talked about then and what you insisted on, we said that any 
AIDS strategy had to be seen from the perspective of prevention, care, 
and treatment. In fact, we talked about the disproportionate numbers of 
African Americans being infected and affected and how the resources 
should be targeted to the communities in most need.
  Fast forward to Toronto, Canada, to the HIV/AIDS International 
Conference. And I'll never forget this--and I have to say this because 
today is really a milestone, I think, in Congresswoman Waters' work 
around this--we were there with the NAACP, we were there with all of 
our black AIDS organizations. And you whispered to me, you said, I'm 
getting ready to do something that's very controversial; some folks may 
not like it, but are you with me? I said, ``Yes, ma'am.'' You said, 
``We're going to do a mandatory testing bill.'' And we talked about it. 
And you made it public at that conference, and you said you were not 
going to rest until this is done. You talked about the bill in concept, 
in terms of stopping AIDS in prison, because you were talking about the 
rates of infection with regard to African American women and what is 
taking place in prisons and how all of our heads really are in the sand 
about this, we just didn't want to deal with it at all. But you were 
determined that all of us--the NAACP, all of our groups--were going to 
deal with it. Some said it was going to be impossible to do because of 
mandatory testing requirements. We talked about how to deal with that, 
and you found a way, and that is, by allowing anyone who wants to opt 
out to opt out.
  I always have to say, Congresswoman Waters, that you always insist on 
doing this work--if we have to do it out of the box, we will, but where 
there is a will, there is a way. I think today really just demonstrates 
that where there is a will, there is a way. And with the bipartisan 
support now on H.R. 1429, with our President supporting the development 
of a national AIDS strategy and a national AIDS plan, I have a lot of 
hope.
  The SPEAKER pro tempore. The time of the gentlewoman has expired.
  Ms. WATERS. I yield to the gentlelady as much time as she may need to 
continue this wonderful talk she's giving.
  Ms. LEE of California. I have to say I am really excited today 
because I have a lot of hope. When you look at the numbers in the 
District of Columbia, for instance, what, 33 percent new infections for 
African American women? When you look at what is happening around the 
country and when you look at the disproportionate rates of African 
American men in prison, you can't help but be thankful today that this 
bill is on the floor, and with bipartisan support we're going to move 
it off the floor. Because I think that if we really are being for real 
about tackling this, we have got to do it, and we have got to require 
what this bill requires in our prisons.
  I just have to say today, on behalf of my constituents, where we 
declared a state of emergency in 1999 in the African American community 
in Alameda County, on behalf of the entire country, thank you very 
much. It is a very hopeful day.
  I urge support of this bill, and look forward to our continuing work 
and getting it to President Obama's desk so he can sign this into law.
  Mr. SMITH of Texas. I am pleased to be original co-sponsor of H.R. 
1429, the ``STOP AIDS in Prison Act of 2009.''
  The Stop AIDS in Prison Act of 2009 requires the federal Bureau of 
Prisons to develop a comprehensive policy to provide HIV testing, 
treatment and prevention for inmates in federal prisons.
  This legislation will combat and prevent the continued spread of HIV 
and AIDS among the prison population and the community at large.
  There are about 200,000 prisoners in the federal system. But, the 
incidence of HIV and AIDS in the prison population is difficult to 
measure because not all inmates are routinely tested.
  In a 2006 report, the Justice Department estimated that over one 
percent of federal inmates were known to be infected with HIV. The 
United Nations Joint Program on HIV/AIDS and the U.S. Centers for 
Disease Control and Prevention have historically defined an HIV 
epidemic as occurring when the overall percentage of disease among 
residents of a specific geographic area exceeds one percent.
  That means that the percentage of prisoners who carry the HIV/AIDS 
virus may have reached epidemic proportions.
  The occurrence of HIV and AIDS cases in federal prison is at least 
three times higher among prison inmates than it is among the United 
States population as a whole.
  H.R. 1429 requires routine HIV testing for all federal prison inmates 
upon entry and prior to release. For all existing inmates, testing is 
required within six months of enactment.
  This reasonable requirement will enable prison officials to reduce 
HIV/AIDS among inmates and provide counseling, prevention, and health 
care services for inmates who are infected with the disease.
  For those prisoners tested when they enter prison, such testing will 
ensure that they receive adequate treatment, education and prevention 
services while incarcerated.
  Similarly, it is important that prisoners are tested shortly before 
release into the community so that adequate services can be coordinated 
for the prisoner after release. That, in turn, will protect the 
community.
  I believe in tough punishment for criminal offenders because the 
public deserves to be protected. But we have a duty to treat prisoners 
humanely and to rehabilitate them.
  To me, preventing the spread of HIV and AIDS among prisoners is an 
essential part of humane treatment and rehabilitation.
  I would like to thank my colleague on the Judiciary Committee, 
Congresswoman Waters, for her work on this legislation. Ms. Waters and 
I worked together on earlier versions of this bill in previous sessions 
of Congress. She has been an energetic partner in this effort.
  I would also like to thank Chairman Conyers for helping bring this 
legislation to the House floor today.
  As my colleagues will recall, the House passed a version of this bill 
last Congress by voice vote. The bill was placed on the legislative 
calendar of the Senate, but it was never acted upon. It is my hope that 
the Senate will pass H.R. 1429 during this Congress.
  I urge my colleagues to support this important legislation.
  Ms. JACKSON-LEE of Texas. Mr. Speaker, I rise in support of H.R. 
1429, ``Stop AIDS in Prison Act of 2009.'' I want to thank my colleague 
Congresswoman Maxine Waters of California for introducing this 
legislation.
  Mr. Speaker, I strongly support H.R. 1429, which designed to address 
the growing impact that HIV/AIDS is having on minority communities. 
According to the Black AIDS Institute, Centers for Disease Control and 
Prevention (CDC) statistics reveal that African Americans account for 
half of all new HIV/AIDS cases. Racial and ethnic minorities comprise 
69 percent of new cases, according to the 2005 data released by the 
CDC. African-American women account for the majority of new AIDS cases 
among women (67 percent in 2004); whereas white women account for 17 
percent and Latinas 15 percent. The CDC estimates that 73 percent of 
all children born to HIV infected mothers in 2004 were African 
American. HIV/AIDS is now the leading cause of death among African 
Americans ages 25 to 44--deadlier than heart disease, accidents, 
cancer, and homicide.
  The CDC reported that Hispanics accounted for 18 percent of new 
diagnoses reported in the 35 areas with long-term, confidential name-
based HIV reporting in the United States, and that most Hispanic men 
were exposed to HIV through sexual contact with other men, followed by 
injection drug use and heterosexual contact; and that most Hispanic 
women were exposed to HIV through heterosexual contact, followed by 
injection drug use.
  According to the Bureau of Justice Statistics, African Americans made 
up 41 percent of all inmates in the prison system at the end of 2004. 
Since African Americans are disproportionately represented in jails and 
prisons, the Stop AIDS in Prison Bill is one way to begin addressing 
this problem.
  The ``Stop AIDS in Prison Act of 2009'' directs the Bureau of Prisons 
to develop a comprehensive policy to provide HIV testing, treatment, 
and prevention for inmates in federal prisons and upon reentry into the 
community. The bill would require initial testing and counseling of 
inmates upon entry into the prison system and then ongoing testing 
available up to once a year upon the request of the inmate, or sooner 
if an inmate is exposed to the HIV/AIDS virus or becomes pregnant. 
Furthermore, the Bureau of Prisons will be required to make HIV/AIDS 
counseling and treatment available to prisoners, and give testing and 
treatment referrals to prisoners prior to reentering the community. The 
bill protects the confidentiality of prisoners, and allows prisoners to 
refuse routine HIV testing.
  Finally, the bill contains a requirement that the Bureau of Prisons 
report to Congress, no later than one year after enactment, the number 
of inmates who tested positive for HIV upon intake; the number of 
inmates who tested positive prior to reentry; the number of inmates who 
were not tested prior to reentry because they were released without 
sufficient notice; the number of inmates who opted-out of taking the 
test; the number of inmates who

[[Page H3463]]

were tested following exposure incidents; and the number of inmates who 
were under treatment for HIV/AIDS.
  I urge my colleagues to support H.R. 1429 because we must reverse 
these costly trends. Currently, the only cure we have for HIV/AIDS is 
prevention.
  Had the bill gone through regular and been marked up, I was planning 
on offering an amendment that would permit those infected with HIV to 
elect, on their own volition, to be housed separate from the general 
population as long as the prison had the facilities. This way, those 
infected with HIV could be housed in safety.
  The HIV/AIDS pandemic is indeed a state of emergency in the African-
American and Hispanic community. We must use all resources necessary to 
defeat this deadly enemy that continues to devastate the minority 
community. As Americans, we have a strong history, through science and 
innovation, of detecting, conquering and defeating many illnesses. We 
must and we will continue to fight HIV/AIDS until the battle is won.
  Mr. Speaker, I strongly support H.R. 1429, ``Stop AIDS in Prisons Act 
of 2009,'' and urge my colleagues to support it as well.
  Mrs. CHRISTENSEN. Mr. Speaker, incarceration rates in the United 
States have skyrocketed through the years. Approximately 2.3 million 
Americans are incarcerated and more than 1 in 100 American adults were 
incarcerated just at the start of 2008. Although the actual rates of 
HIV/AIDS infections in our nation's prisons are not known due the fact 
that current prison officials do not consistently test their prisoners; 
we see how this epidemic is effecting our nation and especially 
devastating the African American community.
  An estimated 20 percent-26 percent of all Americans living with HIV/
AIDS are incarcerated at some point and are frequently incarcerated 
during the course of their disease. Persons at risk for incarceration 
are more likely than others in our nation to be at high risk for HIV/
AIDS infections especially related to risky behavioral practices and 
characteristics. These risk characteristics include minimal education, 
drug use, low socioeconomic status, multiple sex partners, a high 
prevalence of sexually transmitted infections, and histories of sexual 
abuse and assault. This also renders those in prison who are infected 
to become vulnerable to a whole range of other diseases. In custody HIV 
transmission occur through sexual activity, needle-sharing for drug 
injection, tattooing with unsterilized equipment, and contact with 
blood or mucous membranes through violence.
  Incarceration is a crisis among African Americans. Research and data 
show that African Americans are disproportionately more likely than any 
other racial and ethnic group to be at risk for incarceration. In fact 
African Americans constitute just 13 percent of the American population 
but make up 44 percent of all prison and jail inmates. I am sure it is 
not surprising to see the correlation between this statistic and also 
the statistics that show that African Americans account for the 
majority of new AIDS cases, the majority of new HIV infections, and the 
majority of HIV deaths. The prevalence of HIV/AIDS in incarcerated men 
and women is 3-5 times that of the general population.
  Particularly affected by the HIV/AIDS epidemic in incarcerated 
populations are African American women. The most astounding news is 
that prisons are the only setting in the United States where HIV 
prevalence is higher in females than in males, with approximately 2.6 
percent of female and 1.8 percent of male state prison inmates known to 
be HIV infected. Further, African-American women make up two-thirds of 
newly reported HIV cases in females overall and 34 percent of all 
female inmates' cases.
  In attempt to counter many assumptions, a number of published case 
studies and a smaller number of retrospective cohort studies have 
described cases of HIV transmission in U.S. inmates that occurred 
during incarceration. These studies only suggest that the incarcerated 
population needs to be fully included in HIV/AIDS prevention and 
treatment efforts. There must be a change in people's attitudes and the 
way we promote positive health initiatives through our federal prison 
systems.
  I, therefore, rise today in strong and unwavering support of H.R. 
1429, The Stop AIDS in Prison Act, which would require routine HIV 
testing for all federal prison inmates upon entry and prior to release 
from prison, provide inmates with education and treatment, and reduces 
the risks they may pose of transmitting HIV/AIDS to others in their 
communities after their release.
  We all should support H.R. 1429 and ensure that incarcerated and ex-
offender populations have access to adequate and realistic HIV 
prevention methods, receive voluntary and confidential HIV testing and 
are rolled into adequate HIV/AIDS-related care, treatment and services.
  Mr. ISSA. Mr. Speaker, I yield back the balance of my time.
  Ms. WATERS. Mr. Speaker, I would like to thank Congresswoman Barbara 
Lee for rushing to the floor to participate in the presentation of this 
bill, and I yield back the balance of my time.
  The SPEAKER pro tempore. The question is on the motion offered by the 
gentlewoman from California (Ms. Waters) that the House suspend the 
rules and pass the bill, H.R. 1429.
  The question was taken; and (two-thirds being in the affirmative) the 
rules were suspended and the bill was passed.
  A motion to reconsider was laid on the table.

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