Drug Resistant

Harris County jailers are in no hurry to hand out meds to inmates with AIDS. Inmates claim this and other lockup practices endanger their lives.

Randall Shook's body was at war with itself. Sitting on the concrete floor, Shook gathered his legs close to his chest and groaned. Chills traveled the lanky frame of his body, causing him to shake uncontrollably. His head burned from fever, and his heart beat rapidly.

Shook hollered down the hall for help, but when a Harris County Jail deputy showed up, the jailer refused to take him to the clinic. The clinic was shorthanded, he said. Two days later, still suffering the same symptoms, Shook asked another deputy to call the clinic.

"This is jail. You're not supposed to feel good," he allegedly replied.

In April, Shook had been pulled over on Greenbriar for driving the wrong way down a one-way street. He refused the Breathalyzer test. He pleaded guilty to DWI, prepared to do his time. What he wasn't prepared for was having the pills he took each day, the ones that kept him healthy, taken away from him during his incarceration.

Shook has been HIV-positive for 15 years and has had AIDS for the last four. A person with HIV develops AIDS when the T-cell count drops below 200. (An HIV-free person normally has 1,000 T-cells.)

Shook, whose T-cell count dipped to less than 100, did not see a triage nurse until ten days after his initial written request -- even though the jail's own policy mandates that a nurse should see a patient within 24 hours of a sick-call. It took 18 days for Shook to receive his pills after coming into custody, which seemed a matter of life or death to him because interrupting an HIV drug regimen can render the virus resistant to drugs.

"Should a DWI be a death sentence?" he wrote in a letter from jail.

With a population that fluctuated between 6,029 and 7,701 inmates in the last year, Harris County Jail is one of the largest jails in the country. Treating so many inmates is a complicated task, says Major Don McWilliams, who oversees the sheriff's department public services bureau.

Since 1990 Harris County has contracted with the University of Texas Health Science Center at Houston to provide medical care to inmates. Those who work in corrections praise Harris County Jail for its vast medical system, which functions much like an outpatient clinic. The on-site medical facilities include a pharmacy, laboratory, eye clinic, dental services, tuberculosis clinic, and specialists in infectious diseases, obstetrics- gynecology and nutrition. Its 11-year-old HIV counseling program has served as a model for other correctional facilities.

Yet some AIDS patients who recently served time complain they were deprived of HIV medication for weeks on end, were refused trips to the clinic when sick and were even exposed to an inmate with tuberculosis. Gay and transgender inmates report that guards constantly harassed them over their sexual orientation . Though the county jail may have decent procedures on paper, it does not seem to follow them.


At Christmas, Randall Shook told his mother that he didn't think he'd make it through the summer. A skilled hairstylist who once owned his own salon in Dallas, Shook made $1,200 a week cutting hair at a high-end Tanglewilde spa. But in late March he became too weak to stand up long enough to work. Racked by spells of simultaneous fever and chills, he hardly left his bed, and his mother and brother came to collect him. His younger brother carried him to the car from a near-empty house. Shook had already given most of his possessions away.

Shook spent ten days in Ben Taub for pneumonia. Days after his discharge, he visited Thomas Street Clinic, the Harris County Hospital District's AIDS facility. Five days later, on April 5, he was arrested for his third DWI. It had been seven years since his last DWI and five years since his last arrest. (In 1996 he served time in state jail when a bag with traces of cocaine was found on him.)

Shook instructed his mother not to bond him out because he planned to plead guilty and serve time. He, like everyone else, was made to strip, shower, trade civilian clothes for an orange jumpsuit and submit to a chest X-ray to screen for tuberculosis. Everyone also sees an intake nurse who asks a series of medical and psychiatric questions. By the time Shook saw a nurse and told her about the regimen of six different drugs he took, it was his second day in jail. Then he was called for classification, where inmates are assigned housing based on a number of factors, including criminal history, education and sexuality. On his third day, Shook was moved to a cell block on the eighth floor of 1301 Franklin (the county jail maintains three facilities, all located downtown) for men who are gay, bisexual or transgender.

For security reasons, people are not allowed to bring medication into the jail with them, says Dr. Michael Seale of the UT Health Science Center who serves as medical director of Harris County Jail. The only exception is someone who is participating in an experimental drug study.

"It's difficult to look at a vial of medication and see if it's been tampered with -- if perhaps with illegal substances. So what we choose to do is start fresh with our own supply," he says.

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