Prevention of infectious disease transmission in correctional settings: a review.
OBJECTIVE
To review studies defining risk factors for infectious disease transmission in correctional settings, to determine target objectives, and to assemble recommendations for health promotion in prisons and jails.


METHODS
Electronic databases were searched, using a specific search strategy, from 1993 to 2003.


RESULTS
The principal risk factors in correctional facilities are proximity, high-risk sexual behaviour and injection drug use. Based on the type of disease transmissions and epidemics reported in the literature, four diseases were targeted for which preventive measures should be implemented: tuberculosis, human immunodeficiency virus, hepatitis and sexually transmitted diseases. Knowledge of risk factors helps define effective preventive measures along five main themes of action: information and education, screening, limiting harm from risk behaviour by distributing condoms and exchanging syringes, treatment and vaccinations.


CONCLUSIONS
The effectiveness and feasibility of each of these actions have to be assessed in relation to the specificities of the correctional setting.
Niveau
G
G
Department of Community Health and Medicine, Faculty of Medicine, IUML, Avenue de Champel 9, 1211 Geneve 4, Switzerland. gerard.niveau@hcuge.ch
D003140:Communicable Disease Control / Q000379:methods*; D015658:HIV Infections / Q000517:prevention & control; D006293:Health Promotion / Q000379:methods; D006505:Hepatitis / Q000517:prevention & control; D006801:Humans; D011330:Prisons; D012307:Risk Factors; D012749:Sexually Transmitted Diseases / Q000517:prevention & control; D015819:Substance Abuse, Intravenous; D013557:Switzerland; D014376:Tuberculosis / Q000517:prevention & control; D047568:Unsafe Sex