title: Overview of harm reduction in prisons in seven European countries.
abstract: While the last decade has seen a growth of support for harm reduction around the world, the availability and accessibility of quality harm reduction services in prison settings is uneven and continues to be inadequate compared to the progress achieved in the broader community. This article provides a brief overview of harm reduction in prisons in Catalonia (Spain), Greece, Ireland, Italy, Latvia, Poland, and Portugal. While each country provides a wide range of harm reduction services in the broader community, the majority fail to provide these same services or the same quality of these services, in prison settings, in clear violation of international human rights law and minimum standards on the treatment of prisoners. Where harm reduction services have been available and easily accessible in prison settings for some time, better health outcomes have been observed, including significantly reduced rates of HIV and HCV incidence. While the provision of harm reduction in each of these countries' prisons varies considerably, certain key themes and lessons can be distilled, including around features of an enabling environment for harm reduction, resource allocation, collection of disaggregated data, and accessibility of services.
authors.affiliation: Harm Reduction International, London, UK. gen.sander@hri.global.
authors.forename: Gen
authors.identifier: 0000-0001-6931-6503
authors.initials: G
authors.lastname: Sander
authors.affiliation: Associazione Antigone, Rome, Italy.
authors.forename: Alessio
authors.initials: A
authors.lastname: Scandurra
authors.affiliation: Latvian Centre for Human Rights, Riga, Latvia.
authors.forename: Anhelita
authors.initials: A
authors.lastname: Kamenska
authors.affiliation: Education Centre, Midlands Prison, Portlaoise, Ireland.
authors.forename: Catherine
authors.initials: C
authors.lastname: MacNamara
authors.affiliation: PRAKSIS, Athens, Greece.
authors.forename: Christina
authors.initials: C
authors.lastname: Kalpaki
authors.affiliation: University of Barcelona, Barcelona, Spain.
authors.forename: Cristina Fernandez
authors.initials: CF
authors.lastname: Bessa
authors.affiliation: University of Barcelona, Barcelona, Spain.
authors.forename: Gemma Nicolás
authors.initials: GN
authors.lastname: Laso
authors.affiliation: Associazione Antigone, Rome, Italy.
authors.forename: Grazia
authors.initials: G
authors.lastname: Parisi
authors.affiliation: UL Hospitals Group, Limerick, Ireland.
authors.forename: Lorraine
authors.initials: L
authors.lastname: Varley
authors.affiliation: Helsinki Foundation For Human Rights, Warsaw, Poland.
authors.forename: Marcin
authors.initials: M
authors.lastname: Wolny
authors.affiliation: PRAKSIS, Athens, Greece.
authors.forename: Maria
authors.initials: M
authors.lastname: Moudatsou
authors.affiliation: CIES-IUL/ISCTE-IUL Instituto Universitário de Lisboa, Lisboa, Portugal.
authors.forename: Nuno Henrique
authors.initials: NH
authors.lastname: Pontes
authors.affiliation: Research Centre for Education and Professional Practice, University of Limerick, Limerick, Ireland.
authors.forename: Patricia
authors.initials: P
authors.lastname: Mannix-McNamara
authors.affiliation: Medical Services in Rebibbia Prison (Rome) and Coordinamento Nazionale degli Operatori per la Salute nelle Carceri Italiane, Rome, Italy.
authors.forename: Sandro
authors.initials: S
authors.lastname: Libianchi
authors.affiliation: PRAKSIS, Athens, Greece.
authors.forename: Tzanetos
authors.initials: T
authors.lastname: Antypas
mesh_terms: D005060:Europe; D015658:HIV Infections / Q000517:prevention & control / Q000628:therapy*; D040261:Harm Reduction; D006291:Health Policy / Q000331:legislation & jurisprudence*; D006297:Health Services Accessibility / Q000331:legislation & jurisprudence*; D006526:Hepatitis C / Q000517:prevention & control / Q000628:therapy*; D006801:Humans; D011329:Prisoners / Q000331:legislation & jurisprudence*; D011330:Prisons / Q000331:legislation & jurisprudence; D015819:Substance Abuse, Intravenous / Q000517:prevention & control / Q000628:therapy*
keywords: HIV; Harm reduction; Hepatitis C; Human rights; Needle and syringe programme; Opioid substitution therapy; Prison; Prison health; Prisoner