Migrant Dies in ICE Custody from Untreated HIV

A 45-year-old Ethiopian man died in Immigration and Customs Enforcement (ICE) custody from complications of human immunodeficiency virus (HIV) in January, according to the Maricopa County medical examiner’s report obtained by the Project On Government Oversight (POGO).

Human rights advocates and health experts have long raised alarms about issues of medical neglect and deaths in immigration detention. These long-standing problems may be even more acute for people who are HIV positive and are particularly vulnerable in cases of medical neglect due to their immunocompromised status. 

The man did not receive specialized treatment for HIV while he was held in an ICE detention facility in Arizona during the five months leading up to his death, according to the detainee death report posted on ICE’s website. That report details that he was cleared to be housed among the general population at Eloy Detention Center in August 2024 after an initial medical screening. The man also had tuberculosis when he died, a highly infectious airborne disease for which ICE has special isolation guidance.

POGO has not been able to reach the deceased man’s next of kin to obtain consent to publish his name and so will not name him in this investigation. 

ICE’s death report shows that the man received medical attention for back pain on five occasions throughout the fall of 2024 while in detention, but lists no other medical treatment received prior to the day of an emergency room visit in mid-December. The detainee death report notes that he had lost 20% of his body weight by that point. 

The medical examiner’s report documented a range of infections that the man had at the time of his death, including HIV with “likely acquired immunodeficiency syndrome (AIDS), central nervous system toxoplasmosis, tuberculosis, Diphyllobothrium tapeworm, pneumocystis pneumonia, Klebsiella pneumoniae, Candida albicans, and Cytomegalovirus (CMV).”

The lack of medical care this man received in detention is alarming, according to Dr. Chris Beyrer, a leading expert on HIV/AIDS and director of the Duke Global Health Institute. (Beyrer said that his comments do not necessarily reflect the views of Duke University, and that he was not speaking as a representative of Duke.) 

“He was a gravely ill man,” Beyrer said. “It’s hard to imagine that nobody noticed that he was deteriorating this quickly between August and December.”

Perry Halkitis, an expert in infectious disease epidemiology and professor of public health at Rutgers University, agrees. “If they had run routine blood work they would have seen immediately from his CD4 count that he had HIV. Immediately!”

Halkitis said to imagine your grandparent going to the doctor four months in a row, getting thinner and weaker. “You think the doctors are going to do blood work?” he asked. “They should have been able to tell he was a very sick man.”

A June 2024 report by a coalition of human rights organizations identified medical neglect and denial of HIV treatment among a sample of HIV positive people in detention. (There is no evidence that the man was explicitly denied HIV treatment within detention, only that his set of infections went untreated.)

ICE has not responded to questions about whether this man received any treatment for HIV, but did respond to questions sent in March about his tuberculosis diagnosis. A spokesperson said ICE is “committed to the health, welfare, and safety of those in its custody” and makes efforts to ensure detained people are provided appropriate medical care. 

Beyrer said the man’s death was potentially preventable, explaining that HIV is a very treatable condition and HIV positive individuals have a life expectancy of around 75 years. “This man died at 45,” Beyrer said. “So he lost many years, potentially, of life.”

HIV positive people in detention settings are particularly at risk of contracting other infections such as tuberculosis, which can then accelerate the progression of HIV. The Ethiopian man had tuberculosis when he died, and his full listed cause of death on the medical examiner’s report was “complications of multiple infections in the setting of human immunodeficiency virus.”

The Eloy Detention Center has been singled out by lawmakers and immigration advocates for inadequate medical care and for migrant deaths. 

“Our experience over the last couple decades has been that Eloy is one of the most deadly facilities,” said Setareh Ghandehari, advocacy director for Detention Watch Network. Her organization co-authored a January 2024 report about the inhumane conditions at Eloy Detention Center.

The Eloy Detention Center is owned and operated by private prison company CoreCivic. Ryan Gustin, CoreCivic’s senior director of public affairs, said their staff prioritizes the health and safety of people detained at the facility. He added that ICE Health Service Corps is responsible for medical care at Eloy Detention Center, and that CoreCivic staff do not make medical treatment decisions. 

ICE’s standards for facilities like Eloy stress the importance of the “accurate diagnosis and medical management of HIV infection among detainees,” and include detailed instructions for medical personnel. ICE is also required to thoroughly screen migrants for tuberculosis upon arrival.

Halkitis said one of the most alarming issues in this case is the risk of tuberculosis spreading to other detained people and staff at the facility. 

“Tuberculosis is highly, highly, highly contagious,” Halkitis said. “I would not be surprised if other people became infected with tuberculosis during that time frame when this individual was in custody.” 

As of mid-March, a spokesperson for ICE said there was one case of a tuberculosis-positive person in ICE custody who made a full recovery and is housed at the Florence Correctional Complex in Florence, Arizona. ICE did not clarify where that tuberculosis case originated and said there are no other confirmed or suspected cases of tuberculosis among the detained population or facility staff in response to questions about this incident.

Halkitis emphasized the importance of testing for communicable diseases like HIV and tuberculosis in detention settings, arguing that testing could have made the difference for this man. 

“We have an obligation, I think, as a country, even if we don’t believe these individuals should be in our country, to make sure we’re not putting them in harm’s way,” Halkitis said.