Rasta: Every time I got locked up, there was a lapse in my medication. I think it might not have been until the last time I got locked up that they actually allowed me to go to my doctor's office.
Malachi Stewart: Welcome back to another episode of Positive Voices, and today's episode we are talking about HIV and prison reentry.
My name is Malachi Stewart and I'm here with a few guests. I'm here with Diane, Rasta, and Ashley. So I want to let my guests introduce themselves and tell us a little about who you are and where you're from, and why this topic is important to you.
Diane.
Diane Carter: My name is Diane Carter. Found out that I was HIV positive in 1987. And when I found out, it was such a shock to me. I was incarcerated at the time in Fairfax County Jail and I had became sick and they carried me to Fairfax County Hospital. And I was in so much pain, they told me that the only way they could stop the pain was through an operation, a procedure. And I had that procedure done.
After that procedure, I had to get up out of the bed and ambulate up and down the hall. And as I was ambulating, as I approached my door to my room, I saw a sign on my door and the sign read, Blood and Fluid Precaution, and I called the nurse, "Nurse, nurse, can you come here?" And she came, and I asked her why was the sign on my door? She said to me in a very nonchalant way, "Oh, the doctor didn't tell you?" And I'm like, "Tell me what?" And she said, "Oh, you're HIV positive."
And all I remember was going down to the floor. I fainted and I woke up in the bed that was assigned to me, screaming and crying, "You people have made a mistake here. You made a mistake. I'm not HIV positive, I'm not that way." And they tried to calm me down without any luck. And she asked me did I want her to send for the doctor and I said, "Yes." And the doctor came and he talked to me, and I asked him, "Who gave them permission to test me?" And he explained the procedure of the hospital about once you are having a procedure that involved blood, then you don't really need to sign any paperwork.
And he asked me did I want another test to confirm their findings. And I told him yes, because it was a mistake. And they did another test and it came back the same way, HIV positive. I still didn't believe them. I'm still in denial. I said they don't know what they did, this is not true. And from that point on, I just buried my head in the sand. I just did not want to accept the fact. Although I had done everything to come up with that type of status, HIV positive. Unprotected sex, I was an IV drug user at the time, and I shared works with other drug users, but I still did not believe, I was still in a state of denial.
Once I was released from prison, I started back living the life that I knew how to live. It was the only life I knew. There was no standards, no principles, no values. And I started back using drugs and I lived in a world of fantasy about the HIV diagnosis.
About three years after I was diagnosed, people was just dying all around me with HIV, with AIDS. They were dying with AIDS, all around me. There was only one medication at that time, which was 1987. There was one medication, AZT, and I knew that I wanted to live with this disease. I didn't want to die with it, I wanted to live with it. And I started asking questions.
I got a doctor, I started asking questions about a nutritionist. I started asking questions about groups and therapy, and I knew that I had to get involved in the HIV world. And it was then also that I knew that I wanted to be a part of the solution and not the problem. And that's when I went to Whitman-Walker, and I started working with them as a outreach worker. And I started going into all joints, that's where people shoot up at, and letting them know that if you clean your syringe and your needle out with bleach, this kit right here that I'm giving you, you can save your life. And they would always send two of us in, in case if you got weak for the drug, you had your partner that would have your back. And the streets-
Rasta: Accountability partner.
Diane Carter: ... Huh?
Rasta: I said, "Accountability partner," almost?
Diane Carter: Accountability partner.
And I would catch people on the streets, on the corners, and give them the kits to clean their works. And then my work just kept going on and on with HIV, just letting people know that.
Malachi Stewart: Had you had a history with substance use?
Diane Carter: I had a substance abuse disorder for years. My gateway drug was alcohol, and then from alcohol there was the marijuana. And then from marijuana, it was the heroin, cocaine. I was an IV drug user.
And I used the system as a revolving door, the penal system, it was used as a revolving door. I would use it, although it wasn't by choice, but I would get busted for shoplifting, which is how I supported my habit. And it was through those stints that I had at the jails that I healed and got well, and cobwebs were blown out of my brain. And I would think about my life and I knew that I wanted to do something different with it. I just didn't have that strength to say "No," to the drug. And it was very hard coming off of drugs.
But I kept hoping and I kept praying and it happened. It was like one day I woke up and I was surrounded by brick walls, I was locked up again, and I knew that I couldn't live that life any longer.
Malachi Stewart: What year was this?
Diane Carter: Oh, I think it was 1989, 1990, somewhere like that. I was in Fairfax County Jail again, and it was like a spiritual awakening and I knew I couldn't live that life again. And so they sent me to this reformatory in Goshen, Virginia. And once I left there, I told my counselor, "Please don't send me back to DC. I need to go somewhere where I can rebuild my life."
Well going through the system, I always wanted to be educated and I went in without a high school diploma. I stayed in so much I got two GEDs, one in Maryland, one in Virginia. And then I started taking college courses while I was incarcerated.
And once I got out of jail in Virginia, I went into a nursing school and I got my certified nursing assistance license, and I went back to school. I wanted to be a nurse, so I started taking classes. And so it was at that point that I was an escapee from the halfway house in DC.
Malachi Stewart: Okay.
Diane Carter: And I kind of sneaked through the cracks, and they let me out.
Malachi Stewart: Are you telling me you broke out?
Diane Carter: They let me out.
Rasta: I did that too, okay. You weren't the only one. Escapees over here.
Malachi Stewart: Okay, so we've got two escapes. Okay.
Diane Carter: So I looked up one day and I was in my probation officer's office reporting, and United States Marshalls came and they asked me to come with them. They brought me back to DC and I finished out. I was serving a 10-year sentence. They brought me back to DC to finish up the 10-year sentence, and that was it.
I ran into some people that I used to use drugs with. They were bringing NA, Narcotics Anonymous groups, into the jail. And I was very much attracted to them and the life that they were living, and they gave me hope that I could get off of drugs. Because they were just as addicted as I was, so I'm like, "Well, if they could do it, I can do it too."
Malachi Stewart: Yeah.
Diane Carter: And so I had one of them to meet me at the door once I got released. And that was back in 1997 and I haven't been back since. And I've been involved with HIV work since then. So I took some more classes and I got my bachelor's in Public Health Education, and-
Malachi Stewart: Congratulations.
Diane Carter: ... Thank you. So I work for Ashley McSwain who hired me when I came out of school. That was my first job once I graduated from UDC. And-
Ashley McSwain: Weren't you in school when you were-
Diane Carter: ... I was in school. Yeah.
Ashley McSwain: Yeah, I remember that.
Diane Carter: It was 2010 and she hired me as HIV coordinator and I've been with her ever since.
Ashley McSwain: You sure have.
Rasta: And the rest is history, huh?
Diane Carter: Yeah, so grateful-
Ashley McSwain: Yeah, she's been following me, y'all
Diane Carter: ... I'm so grateful to her.
Ashley McSwain: One of the things that Diane does so well is, when you are a woman who's on the street, the traditional nonprofits aren't going to some of the spaces that she would go into to find the women who really needed the services and support.
It is easy to talk to a woman who's coming out of a jail or prison, and then offer her services. But when she's on the street, and she's at her boo house, and she's at the crack house, there ain't a whole lot of service providers that'll go into those spaces to get the supports that she need. And Diane is the one. I don't care where a sister would be, she would go and provide her support. And that is a rare, rare find.
Rasta: I think that's important [inaudible 00:15:15].
Ashley McSwain: It is.
Malachi Stewart: For sure.
I have a question actually for you about that, but before we do, I didn't get a chance to introduce you, Ashley. Would you like to introduce yourself and the work you do? For context.
Ashley McSwain: Yes. Ashley McSwain. I'm currently the president of Consultants for Change, a consultant firm, but I am the former executive director for Community Family Life Services, and Our Place DC, where we provide services to women returning home from prison or jail. So I mean we specifically target the needs of women.
Rasta: Thank you for introducing yourself and for giving context to how you're connected to the work.
You said something about Diane being the type that will go anywhere with people. As a person whose background is in work where I was a part of HIV program with Whitman-Walker, where we were meeting people everywhere. I mean I have been in drug houses, I have been in alleyways drawing blood, all kinds of things.
Do you feel that makes a difference for people? That, that's the difference? That people really need a person who's able to go into those places when they can't come in?
Ashley McSwain: Absolutely. I mean social workers, they're grounded in theory and like to believe they're looking at practice, but some of them don't want to get their hands dirty, they don't want to go into those scary spaces. And that's where the women really need you to be. And so if I'm leading the company, I'm not frequently, I'm not throwing on my jeans going into those spaces, but you need people with courage and know the importance of that, to do that. And Diane, we're all in awe in the corners that she'll go into.
Malachi Stewart: Yeah.
Diane Carter: I worked at an organization with a partner, and her and I, we tested anywhere we could test. We went into churches, which was a shelter, an overnight [inaudible 00:17:17] shelter. We went there. We did tests there every morning after they ate their breakfast, we did HIV testing. We were in a car, we sanitized the car, we had the car set up in the back, we did testing in the car.
Any place that we could do a test and find out if that person needed to be connected to care, to stop the spread.
Ashley McSwain: And she can connect to people in ways that we just can't.
Malachi Stewart: I was going to ask about that, and I actually have some more questions about that, the connection based on your experience.
But before I ask that, I want to introduce Rasta to the conversation. Rasta, how do you connect with the work? How do you connect with HIV reentry? Tell us a little bit about your story.
Rasta: Okay. Wow.
Malachi Stewart: Where did it all start?
Rasta: So it all started in a sunny, full-paced[inaudible 00:18:13] Florida. So my name is Rasta Esiogi[inaudible 00:18:18]. I'm 27 years old. I have been positive since August of 2016. And actually for me it started with a relationship. I fell into my first relationship a year after I graduated high school. I was not very sexually active and I didn't really know anything about anything. I'm from the country, like I tell anybody, I'm from the country and I was very ignorant to HIV, the whole gay lifestyle. I personally grew up DL. I'm first generation born on my mom's side. My dad's side is from the backwoods of the deep South, and I grew up in the church as well. So for me it wasn't unnormal to hear my grandma, "Turn that channel. They're showing too much."
But anyway, so to fast-forward, I fell into my first relationship. I was working two jobs. I was 19, actually 20 at the time, and I thought I was so in love. Until one day I got a phone call, I was at work, and my what now it's my ex, we're going to call him Amani. Amani called me and he told me that he had gonorrhea. I had never been tested at that point in time. So naturally I left work, went and got tested. My phone got cut off. It was just me trying to support myself at the time. So I had to wait that two weeks for another check so I could pay my bill.
Anyways, ended up getting a home visit from the health department. They left a note on the door. My dad found it was like, "You need to go in and see what's going on." I'm like, "Nah, they just telling me I tested negative." My daddy ain't stupid. So he was like, "Nah, get your ass on."
So I went and this nurse came out in all black scrubs. I don't know why it shook me. I just knew something wasn't right. And I'm very spiritual, so I don't know, to me that was just like a sign. And she took me in the back and she was like, "You tested negative for gonorrhea." Okay cool. I'm like, "All right." I'm about to go. She's like, "But you tested positive for HIV." And she just kept talking, and just kept talking, and just kept talking. And I'm just like, "Okay ma'am, you just told me this and you just going to speed over that. This is not even a bump. You just going to keep speeding over that."
So at that point, I don't know, my spirit just broke. That's what I felt. I felt my spirit die. The inner being in me just died that day. That started a whole cycle of incarcerations, really dealing with mental instability, and having to learn how to contain it but also know how to process it in healthy ways. Because I had my time where I just sprawled out. I didn't care.
But man, yeah, that's how I got introduced to HIV. I contracted it through a friendship. Not even that relationship but a previous friendship. And like they say, "It only takes one time." We had sex one time. It was unprotected, started out consensual and it quickly turned into rape. And crazy, because not too long after that I didn't know he had it. I didn't know I had it. So I was walking around for a while wondering what was wrong with my body, certain things it just wasn't right.
Malachi Stewart: You felt changes in the body?
Rasta: I felt changes in my health. And so once I did find out, obviously I made the connection to that. About six months after I found out is when I first got incarcerated.
Malachi Stewart: So what was the timeline? You found out in August of 2016?
Rasta: So I contracted it probably about six months before, six months to a year before. I'm sorry, I keep hitting this mic.
Malachi Stewart: You're okay.
Rasta: August of 2018 is when I found out. November is when I got incarcerated. No meds, no nothing. It was just in there. I actually didn't get my meds until I was getting ready to get out. Which was summer, that March of 2017.
Malachi Stewart: So you weren't medicated while you were incarcerated at all.
Rasta: No.
Malachi Stewart: But they knew you were HIV positive.
Rasta: They knew.
Malachi Stewart: Okay.
Rasta: My dad tried to get my meds into the jail, because there was a point in time where my mom was switching jobs, so there was a lapse in insurance, so I just could not get meds for the first two to three months that I was diagnosed. Got incarcerated, my dad literally fussing and fighting at the jail just to... He couldn't get my meds in. He knew a security guard that worked at the jail, and that security guard is who, shout out to you, who actually got my meds in for me and actually got, "Y'all need to do something with this guy. I know his people."
Malachi Stewart: Is that the expectation? For you to provide your own medication?
Rasta: No. This is just the deep South and their expectations is to make you suffer.
Malachi Stewart: Yeah. Wow.
Rasta: [inaudible 00:25:15]like that. But that's what it was given. Every time I got locked up there was a lapse in my medication. I think it might not have been until the last time I got locked up that they actually allowed me to go to my doctor's office for my appointment.
Malachi Stewart: So every time you were incarcerated you basically were out of care.
Diane, was that the same for you when you were incarcerated? Were they caring? Were they treating your HIV?
Diane Carter: Yeah.
Malachi Stewart: They did treat your HIV?
Diane Carter: Yeah, my HIV was being treated throughout the time. Yeah, it was.
Now when I found out that I was HIV positive and I was sent to the reformatory, they did not do a HIV test and I didn't tell them that I was HIV positive.
Rasta: I told them.
Malachi Stewart: And so because you were in denial, you kind of like-
Diane Carter: I was still, yeah,
Malachi Stewart: [inaudible 00:26:25] Okay, I see.
I have a question, and I want to ask you both. I'll start with you Rasta, because we went through it quickly. But I need to get into this feeling with you, and our stories are so similar, so it's what made me think about it. You found out while you were incarcerated, Diane, you were navigating the process of just finding out that you were diagnosed and then were incarcerated right after. So you're processing that while you were incarcerated.
What was that like being incarcerated? Because you're already dealing with whatever incarcerated feels like. I'll let you all tell your stories. But you're dealing with that and you are navigating a new diagnosis. What was that like for y'all? I'll Let you start Rasta.
Rasta: So at that point in time I was trying out mood stabilizers, prescribed, and they had me on Duloxetine, which pretty much almost zombie-fied me. So I was going through so much mentally that incarceration for me was a break from reality, even though they wasn't treating my HIV, but it was almost like a break from reality. But being that they wasn't treating my HIV, it was starting to have the reverse effect.
So I would give my patience like, "Okay, I understand you have a lot of people to deal with. Cool. Even though I should be on the top of the list because I'm positive." You know what I'm saying? It was crazy. It was crazy for me.
Malachi Stewart: Did you feel supported?
Rasta: Huh?
Malachi Stewart: Did you feel supported? Were there any supports?
Rasta: No, I did not have any support at that time. My parents didn't really know much about HIV or even how to help me. The jail systems were failing any and everyone that they was letting in. The people inside the pods, or what we called pods, there were some people that were accepting of me because my dad was well known in our area. But there were those other couple, those couple that dragged me off my bunk. I hope y'all still in there. Yeah, certain things made it harder. You know what I'm saying?
To be honest, it's still hard for me to even vocalize how I felt at that point in time, because it was so much going on and there was so much turmoil, hurt, pain, PTSD, trauma. Trauma that was still being inflicted even while being locked up. Like I said, a group of guys dragged me off my bunk, must because... I was placed by the showers and I was a gay black man. Dragged off of my bunk, reading a book and everything.
Malachi Stewart: I want to stop to just ask you Ashley, because I'm hearing their stories, I'm hearing Diane say that she was processing the denial through herself. And it sounds like the denial was able to be fueled by a system that wasn't really built to support anyway, so you can just coast through that. Hearing Rasta say there was no support inside, there was no support outside. I know you've worked with the population of people who are reentering, people who are incarcerated. Is this what you hear a lot? Is this normal?
Ashley McSwain: It is very normal. I mean I actually started my career out as a probation officer, and I mean there was nothing. No supports. There was no services. I mean you didn't even have to have HIV not to have supports or services. And the thing that was so important is that women have such a different experience than men. And so just imagine having HIV, trying to navigate that, trying to move into the community. You've got children, you've got trauma, you've got domestic violence, you've got unemployment. And there just was very few services and supports for this population.
And so I felt fortunate to be a part of the solution for women who were coming home, and trying to help them identify and prioritize, how to navigate all of those collateral needs that showed up as a result of having been incarcerated.
Malachi Stewart: And speaking of coming home, I have a question for the collective. Anyone can respond.
But we talked about the diagnosis, we talked about navigating being incarcerated, going through the process of, "You have HIV," processing that. What was reentry like? And I'm asking because what we hear a lot is that reentry into society, reentry and reintegrating, it's hard for people to find employment. It's hard for women, even when there are employment that's being offered, to find occupations that are specific to what they want to do. It's hard to find housing.
I'm interested in what that was like for you as a person who formally was a Criminal Justice major and who understands the recidivism rate. The rate of people coming back is very much dependent upon how their support, what they have, what resources are available. What was that like for y'all reintegrating?
Rasta: I guess for me it was scary for real, because do you know I wouldn't even say that I'm still looking, I've actually almost given up on looking for resources. I really have. Because for my career field, I actually wanted to work in the HIV field, helping people. No one ever gave me a chance with that. Mind you, I also wanted to work in outreach, helping people at least just find jobs and stuff like that. Because for myself, I do decent for myself, I think, when it comes to job searching. But even just trying to find a career field, that was... Like housing, oh, still looking for that. And it is been really hard. It still has. At 27 now it still has been very hard to find those resources.
I've always wanted someone that would mentor me, that would just show me a better way on how to do and live. Do and live. Because me, it is just me. Just me. I don't have any support system here. All my folks are down South. So it's just me, myself, and I for the past six, seven years, trying to figure it out, trying to make things work, make ends meet. And that was even telling my story to social workers. It is just, "Oh wow, I bet that's hard for you." And I'm just like, "Yeah."
Ashley McSwain: That's pretty standard too. I mean a lot of people I talked to about the work I was doing, and they were like they never really thought about what happens when someone comes home from prison. I don't know what they thought. They seemed to believe that these things magically appeared for people. Women coming home actually had all the supports they needed, when nothing could have been further from the truth.
Diane Carter: Yeah.
Malachi Stewart: I want to ask you something, because I want to go to Diane, but just quickly, you mentioned that it's different for women. And what came to my head listening to your story is, now I know a lot of women who work in the field and Diane's experience is common from what I hear. I don't know a lot of men who have been incarcerated and work in the field, who are living with HIV.
And my question, for either of you, do you think being a man, particularly a black man, saying "I was incarcerated," going here with this job application to work in these places that a lot of places where you do HIV work, we know what it looks like, we know what the population is there. Do you think that's intimidating for people to hire people who are formerly incarcerated?
Rasta: It is. Most definitely. Even coming from out the South, the deep South, it is. It's funny because I can go in, expresso-ed up, got my latte, "Hi, how are you? I'm here for an interview."
Malachi Stewart: [inaudible 00:35:01]and ready.
Rasta: And they're still like, "Oh. Oh, okay." And that's all I get. That's not even all I get, but that's all I need. And it's just like, okay, yeah, this isn't going to go so well. I can already see it. And it doesn't. Before I even say I was incarcerated. Now they're going to find out.
Ashley McSwain: It's a never ending-
Rasta: Never ending cycle.
Ashley McSwain: ... Journey. One of the things I see is that if you have a criminal history, and let's just say you figure it out and you get a job, if you lose that job, then you almost starting from square one. Because now you have to find somebody to accept that you have a criminal history. I mean, and it is perpetual for your entire life. You are constantly, if you lose that job, you get laid off, you almost starting back from square one.
Rasta: Yeah, that's exactly what it is actually.
Ashley McSwain: ... It's just a vicious cycle. Say that again.
Rasta: I said that's exactly what it is actually. My dad had to get his whole record expunged just to be able to continue his own business.
Ashley McSwain: Right, it's crazy.
Rasta: So he could feed his family. It's crazy.
Malachi Stewart: Diane, what was that experience like for you? I know you talked a little bit about coming in, and it sounds like you had exactly what Rasta was saying he needed. He's saying, "I needed mentors." And it sounds like you said you had them meet you at the door. What was that like for you coming in? Did that make things easier, more difficult to navigate? Did you feel like there was employment opportunities, housing opportunities for you?
Diane Carter: Well, it made it easier for my substance abuse disorder because these people made sure I got to meetings, and they taught me the principles of NA, and the 12 traditions and the steps, and all that. But it was a struggle as far as work. There was no Ashley McSwain's with organizations like Our Place DC, and Community Family Life Services. There was nothing actually for women. And when you went to the churches to get help, they would tell you, "Well, our money is gone for this month." Everywhere I went it was always, "Well, the money is gone. The money is gone."
But I would walk around, I would get up every morning, I would go out, like I had a job looking for work. I took my resume with me. I would knock on doors, I would go into establishments, organizations asking, "Do you have work? I'm willing to do whatever." All I knew is I didn't want to go back. And I also knew that I had to crawl before I walked. And at the meetings I would share and let people know, I'm just coming home from prison, if anybody had any type of lead on a job, see me after the meeting.
So it was difficult because none of the organizations that set up to do what they say they're going to do for the money that they get. They weren't doing it. And if they was doing it, the money was going so fast, by the time the end of the month it is gone. Or the end of however amount of months that they had to work with the money, it was gone. So what happened for me was, one of the people that came to that meeting, that I saw, that I used to use drugs with, she worked at Miriam's House, which is a house for women. At that time it was for women who were HIV positive and women who had AIDS, and she worked as a substance abuse counselor.
And I had saw Marion Barry coming out of a speaking engagement, and I walked up to him and I told him that I had just came home from prison. And I said, "I want to be a nurse and I need some money to go to school." And he said, "You do?" I said, "Yeah." So he gave me a phone number and told me to call that number and tell this lady to give me whatever it was I needed. And that opened some doors for me as far as getting a certification to become a Home Healthcare Aide. And then from there some other jobs. So I had my Home Healthcare certification, and she got me into Miriam's House as a Home Healthcare Aide. I had got my Certified Nursing Assistants license in Virginia at a halfway house when I got released, so I had a little paperwork behind me.
And that's what happened for me. And I never stopped looking. I never stopped searching. I never stopped taking classes in HIV certifications, anything about HIV I went to.
But it is difficult. That's why when Ashley started a program for reentry women... Women that come home to your mother, ready to just throw all your kids at you, as soon as you step out the door. "Take these kids, I've had them ever since you've been locked up." A woman stepping out the door, no clothes, no work, nowhere to live. "You can't live here. Find somewhere else to live." For her to open up a program that offered women jobs, job training, a computer room where you can go and type up your resume, and get your paperwork together to look for work, and have someone there to help you. Apartment buildings where you could come into if you had an abusive spouse or lover, and take your kids in there if your mother wouldn't let your kids or you stay in her house any longer.
All this was what women needed. And I was like going out into the community letting them know-
Malachi Stewart: That those services were available.
Diane Carter: ... That these services was available. Because we had never had this type of thing before. And then she went out and she started getting houses where women would have transitional living. We only had one, that was Fairview.
Ashley McSwain: That's a halfway house.
Malachi Stewart: Well, tell us, Ashley, I'm hearing both stories, and even in both stories, I'm hearing that it doesn't seem like much has changed. But I want to hear you be able to speak to how it has changed. Because even in Diane's story, it was a lot of hard work, luck, and a little gangster too, because she definitely pressed Marion Barry like, "You going to help me go to school?"
For somebody who's watching right now, who's reentering, who is struggling with the same things, employment, housing. All of these things, like where do I go? Where do I find help? Where do I find support? You have so much experience. What would you say to them?
Ashley McSwain: You know after 15 years in this space, there still isn't a lot of services. Community Family Life Services, which I really expanded to provide the level of support for women, and the comprehensiveness. Because women are coming home, they've been victims of domestic violence and so let's make sure that there's some safety for them. Women are coming home, they don't have employment, so let's make sure there's a pathway to employment. Women are coming home, they don't have access to their children, so let's make sure that they have some parenting supports. Women are coming home, they've got legal barriers, so let's make sure that they can talk to an attorney. And then women that are coming home who have a voice and need to be heard, so that other people can hear their experiences. And so we created a platform for them to do that.
And that's specific to DC. There are just a lot of communities that don't offer anything. Even today, 2023. I'm from Philadelphia and there is just very few services available in general for reentry, and specifically for women. So if you're in DC, Community Family Life Services, they do it all. There's a Drop-In Center, they do medical case management. We specifically target the needs of women and HIV. So that's a resource and it's a consistent resource. But depending on which State you're in, those services don't exist.
Malachi Stewart: I want to thank all of you all.
Ashley McSwain: But I would like to just share that one of the challenges for men is there's so many men, and there just aren't enough resources to address the needs. So out of all of the people that are incarcerated, 90% are men. And so it's really hard, if you're a male trying to navigate the reentry system, because there just aren't enough services to accommodate the need. Which is why we target women. Because if you have an organization that services everyone, the first nine people are going to be men, and then you run out of services for the women. So you have to specifically target women in order to get to their needs.
But it's so hard for men in all States because the numbers are so high. So I'm not sure how do you deal with that? You just need more programming, more services, and it just doesn't exist right now.
Diane Carter: Yeah, I run into quite a few guys and what I have been doing, lately I've been sending them to Voices for a Second Chance, because they deal with the reentry population, not only guys, but females and males coming home from prison. And they have resources where they can help both genders. And for the LGB population, I like sending them to Us Helping Us. They have services as well that can help the males and the females, now that they have opened their services up to females.
Ashley McSwain: Is that a new organization, Us Helping Us?
Diane Carter: No. Dr. Simmons, he's no longer with us, but he's had that program open for, oh my God, I know he stayed-
Rasta: It's been a while.
Diane Carter: Yeah.
Rasta: It's been a while.
Diane Carter: Yeah.
Malachi Stewart: I'm also from Philadelphia and I've been in the DMV for 11 years now, and Us Help Us has been here at least that amount of time. It was a long time thing. So yeah, they've been around and they're still doing the work. And like you said, they've opened their services to women.
It sounds like, because none of us have the power here to create these resources where there are none, but it sounds like what you all are doing, especially as frontline workers is creating alternatives. Like we may not be able to provide resource A, but at least there's some support. So having someone. Are you noticing that for people, "Okay, maybe we can't find you housing, but at least you have someone to call, at least you have someone to talk to." Specifically, thinking about your story, Diane, if I'm coming home, and I've suffered with substance use disorder, and I'm trying not to use substances and I don't have housing, and that alone is motivating me to go back to everything that I know, all of my old behavioral patterns.
Do you find that it's helpful for people to at least have someone to talk to, to at least have community?
Diane Carter: I do. Especially if they have a substance abuse disorder. I ask them about meetings, "Would you like to go to an NA meeting with me?" Because there's a lot of support there.
I think as long as you don't pick up, and this is just my thoughts on it, as long as you don't pick up and start using again, then there's hope for you.
Ashley McSwain: There's hope for you around dealing with your HIV, or just in terms of the reentry?
Diane Carter: Well, dealing with life. Dealing with life, period. If you have HIV, if you don't have HIV, if you need work, if you need housing, whatever it is. And you are in need of these things, then you have a chance to get them. But if you are using, your mind is just on that drug and on that drug only.
Rasta: And you go and get it again.
Diane Carter: So what do you think?
Rasta: I mean personally, so I've dealt with homelessness on and off, and I come in contact with people all the time who's addicted to a wide range of substances. And as I explained to y'all before, I lived in a halfway house around addicts as well, so I've worked the steps myself. I've gone to meetings and I have had to help people deal with and get through. I lost a close friend to an overdose when I was living in a halfway house. But at this point in my life, I could say they have a lot of resources when it comes to people that are dealing with substance abuse issues, along with other life issues.
They have the Oxford House, which I've stayed in the Oxford House myself. And with the Oxford House comes networking, community and resources. So just being that you have that community there, you get access to all those other things.
Ashley McSwain: Can I make a distinction though? I want the listeners to understand the distinction between the experience of women versus the experience of men.
Women are coming home from or jail, oftentimes they've been victims of domestic violence, which limits where they can live, which limits where they can work. That's specific to women. Women have children. They're the primary caregivers of their children. So they coming home, they got to get custody of their children. They're very different from men.
And then at a systems level, because the numbers of women are so low, then many States don't want to invest the resources because it's not cost-effective, because there aren't enough. So when women are coming home from prison, it's just a different experience that requires a very nuanced approach, so that they can be successful. And when you forget that the women have a different experience than men, then you design all these programs for men that don't really address those very specific needs of women.
Malachi Stewart: Right. Like programs that offer CDL license.
Ashley McSwain: Exactly-
Malachi Stewart: Not that women can't-
Ashley McSwain: ... Jobs that are construction.
Malachi Stewart: ... But you might not want to.
Ashley McSwain: Exactly.
Malachi Stewart: I wouldn't want to.
Diane Carter: I'd like to say too, that there are more HIV programs now available for males and females. So if you are coming out of prison today, you're not coming out without medication. If the jails know that you're HIV positive, you're coming out with medications to hold you over for 30 days. And you can get connected, they will connect you to a clinic while you are doing your time, just before your release date.
Ashley McSwain: Do you have to tell them you're positive or do they test you?
Diane Carter: Well, you tell them that you're positive.
Ashley McSwain: Oh, wow.
Diane Carter: But, um-
Ashley McSwain: If you don't tell them, then you can't get the care?
Rasta: You can. They also do testing in jails as well-
Ashley McSwain: Yeah, that's what I thought.
Rasta: ... So from my experience when you go in, I told them off the bat, so I was hoping I didn't have any problems. But they also did testing as well. TB testing, and STD and STI testing as well.
Now I wanted to speak on what you said after. Now, not to minimize a woman's experience, because I've been close to a lot of women.
Ashley McSwain: It's just different.
Rasta: It is very different, especially with the type of lifestyle a lot of women sometimes are forced to live while out there. But I would like to say even the LGBT community, we go through some of the same similar experiences as women, and a lot of people don't realize that.
Malachi Stewart: I'm glad you said that.
Rasta: So all the way down to prostitution, to not having anywhere to stay, or if you are staying somewhere sex is involved. Sex and drugs are involved. I've talked to some LGBT men who had kids as well, who have kids, and it was still just as hard. And like I said, not to minimize a woman's experience, because again, a woman is a creator of life. So with that, it's just like, okay, yeah, we should be wanting to protect our queens all the more.
Ashley McSwain: I just think it's important to know that there's a difference.
Rasta: There is. There's a big difference.
Ashley McSwain: I mean, one size doesn't fit all
Rasta: And that is very true. But there's several differences, because there's the men, there's the LGBT, and then there's women as well.
Ashley McSwain: That's real. That's right.
Malachi Stewart: And the people who kind of stand in that-
Rasta: Yeah, in the middle.
Malachi Stewart: ... You know, being a woman and being a lesbian. Being male or female, and being trans identifying.
Rasta: It gets deep.
Malachi Stewart: Intersectionality definitely is.
As a former Adherence Specialist, when I hear you all talk about these experiences, and I think about my experiences dealing with populations, I would notice that, and I'm sure you can relate Diane, you really can't treat people or help people, assist people with their HIV adherence and get their buy-in, until you address whatever their primary issue is, or primary concern is in their life.
Imagine you're facing homelessness, and like you even said, for example, if you are having survival sex, and that requires a lot of hopping around. Well, survival sex sometimes means I can't have my medication here because that's not sexy. So I may have to forego.
So these are the kind of things-
Rasta: Or it can become dangerous, just having that it medication there.
Malachi Stewart: ... Or it can become life-threatening-
Rasta: Life-threatening.
Malachi Stewart: ... Just having those things.
Have you seen that impact other people? How has that impacted you? Not having those resources addressed, but still having to come out and live with HIV, still having to be adherent, still having to prioritize your health.
Rasta: Even just reentering DC's society, that has been a big challenge for me. Having a safe space to keep my medication, keep all my important stuff while experiencing on and off homelessness. Trying to keep up with my meds and keep myself safe. That has been hard. It is like, I don't know, it is hard. That has been hard.
I'll let somebody else answer, but yeah, that's been hard.
Malachi Stewart: [inaudible 00:57:35] for sharing your stories, and thank you for sharing those resources. I hope that these kinds of conversations help, start getting that ball rolling towards not just, I'm sure someone's going to hear and be affirmed by it, but also gets us thinking as a society, as a collective about how to start getting resources in those areas. So I really appreciate you all for having that conversation.
Thank you all for being a part of this conversation with us. Listen, if you're watching, if you're listening, and you are looking for resources, you can always visit us at www.DCEndsHIV.org/podcast. As soon as you go on the website, you're going to see a little popup that's going to ask you for your zip code. Anywhere in the nation, if you put your zip code, there are a range of services in your area. From employment to housing to rental assistance.
Until next time.