title: HIV and incarceration: prisons and detention.
abstract: The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners.The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.
authors: rjurgens@sympatico.ca
authors: Ralf
authors: R
authors: Jürgens
authors: Manfred
authors: M
authors: Nowak
authors: Marcus
authors: M
authors: Day
references: Salud Publica Mex. 2003 May-Jun;45(3):181-90
references: 12870419
references: AIDS. 1990 Oct;4(10):1023-6
references: 2261117
references: AIDS. 1993 Nov;7(11):1485-91
references: 8280416
references: Med J Aust. 2003 Jun 2;178(11):546-9
references: 12765501
references: Addiction. 1998 Dec;93(12):1851-6
references: 9926573
references: Am J Med. 1999 Dec 27;107(6B):100S-103S
references: 10653468
references: MMWR Recomm Rep. 2005 Jan 21;54(RR-2):1-20
references: 15660015
references: Clin Infect Dis. 2004 Jun 15;38(12):1754-60
references: 15227623
references: Am J Public Health. 1988 Apr;78(4):447-9
references: 3258134
references: Addiction. 2003 Feb;98(2):153-8
references: 12534419
references: Eur J Public Health. 2001 Sep;11(3):243-50
references: 11582600
references: Lancet Infect Dis. 2007 Jan;7(1):32-41
references: 17182342
references: Health Hum Rights. 2005;8(2):46-74
references: 17136903
references: Ann Intern Med. 2006 May 16;144(10):762-9
references: 16702592
references: BMJ. 1995 Feb 4;310(6975):293-6
references: 7866170
references: JAMA. 1991 Mar 6;265(9):1129-32
references: 1995998
references: CMAJ. 2007 Jul 31;177(3):252-6
references: 17664448
references: Lancet. 2010 Aug 7;376(9739):475-85
references: 20650514
references: Can HIV AIDS Policy Law Rev. 2000;5(4):20-1
references: 11833158
references: J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Apr 1;8(4):399-405
references: 7882106
references: Can J Public Health. 2004 Mar-Apr;95 Suppl 1:S9-63
references: 15125459
references: Addiction. 2000 Aug;95(8):1207-16
references: 11092068
references: Int J STD AIDS. 1999 Jul;10(7):475-8
references: 10454185
references: Addiction. 2005 Jun;100(6):820-8
references: 15918812
references: JAMA. 1998 Nov 25;280(20):1769-73
references: 9842953
references: CMAJ. 2007 Jul 31;177(3):257-61
references: 17664449
references: PLoS Med. 2008 Dec 9;5(12):e234
references: 19071954
references: AIDS Educ Prev. 2002 Oct;14(5 Suppl B):53-64
references: 12413193
references: Can HIV AIDS Policy Law Newsl. 2000 Spring-Summer;5(2-3):60-4, 65-9
references: 11833203
references: Can J Public Health. 2005 Mar-Apr;96(2):97-101
references: 15850026
references: Subst Use Misuse. 2002 Jan;37(1):47-63
references: 11848159
references: BMJ. 1993 Jul 24;307(6898):228-31
references: 8369682
references: AIDS Behav. 2003 Jun;7(2):153-61
references: 14586200
references: AIDS Educ Prev. 2002 Oct;14(5 Suppl B):7-23
references: 12413189
references: AIDS. 1991 Dec;5(12):1509-13
references: 1814333
references: Lancet Infect Dis. 2009 Jan;9(1):57-66
references: 19095196
references: Epidemiology. 2002 Nov;13(6):738-41
references: 12410020
references: Epidemiol Infect. 1999 Aug;123(1):95-102
references: 10487645
references: Int J Epidemiol. 2000 Aug;29(4):734-43
references: 10922353
references: JAMA. 2000 Sep 27;284(12):1516-8
references: 11000643
references: Emerg Med J. 2001 Jul;18(4):242-5
references: 11435354
references: J Public Health Policy. 2005 Apr;26(1):30-59
references: 15906874
references: Eur Respir J. 2005 Aug;26(2):298-304
references: 16055879
references: Lancet. 1991 Mar 16;337(8742):647-8
references: 1671996
references: Can Commun Dis Rep. 1995 Jul 30;21(14):134-6
references: 7670433
references: J Med Microbiol. 2006 May;55(Pt 5):593-597
references: 16585647
references: AIDS. 2005 Apr 29;19(7):709-16
references: 15821397
references: Med J Aust. 1994 Jun 6;160(11):734
references: 8202021
references: Trans R Soc Trop Med Hyg. 2002 Nov-Dec;96(6):617-9
references: 12625135
references: Clin Infect Dis. 2004 Jun 15;38(12):1761-3
references: 15227624
references: Subst Use Misuse. 2005;40(1):99-123
references: 15702651
references: Eur J Epidemiol. 1998 Jun;14(4):327-31
references: 9690748
references: AIDS. 2001 Sep 7;15(13):1741-4
references: 11546955
references: HIV Clin Trials. 2005 Jan-Feb;6(1):25-37
references: 15765308
references: Can Commun Dis Rep. 2004 Aug 15;30(16):141-8
references: 15352686
references: BMJ. 2002 Apr 6;324(7341):850
references: 11936162