Inmates Living with HIV in Cuba

Daysi Rodríguez Alonso has served two of the eight years of her sentence since her arrest on July 12, 2021, just 24 hours after she got on top of a patrol car that others overturned during the Toyo protest in Havana. Rodríguez Alonso, 40, who has been living with HIV since the age of 25, shared a small space with more than 20 relatives in the house at number 439 on the Calzada de 10 de Octubre. She now resides in a cell where she has struggled with several ailments and, worst of all, very few medications.

"Nothing for anemia. Nothing for AIDS. The food is still pork brains and flour. The ‘punishment cells,’ if she misbehaves, are damp and filthy caverns like those that did in her deceased uncle," reads a report by journalist Manuel de la Cruz, published by Cultura Democrática. The document delves into the life of Daysi, the 5,869th person to be infected with the Human Immunodeficiency Virus in Cuba, and one of the 1,812 people who, since the mass protests on 11-J, have been arrested in the country for political reasons, in contexts of protest. It also forms part of the statistics collected by Justicia 11J on 675 people who remain imprisoned; among them, 57 are women, including Daysi.

Daysi was caught by cameras for just a few seconds on top of a patrol car, which was enough to initiate criminal proceedings against her and put her in prison. Not much more was needed for State Security to rig the process against the young LGBTI+ and HIV-positive Yoan de la Cruz, who, on July 23, around 5:00PM, patrol car 151 picked up in front of his house.

The Cuban Prosecutor's Office initially sought an eight-year prison sentence for him, for livestreaming via Facebook the 11-J protest in San Antonio de los Baños, triggering others in dozens of locations across Cuba. Thousands of people found out about the anti-government demonstrations thanks to the young man's direct contact via this means. This served as a pretext for State Security to portray him as a ringleader and resulted in him remaining virtually incommunicado while awaiting trial at the prison in Melena del Sur, Mayabeque, until he was sentenced to six years in jail. Upon appeal, Cruz received a subsidiary penalty of five years of correctional work without incarceration. Nothing changes their experiences at their detention centers, however.

Yoan spent the first 20 days after his arrest in a prison in Guanajay, far from his residence in San Antonio, such that visiting him was difficult for his mother given the restrictions imposed due to Covid-19. In the prison to which he was subsequently taken, the food was equally scarce and deficient, to the point that chicken became a sporadic luxury despite the fact that an HIV-positive person should be allocated a diet including beef. For months, his mother provided him with the meat that his humble family could afford. Compounding these dangerous conditions, Yoan had to endure humiliations violating his human rights, as State themselves branded him a maricón (faggot).

It was no different for trans protester Brenda Díaz, who had her head shaved in prison, thereby stripping her of one of the symbols of her gender identity. Her mother told reporter Mel Herrera that Brenda lived for her hair, so it was very painful for her to have it taken from her. Worse still,  the young woman was placed in a penal section that does not correspond to her gender identity, with no record of her providing her consent for this. She is being held in the men's section of a (binary) prison in the municipality of Güines, province of Mayabeque, which has a section for each gender (female and male), and is designed for people who, like Brenda, are carriers of HIV.

On Thursday, August 4, 2022, the EFE agency indicated that an appeal filed in favor of the 11-J protester, expanded to another 20 people, resulted in 11 of them having their sentences reduced by at least six years.

However, Díaz did not benefit from this revision and, besides receiving the additional sanction of having the dress she was wearing confiscated, she continues to face a sentence of 14 years of incarceration at facilities where she has also suffered, according to her mother, sexual assaults. According to testimony obtained exclusively by Justicia 11J, Brenda has been sexually assaulted, systematically, by an inmate. There was no security for Brenda at the first penal center where she was held, nor is there where she is now, at a prison exclusively for HIV+ people, one of several of its kind in the country.

Detention centers for HIV+ persons only

International standards recognize the principle of separation as a measure applied to help protect the physical and mental safety of persons deprived of their liberty, to facilitate their individual surveillance, and to contribute to their rehabilitation. It can also facilitate the proper management of prisons. Separation, though justified in cases where it is intended to protect persons detained in situations of special vulnerability, due to their age, health status, ethnic origin, sexual orientation or gender identity, should not be systematic or confused with classification.

"We don't put healthy people in the same establishment as those who have HIV/AIDS," said Colonel  Osmani Leyva, the second head of the Ministry of the Interior's (MININT) Penitentiaries Directorate. In fact, the Criminal Enforcement Regulation, updated in 2022 in Cuba, defines so-called "AIDS" prisons as a "special" type of detention center. Justicia 11J has found references to some of these establishments in different provinces: that of San José, in Mayabeque; Santa Clara, in Villa Clara; and Holguín; in El Caguayo, Santiago de Cuba. The first of them was opened in the early 2000s, according to a  CubaNet report that back in 2013 had already condemned corruption, overcrowding and poor medical care in that prison, where five years later —according to a report by Martí Noticias— Yuniel Cabrera Álvarez died. Days prior fellow inmates, through a video, warned of Cabrera's physical deterioration and the dreadful conditions to which they were subjected there.

The cases of Brenda, Daysi and Yoan have all occurred in western Cuba. The young LGBTI+ and HIV positive Yordan Petiton Villart, on other hand, was in the east of the island -  specifically, the municipality of Contramaestre, in Santiago de Cuba - where he was arrested along with his cousin Gerardo García Villart.

Justicia 11-J records indicate that Petiton remained in the El Caguayo AIDS prison, as Contramestre's prosecutor sought for him a joint sanction of ten years behind bars for the crimes of public disorder, disobedience and assault. Following his trial on 13 December, he was sentenced to seven years. A video of the protest in which the young man participated shows a law enforcement officer as draw his weapon and point it at two young men who were only demanding their right to demonstrate peacefully and for others to join them.

In a collective trial, relatives of the defendants told CiberCuba at the time that the agent testified claiming that he acted in self-defense in response to a "death threat" from a third protester. "The officer who pointed a gun at Ibrahim accused Gerardo [Yordan's cousin] of a death threat."

During the judicial proceedings a "loss of evidence" contained in a USB stick was reported, which was to be presented by the defense to prove the innocence of the accused. Family members reported that the officers involved in violence against protesters denied it all - despite images circulating on social media constituting irrefutable proof of police and paramilitary repression during the protests - while "defense lawyers were almost not allowed to speak" during the oral hearing.

The footage "magically lost" included images of attacks with sticks and stones committed by the police, presumably leading to what seemed to be Ibrahim's death. A video documents the moment when the young man was rushed away by his arms and legs after receiving a brutal beating. The severest penalties sought in this case were those for Ibrahim Domínguez Aguilar and Yordan Petitón Villart: 15 and 10 years, respectively, followed by those of Gerardo and others, for whom eight years were requested.

It has not been possible to obtain information on the current situation of the prison where Yordan is located or the conditions that the young HIV+ inmate faces, although transparency, objectivity and balance in the coverage of issues and the handling of information are among the guiding principles of the Observatory on HIV, Prisons, Drugs and Human Trafficking.

This observatory was created by the United Nations Office on Drugs and Crime (UNODC), in collaboration with UNAIDS "in order to strengthen the capacities of Latin American and Caribbean States, making available to visitors extensive information on the countries in the region that facilitates analysis, discussion and the development of strategies with a multidisciplinary and multisectoral approach."

The HIV infection rate, higher in prisons

According to the Observatory on HIV in Latin American and Caribbean Prisons, which is defined as an interdisciplinary and intersectoral system for research, analysis, proposals and the communication of information related to HIV and AIDS in the region's prison systems, "worldwide, the rate of HIV infection tends to be much higher in the prison environment than outside it."

In Cuba, incarcerated inmates are usually held at specialized centers, and even before the first cases of HIV were reported on the island in the late 1980s, the Los Cocos specialized sanatorium was opened, where patients were received, but under a regime lacking any freedom. The isolation approach does not appear to have been abandoned.

According to Cubalex, in a 2013 alternative report for the EPU, there are medium-security establishments and minimum-security centers for the accommodation and specialized care of inmates living with HIV or AIDS. The NGO reports that no health prevention and promotion work is carried out at these facilities, where prison staff have no training in health issues, especially in relation to the prevention of suicide and issues related to HIV/AIDS and other communicable diseases.

"Cases of the spread of HIV via unprotected sex were reported, but also as a way to be transferred to laxer prisons, special facilities for prisoners carrying this disease or the virus. Syringes infected with the virus have been sold," Cubalex said.

The study (HIV/AIDS) and its legal regulation in Cuba, by Lisbeth Infante-Ruiz and Ricardo Silva-Zaldívar, attached to the University of Holguín, recognizes, through a case study of the specialized penitentiary institution in that province, that people with HIV/AIDS who commit crimes or who, after entering the prison, are found to be HIV positive, reside apart from the other prisoners, in a Special AIDS Unit.

At this center, which the authors describe as a hospital, "there are about 89 inmates from the eastern provinces (Granma, Santiago, Holguín, Guantánamo) complying with provisional detention time, security measures, correctional work with internment, and other sanctions. There are different forms of work for them there, with some working voluntarily, as gardeners or nurses, while some study. These detainees enjoy a varied and balanced diet, a specific medical diet for people with (HIV)," the document reads.

Press reports, however, have related that the lack of medical care and poor living conditions at these centers have triggered protests. In 2015, at the special prison for HIV/AIDS patients in Caguayo, located at kilometer 22 —on the national highway, Santiago de Cuba, some 120 inmates protested, according to CubaNet. For years people being held (including those deprived of their liberty for political reasons) have complained about these prisons.

In 2012 Martí Noticias covered a statement put out by the Cuban League Against AIDS, an independent organization, in which it declared that in June of that year the number of protests in Cuban prisons for prisoners with HIV/AIDS had increased. At several detention centers in the provinces of Santiago de Cuba, Holguín, Santa Clara and San José (in Mayabeque), protests were recorded that "demonstrate the discontent among the Cuban penal population affected by this disease." At that time, according to the text, there were more than 700 prisoners with HIV or AIDS scattered across six penitentiaries for the serving of their sentences.

Three deaths

A report by Archivo Cuba on deaths in 2012-2022 at the hands of agents of the Cuban State, in alleged violation of the Convention Against Torture, indicates that several of the victims were HIV positive, and others died from outbreaks of cholera or tuberculosis, without treatment. "Prison authorities' lack of interest in providing medical treatment to prisoners who regularly complained, or appealed for help, or refusals to do so, were persistent," the report said.

• Case 1 (documented as #316): Arniolkis Frómeta Naples died on 2013-9-12 at the San José de las Lajas HIV-AIDS correctional facility in Mayabeque, Cuba.
• Case 2 (documented as #421): Ricardo Pagés Moré, 41, died on October 18, 2013 at his home in Cuba, on medical leave. He had contracted HIV/AIDS at prison 5 1/2 of Pinar del Río. He was transferred to a special prison in the province of Mayabeque, where he was infected with a parasite that prevented him from eating (throat problem) and caused other symptoms for which he did not receive medical treatment. His mother unsuccessfully tried to get him a specialist or have him sent home on medical leave. On November 12, 2012 he was transferred to the National Hospital of the Eastern Penitentiary, in Havana, and in June 2013 he was sent to the Institute of Tropical Medicine, but he was not treated there (because it was crowded with cholera patients). He was ultimately admitted to the La Dependiente Clinical Surgical Hospital, where he suffered a heart attack. On October 10, 2013, he was sent home on medical leave. He died eight days later.
• Case 3 (documented as #11356): Joaquín Martínez Rosabal, 32, died on December 16, 2020 at the Eastern Penitentiary's National Prisoner Hospital, in Havana. He was serving time at a center for HIV patients in Güines, in the province of Mayabeque. In October 2019, he was diagnosed with tuberculosis and transferred to the prison hospital, where he was placed in an isolation cell for allegedly having medicines that had not been prescribed to him. Prison authorities said that, in the early morning, he hanged himself with a sheet from the bars of his cell. On the same day they found him dead, however, two nurses claimed to have heard him screaming that he was being suffocated. His mother believes that he was murdered, and demanded an investigation and the exhumation of the corpse, which presented wounds from blows.

"AIDS Prisons" reopened with another approach

After the 11-J protests, due to the great number of arrests, detention centers that were in disuse were reopened to assimilate the demonstrators, despite their ramshackle states. At least 22 people were transferred to detention centers known as "AIDS Prisons" in the country's territories. One of them was Yurisleydis de la Rodríguez Piña, who shared her testimony about those days spent at the AIDS prison in San José. She was arrested along with her boyfriend, Eduardo M. Baez Mederos, on July 12.

"We went out (my boyfriend and I) to peacefully demonstrate on Sunday [July 11]. I shouted a couple of slogans, like Patria y Vida (Homeland and Life), and I was filming the events. On Monday there was another protest but I didn't demonstrate because I had a toothache. On my way to the clinic, I passed through a park where there was a Party rally. I had my phone in my hand and it seems they thought I was filming, so they arrested me and my boyfriend. On my chest I had Patria y Vida written, which I had put on the day before. We were transferred to the AIDS prison, where there were men and women. In the women's section there was an area with 10 bunk beds (20 women) and I was there for 15 days. On the 27th I was released at around midnight. They gave us four meals a day: breakfast, lunch, a snack and, before bed, a stew. The first few days the food was very bad.

Later, it got a little better. We were women from different municipalities of Mayabeque and we started talking about the demonstrations. When we exhausted that topic of conversation, we began to tell each other about our lives. Sometimes they would check us out. They would put us in a room with female officers, and we'd have to squat there, without any clothes. It was like three times in 15 days. When we got back to the cell, everything was turned upside down. They conducted searches to see what they could find. We were seldom let out. Then, in the last few days, they let us out a little into a little patio, to get some sun. When I left there were about eight girls left. I wrote their names on a card, but in one of the searches they took it. I lost contact with them, and later learned that many of their relatives were also imprisoned. We were not beaten, but the men were; we saw them being taken out with wounds."

A relevant case: Daysi

According to the report "11-J Protestor Daysi Alonso: One More Tragedy for House 439," it took four days for Maritza to find out where her niece Daysi was, and more than three months to learn that the Provincial Prosecutor's Office sought a 20-year prison sentence for her. This violates the provisions of the Standard Minimum Rules for the Treatment of Prisoners, whose Section C, concerning persons detained or awaiting trial, states that prisoners must be presumed innocent and treated in a manner consistent with that presumption. In general, it is indicated that authorities must have a valid detention order, which must record the person's identity, the reasons for their detention, the authority that issued it, and the date, time and place; as well as contact and transfer information.

In addition to the lack of transparency, Daysi's relatives report that she has certainly not received adequate "medical care" since July 12, the day on which the Police took her, without saying where or until when. Only later did they learn that Daysi had been transferred to the Güines prison for people with HIV-  a month spent at the 100 and Aldabó State Security interrogation center.

The Association for the Prevention of Torture states that persons detained with HIV/AIDS should not be separated from the rest of the prison population on the basis of their HIV/AIDS status. Daysi's legal proceedings are rife with contradictions between international recommendations and what is done in Cuba.

"The first month she was held, at 100 and Aldabó, her relatives were not allowed to bring her medicines, nor did they [the agents] administer them. After this, Daysi was transferred to the prison for people with HIV/AIDS in the municipality of Güines, in Mayabeque province, more than 50 km from her home. The authorities allowed them to supply her with antiretrovirals, but for Maritza [Daysi's aunt], paying monthly transport fees of more than 3,000 pesos [about 300 dollars at the unofficial exchange rate] was not easy, so her niece had to manage without her treatment. After 11 months in prison, Daysi Alonso has only managed to get her antiretrovirals in just two."

According to the report, a few months before July 11 doctors deemed surgery to save Daysi's life urgent, as she was also afflicted by the Human Papilloma Virus, which led to cervical cancer. After more than a year in prison, however, she remained untreated and without surgery.

At the prison, supposedly "outfitted for HIV-positive inmates," the protester, who before being arrested was receiving chemotherapy at the Daughters of Galicia Capital Hospital because in 2017 she was diagnosed with CIN-3 cancer, was not given any treatment and, the family complained, the food had also been terrible. "From the very first month Deysi presented anemia, for which she has received not treatment, and her diet has not been adjusted. Once, Maritza was able to bring her a few vials of Rosefín, given to her by a friend, and that they gave to her at the prison."

The Standard Minimum Rules for the Treatment of Prisoners indicate that the provisioning of medical services is the State's responsibility, and state that all penitentiary establishments should provide prisoners with rapid access to medical care in urgent cases, and transfer those who require special care or surgery to specialized establishments or civilian hospitals. Daysi's aunt, however, was unsuccessful in seeking medical certificates that would entitle her to adequate treatment. The Prosecutor's Office went so far as to request 20 years of incarceration for the crime of sedition. As an alternative, the family was willing to accept her transfer to the Havana hospital for her treatment and operation, but only got a transfer permit for the hospital of the El Combinado prison, to start a cancer treatment there.

Daysi's experience makes at least one thing clear: the separation approach employed by the Cuban State in the penal system for people living with HIV is no guarantee that their human rights will be respected. The Cuban State continues to ignore and violate international instruments and the nearly 1,000 documents (including legislation, jurisprudence, good practices, research, monitoring reports, among others, from countries in Latin America and the Caribbean) comprising the database of the Observatory on HIV and Prisons in the region, which set down the technical bases for dialogue and promote international standards and internal policies to guarantee universal access to HIV prevention, treatment, care and group support for those facing conditions of extreme vulnerability, such as inmates.