The Carceral-Medical Nexus: HIV Care, Social Disenfranchisement, and the Matrix of Violence

• In Event: Medical Sociology Section Roundtables
  In Refereed Roundtable (90 minute): Table 16. The State, Legal System, and Healthcare Policy

Abstract

The Matrix of Violence framework conceptualizes the "prison nation" as an active perpetrator of structural violence, yet the specific domain of carceral healthcare within this matrix remains theoretically under-examined. Incarcerated individuals must navigate a landscape where medical care and punishment are inextricably linked, a "carceral-medical nexus" that reproduces profound health inequities. For those living with HIV, the dual stigmatization of HIV status and criminalization intensifies exposure to systemic harm. Drawing on 26 semi-structured qualitative interviews with formerly and currently incarcerated individuals living with HIV in Miami-Dade County jails, this study applies the Matrix of Violence to examine how structural violence manifests within carceral medical treatment. Findings reveal that clinical breaches of confidentiality, HIPAA violations, and medical malpractice are not merely administrative failures; they constitute a critical axis of social disenfranchisement. These breaches function as "links" within a matrix of violence that further marginalizes criminalized individuals, facilitating staff and peer mistreatment and heightening vulnerability to systemic neglect. By documenting how the carceral-medical nexus serves as a primary site of structural violence, this study argues for a theoretical shift in medical sociology that recognizes the prison as an engine of health inequality rather than a mere backdrop for care.

Author

• Kim-Phuong Truong-Vu, University of Miami