A transgender immigrant locked up by Immigration and Customs Enforcement in a private, remote New Mexico jail told staff she was bleeding from her rectum — and then had to wait 13 days for urgent medical care, according to a secret memo sent by a top Department of Homeland Security official to ICE leadership and obtained by BuzzFeed News. When the woman was finally tested, the memo said, “it was determined she had HIV.”

“The negligence of addressing a medical emergency such as this not only placed the infected detainee at risk for severe medical complications,” wrote Dana Salvano-Dunn, director of the compliance branch for the DHS Office for Civil Rights and Civil Liberties, “but it also exposed other detainees and facility and ICE staff to an infectious and potentially deadly disease.”