In this powerful conversation, I’m joined by Dr. Chad Zawitz, a physician who spent over two decades delivering frontline medical care inside one of the largest urban jail systems in the country. Dr. Zawitz pulls back the curtain on carceral healthcare, explaining the critical differences between jail and prison, the constitutional right to medical care for incarcerated individuals, and why many patients actually experience better measurable health outcomes while locked up.

We spend significant time unpacking the evolution of HIV treatment, from the early days of fear and stigma to today’s extraordinary advances, including long-acting injectable antivirals and the game-changing reality that people with undetectable viral loads cannot transmit HIV. Dr. Zawitz explains why, with proper access and adherence, HIV could be effectively eliminated within a single generation, without a cure or vaccine.

This episode also explores stigma, language, trauma, addiction, and the power of treating people like human beings. From stories inside the jail to reflections on COVID, public health messaging, and medical ethics, this conversation is a reminder that healing doesn’t begin with protocols, it begins with compassion.

Episode Highlights

[00:00] – Why HIV could be eliminated in one generation with the tools we already have

[03:15] – Dr. Zawitz’s path into correctional healthcare and why it matters

[05:40] – Jail vs. prison: understanding the difference and why it impacts care

[10:30] – The constitutional right to healthcare for incarcerated individuals

[14:50] – How HIV care is delivered behind bars

[18:30] – The evolution of HIV treatment: from AZT to modern long-acting injectables

[22:55] – U = U explained: undetectable equals untransmittable

[26:30] – The role of stigma, language, and bias in healthcare outcomes

[35:55] – Treating patients as people: why simple kindness changes everything

[43:00] – Why health markers often improve during incarceration

[48:40] – COVID in jails: fear, access, vaccines, and media narratives

[55:35] – “Tales from the jail”: surprising clinical lessons from real life

[01:08:50] – Public health, vaccines, and the cost of polarization

[01:17:45] – Lessons from Dallas Buyers Club and early HIV innovation

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