HIV treatment withheld from Guam detainee

HAGATNA, Guam — Guam's Department of Corrections hasn't been treating an HIV-positive detainee because it was waiting for him to become more sick first, the prison's director said Thursday.

Director Jose San Agustin said he didn't think the virus could be treated until after AIDS symptoms had developed. San Agustin said he realizes he needs to learn more about the disease.

"I'm just starting to learn these things," he said.

The prison's doctor several months ago said the detainee should be treated immediately, San Agustin said, but San Agustin decided to take more time to consider the case.

As of Thursday, murder suspect Keith Garrido had not received treatment for HIV, despite a court order issued Wednesday by a Superior Court judge requiring the prison to begin treatment.

San Agustin said the prison is doing evaluations and assessments first, to determine the next step.

Treatment, he said, would begin "as soon as we can."

On Wednesday, defense attorney Stephen Hattori alleged that Garrido was being denied medication for HIV because he is a pretrial detainee and not an inmate. Hattori said Garrido was prepared to plead guilty to murder and other charges in order to become an inmate and receive treatment.

Magistrate Judge Alberto Tolentino declined to accept the plea and instead ordered the prison to provide treatment. The order stated the Corrections Department must provide "all treatment for such a diagnosis and shall ensure that (Garrido) receives the medical treatment deemed necessary by his treating physicians."

As it turns out, the failure to treat Garrido isn't related to his status as a detainee, but rather because of the prison's unclear policies about how to deal with such patients.

The Department of Corrections in 2012 approached the Department of Public Health and Social Services to find out how to handle people with HIV, according to Public Health STD/HIV program supervisor Bernie P. Schumann.

She said the prison was told it would have to develop its own medical plan, and that Public Health would help with the standards.

San Agustin said the policies were developed but never fully implemented. He cited staffing and funding shortages as the reason it was not implemented.

San Agustin said he based his handling of the current situation on the department's experience with a previous inmate who had "full-fledged AIDS."

As a result, he said, officials were waiting for this incidence of HIV to become "more serious."

Guam law requires the Department of Corrections to provide medical treatment for all inmates and detainees.

That requirement was expressly stated to the prison in a 2009 legal memorandum from the Office of the Attorney General. It revised an earlier legal opinion, which stated pretrial detainees could be treated differently than inmates.

Federal Public Defender John Gorman yesterday said the denial of medication would be a violation of the U.S. Constitution's prohibition on cruel and unusual punishment.

"Medical conditions shouldn't be used to coerce someone into a plea," he said.