Josiah Rich: speaking up for the incarcerated

Abstract

Click on to the website of Brown University's Center for Prisoner Health and Human Rights and you're greeted by a shocking nugget of information. “The nation's three largest psychiatric facilities”, it says, “are the New York, Los Angeles and Chicago jails. More than half of the incarcerated population has a mental health problem.” The Center's Co-Director is Josiah “Jody” Rich, Professor of Medicine and Epidemiology at Brown University's Warren Alpert Medical School in Providence, Rhode Island. Co-founded in 2005 by Rich and colleague Scott Allen to draw attention to the plight of prisoners, the centre had humble origins. “We started it with a website and some stationary—and some chewing gum and a little piece of string”, Rich jokes. But he believes it's achieving the critical mass required to make an impact. “As soon as you put that flag in the ground people start coming out of the woodwork…It's identified a lot of people within the academic community who are doing things already.” Rich speaks whereof he knows; since he joined Brown University's affiliated Miriam Hospital as an attending physician in 1994 he's made countless visits to his local prison, tackling problems of infectious disease, particularly HIV, and drug use. Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detaineesThe prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV, viral hepatitis, and tuberculosis. We did a comprehensive literature search of data published between 2005 and 2015 to understand the global epidemiology of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and tuberculosis in prisoners. We further modelled the contribution of imprisonment and the potential impact of prevention interventions on HIV transmission in this population. Full-Text PDF Clinical care of incarcerated people with HIV, viral hepatitis, or tuberculosisThe burden of HIV/AIDS and other transmissible diseases is higher in prison and jail settings than in the non-incarcerated communities that surround them. In this comprehensive review, we discuss available literature on the topic of clinical management of people infected with HIV, hepatitis B and C viruses, and tuberculosis in incarcerated settings in addition to co-occurrence of one or more of these infections. Methods such as screening practices and provision of treatment during detainment periods are reviewed to identify the effect of community-based treatment when returning inmates into the general population. Full-Text PDF Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisonersThe prevalence of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis are higher in prisons than in the general population in most countries worldwide. Prisons have emerged as a risk environment for these infections to be further concentrated, amplified, and then transmitted to the community after prisoners are released. In the absence of alternatives to incarceration, prisons and detention facilities could be leveraged to promote primary and secondary prevention strategies for these infections to improve prisoners health and reduce risk throughout incarceration and on release. Full-Text PDF HIV, prisoners, and human rightsWorldwide, a disproportionate burden of HIV, tuberculosis, and hepatitis is present among current and former prisoners. This problem results from laws, policies, and policing practices that unjustly and discriminatorily detain individuals and fail to ensure continuity of prevention, care, and treatment upon detention, throughout imprisonment, and upon release. These government actions, and the failure to ensure humane prison conditions, constitute violations of human rights to be free of discrimination and cruel and inhuman treatment, to due process of law, and to health. Full-Text PDF HIV and tuberculosis in prisons in sub-Saharan AfricaGiven the dual epidemics of HIV and tuberculosis in sub-Saharan Africa and evidence suggesting a disproportionate burden of these diseases among detainees in the region, we aimed to investigate the epidemiology of HIV and tuberculosis in prison populations, describe services available and challenges to service delivery, and identify priority areas for programmatically relevant research in sub-Saharan African prisons. To this end, we reviewed literature on HIV and tuberculosis in sub-Saharan African prisons published between 2011 and 2015, and identified data from only 24 of the 49 countries in the region. Full-Text PDF The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and tuberculosis in Eastern Europe and Central AsiaDespite global reductions in HIV incidence and mortality, the 15 UNAIDS-designated countries of Eastern Europe and Central Asia (EECA) that gained independence from the Soviet Union in 1991 constitute the only region where both continue to rise. HIV transmission in EECA is fuelled primarily by injection of opioids, with harsh criminalisation of drug use that has resulted in extraordinarily high levels of incarceration. Consequently, people who inject drugs, including those with HIV, hepatitis C virus, and tuberculosis, are concentrated within prisons. Full-Text PDF