Tales from behind the Wall: ACT UP/Philadelphia and HIV in Prisons

During the 1990s, the AIDS Coalition to Unleash Power (ACT UP)/Philadelphia became increasingly involved in the fight against HIV/AIDS in poor communities of color, even as chapters of the group declined nationwide. The Philadelphia chapter became concerned with intersections between HIV and incarceration, taking up the case of Greg Smith, a black gay man in New Jersey, “serving what may be a life sentence, solely for being HIV positive.”¹ Smith’s story highlights two points of intersection between HIV and incarceration: the criminalization of people with HIV and the lack of adequate medical care in prison for people with HIV. ACT UP/Philadelphia’s involvement in Smith’s case points to the group’s interest in addressing the twin epidemics of HIV and mass incarceration.²

In June 1989, Smith was serving a five-year sentence for burglary in Camden County Jail, just across the Delaware River from Philadelphia. After falling in his cell, Smith was taken to the county hospital for treatment. When a technician refused to take an x-ray of his back, Smith became angry and allegedly bit a guard on the hand while being subdued. The state charged Smith with attempted murder, arguing that, though the virus is not transmitted through saliva, his HIV constituted a murder weapon. At trial, prosecutor Harold Kasselman’s argument turned on Smith’s alleged intent to kill. Kasselman claimed that after biting the guard Smith had shouted, “Now die, you pig!” While AIDS advocates protested that the state had singled out Smith because of his race and HIV status, Kasselman painted Smith as a “selfish, malicious, three-time felony loser.” After an all-white jury convicted Smith, Judge John Mariano sentenced him to twenty-five years in prison.³

On its website, ACT UP/Philadelphia gave Smith a chance to tell his side of the story. He wrote, “At the time of the incident I was handcuffed and shackled, suffering with a back injury and facing two armed guards. . . . [J]ust how many ‘weapons of choice’ does a shackled person have, anyway?” Smith protested the poor care that inmates with AIDS received, linking inmates’ substandard treatment to Governor Christine Todd Whitman’s efforts to privatize prison medical care by outsourcing it to Correctional Medical Services (CMS). Smith claimed that because CMS had the inmates’ HIV medications shipped from Oklahoma, the prescriptions often arrived late or not at all. HIV drug regimens require strict adherence to be effective, so unreliable delivery meant that “this company is killing the inmates.”⁴

ACT UP/Philadelphia hoped that publishing Smith’s account would arouse sympathy and action for those living with HIV behind bars. The group described Smith as a “tireless advocate for prisoners with HIV/AIDS,” which made him a target for “unlawful segregation and discrimination” by prison staff. ACT UP/Philadelphia encouraged readers to correspond with Smith, donate money for food and incidentals, and publicize health care issues within New Jersey prisons, such as the “law requir[ing] prisoners to pay for a portion of their health care costs . . . discourag[ing] preventative care.” This treatment, the group argued, constituted “criminal neglect.”⁵

When Smith died in prison in late 2003, ACT UP/Philadelphia made sure that he would not be forgotten. In January 2004, members staged a political funeral at Judge Mariano’s home in Haddonfield, a wealthy New Jersey suburb just outside the city. Arriving early on a Tuesday morning, activists chanted, “Murderer!” while carrying a black casket to Mariano’s front yard. Waheedah Shabazz-El, a new ACT UP member who had herself recently been incarcerated, recalled that, “We all went out there and turned his town upside down, put flyers on the neighbors’ cars, and knocked on the neighbors’ doors, and woke everybody up. ‘Did you know there’s a murderer that lives across the street in that house?’ ”⁶

ACT UP/Philadelphia’s advocacy on Smith’s behalf highlights the city’s radical tradition, as the...