Increased HIV-risk has been independently associated with imprisonment in a wide range of settings from Thailand to Canada. Putting injecting drug users in prison has major consequences for public health because of the potential for infectious disease transmission between drug-using inmates. Within prisons, HIV-infected populations are often kept close to high-risk populations, and these social-network characteristics undoubtedly contribute to HIV-risk behaviour in these environments, state Evan Wood (British Columbia Center for Excellence in HIV/AIDS, Vancouver, Canada) and colleagues. This problem is made worse because successful prevention methods are rarely available in prison, despite international guidelines, which state that the standard of healthcare for prisoners must be similar to that for the general community.
Dr Wood concludes: "Incarceration does not reduce overall levels of illicit drug use, or the related health, social, and fiscal harms. Thus the policy of mass incarceration of non-violent drug-offenders needs review. However, in the short term, there is an urgent need to ensure that standards of HIV prevention in prisons are consistent with the best available evidence and the standards outlined in international guidelines."
Contact: Dr Evan Wood, British Columbia Center for Excellence in HIV/AIDS, St. Paul's Hospital, 608-1081 Burrard Street, Vancouver, BC V6Z 1Y6, Canada T) +1 604 806 9116 ewood@cfenet.ubc.ca
Journal
The Lancet