The Second Sentence: AIDS in Dublin’s Mountjoy Prison

In January 1986, Irish current affairs program Today Tonight reported on a spate of deaths and attempted suicides in Dublin’s Mountjoy prison. These, the reporter intoned, “reveal something seriously wrong in the Irish prison system. A system long-known to be overstretched, antiquated and inadequate has been pushed into the front line of modern Irish society’s confrontation with drugs.” The situation had reached a breaking point — and the attention of Today Tonight — with the emergence of AIDS among drug users in Irish prisons, bringing “a new dimension of fear.”

We tend to think of AIDS in the West as something that affected (and still affects) gay men first and foremost. In many places in the 1980s, this was the case, but it’s only part of the picture. During the early years of the epidemic, researchers were also connecting AIDS with injected drug use.

Heroin, in particular, was booming in popularity in cities like New York, Edinburgh, Rome, Madrid, and Dublin, and it was in these locations that those working with drug users began to realize the scale of this new threat to their clients. Once a test for HIV became available in 1985, alarming statistics started to emerge. In some communities, well over half of all drug users were testing positive for HIV, and many feared that this would only increase.¹

In Ireland in the 1980s, some 60% of all HIV and AIDS diagnoses were attributed to drugs injected with dirty, shared needles. Dublin had experienced an “opiate epidemic,” and rising rates of users injecting heroin; early research found that those affected were often teenagers and young adults from the inner city, who had left school at a young age and struggled to find employment in a city struck by recession. Bereavement and a family history of alcoholism was not uncommon. Importantly for this story, three-quarters had been arrested, and three-fifths had served a prison sentence.² In September 1985, 27% of patients at Dublin’s drug treatment clinic tested positive for HIV. A matter of weeks later, the first prisoner in Mountjoy received the same diagnosis.

Interviewed for Today Tonight, Ben Hogg was described as a heroin user from the age of 15, who had spent most of his life in Mountjoy or its counterpart for juveniles, St. Patrick’s Institution, also located in Dublin. Hogg gave an emotional account of being told that he had “AIDS” by the prison doctor, and how quickly word spread around the prison. Within moments of him leaving the doctor’s office, it seemed that staff on his landing knew. As he sat in the administration block that afternoon, waiting for prison officials to make hasty plans for him, he became the object of interest and, he felt, mockery. “They were making up excuses just to come in to the office and look at me and snigger at me,” he told Today Tonight. “It must have been every prison officer in the jail walked in and looked at me, and they were laughing and sniggering.”

Ben Hogg was abruptly released from prison that same day, on instructions from the Department of Justice. He had no information about his new and devastating diagnosis, but nor, it seemed, did the prison service, despite the many heroin users coming through their doors. Prisons were unprepared for inmates with HIV/AIDS, and there was more than a hint of panic in their reaction as well as the scorn Ben remembered. Staff feared for their own health, and feared an outbreak within the close confines of the prison — an outbreak of HIV/AIDS, or perhaps more urgently, an outbreak of violence and disorder if inmates began to target those they thought might be infected.

We should remember that at this time there was no cure, very little treatment, and a lack of clarity and certainty about how HIV could be transmitted. This was true all around the world in the mid-1980s, but was intensified in Ireland, where information was particularly thin on the ground.

In many countries, staff in STD clinics developed some expertise in HIV/AIDS as they worked, public health experts could gather data and share the latest international findings, and gay activists helped to raise the profile of this new disease amongst researchers and politicians alike. Ireland had few STD clinics, little investment in public health, and homosexuality remained illegal, limiting the reach of the very new Gay Health Action group.

There had also been few deaths in Ireland as a result of AIDS: only eleven nationwide by the end of 1985.³ HIV/AIDS was still a very niche concern. Those making decisions about prisoners who were affected had little to inform them.

Widespread anxieties and uncertainties about AIDS were exacerbated by the prison environment.

Rumor and suspicion abounded on all sides. Overcrowding and unsanitary conditions intensified fears of infection, and the prison doctors were neither trusted nor respected. Releasing HIV-positive prisoners was no long-term solution: more and more prisoners were coming forward to request a test, and within a short time some 10% of Mountjoy’s inmates had received a positive diagnosis. They were placed in segregation: a prison within the prison.

The segregation of women with HIV was quickly abandoned, but many men remained in the separate area of the prison for years. The policy of segregation was not formally set aside until January 1, 1995. Segregation was not without advantages: prisoners had access to a new doctor with some interest and expertise in HIV/AIDS, better facilities, better terms for release, and could even be “prescribed” 7Up. But, unsurprisingly, distress and mental illness were prevalent, and drug use continued. Residents fell ill; AIDS-related illnesses took their toll. The separation unit became bleak, and ultimately reinforced the impression that people with HIV/AIDS were different, dangerous, and to be avoided.

Over the late 1980s and early 1990s, at least one-sixth of all people with HIV or AIDS in Ireland passed through Mountjoy.⁴ The ongoing use of segregation encouraged some to conceal their diagnosis, and compounded the sense of fear and stigma. The story of AIDS in Ireland should remind us of just how differently HIV/AIDS was experienced and managed in different places. It should also remind us of the heavy toll of HIV/AIDS upon already-marginalized lives, including those of drug users and people in prison.

Janet Weston

Janet is currently a Research Fellow at Centre for History in Public Health, at the London School of Hygiene and Tropical Medicine, where she is part of the team working on the Wellcome Trust-funded project 'Prisons, Medical Care, and Entitlement to Health in England and Ireland, 1850-2000'. Her PhD examined medical approaches to sexual crime over the twentieth century, and forms the basis of a book out with Bloomsbury in late 2017, 'Medicine, the Penal System, and Sexual Crimes in England, 1919-1960s'.

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