HIV In Prisons Research Articles

P3.175 Prevalence of HIV, Syphilis, Drugs Use and Sexual Risk Behaviours Among Prisoners in Guatemala, 2012

BackgroundIn Guatemala, there is limited information on the situation of HIV in prisoners. Therefore performed the first representative Behavior Surveillance Survey (BSS) and Prevalence of HIV and syphilis conducted among...

Alcohol use disorders and antiretroviral therapy among prisoners in Argentina.

While Argentina has significantly improved access to HIV care and antiretroviral therapy (ART) for both the general population and prisoners, the prevalence of alcohol use disorders (AUDs) among HIV-infected prisoners and their relationship to accessing ART in Argentina is currently unknown. This study aims to characterize the substance abuse patterns of HIV-infected prisoners in Argentina and to assess the independent correlates of receipt of pre-incarceration ART. An anonymous, cross-sectional survey of 100 HIV-infected federal prisoners was conducted in the Buenos Aires municipality from July-December 2010. AUDs were assessed using the AUDIT scale. A majority (63 per cent) of participants met criteria for AUDs, 45 per cent of subjects were diagnosed with HIV in prison and one-quarter had initiated ART during the current incarceration. In addition, over one-third (35 per cent) of participants did not receive ART during the pre-incarceration period despite receiving it upon incarceration. This correlated significantly with the presence of having an AUD (AOR 0.20, 95 per cent CI 0.06-0.74, p = 0.016). AUDs are prevalent among HIV-infected prisoners in Argentina and are significantly related to negative secondary HIV prevention and treatment outcomes. While Argentina has provided an exemplary model of HIV-related health care reform within its prisons, future efforts to provide screening and treatment for AUDs are needed to improve the health of the nation’s incarcerated population. This paper is the first to describe pre-incarceration drug and alcohol use disorders and issues related to access to ART among prisoners in Argentina.

Tuberculosis in prisons: anatomy of global neglect

Infectious diseases can be transmitted readily within prisons due to close contact between prisoners. Tuberculosis (TB) and HIV/AIDS are two important causes of morbidity and mortality from infectious diseases worldwide [1, 2]; prisons have become reservoirs for these diseases in many settings. TB prevalence among prisoners worldwide can be up to 50 times higher than national averages [3, 4]. Prisons account for a substantial proportion of the TB burden in the USA [5] and TB in prisons poses a major problem in the rest of the world, especially in countries of the former Soviet Union [6, 7] and sub-Saharan Africa (SSA) [8, 9]. Co-infection with HIV in prisoners with active or latent TB is well documented [4, 10, 11] and this presents difficult diagnostic and management challenges to prison health systems. Apart from immunosuppression due to HIV, the high concentration of TB in prisons is often related to prisoner-associated risk factors such as poor nutrition, stress, drug and alcohol abuse, malnutrition, and associated chronic illnesses [3, 4, 9]. In addition, poor prison living conditions and mass incarceration [12] with inadequate ventilation, in such congregate settings, promote the transmission of Mycobacterium tuberculosis between prisoners. Such host and environmental risk factors facilitate new M. tuberculosis infections to progress to active disease, or may cause re-activation of latent TB in prisoners, the risk of which is at least an order of magnitude higher in prisons than in the general community [3]. Prisons serve as reservoirs of drug-resistant TB [10–12] which is increasingly being reported from Eastern European [6, 7, 10, 11, 13] and SSA prisons [8 …

HIV in prison in low income countries

HIV and tuberculosis are highly prevalent in institutional settings in low income countries. This is due to the communities where the institutions are located and the risky behavior of inmates. Many low income countries do not survey these populations or are unwilling to release this information. Thus it is difficult to accomplish change in prison health systems. One study surveyed the prisoners at the MACA prison whose medical staff provides for approximately 1800 prisoners a month. Multiple governmental agencies stepped in to provide education HIV testing and counseling to prisoners. Testing indicated the HIV prevalence among prisoners was higher than that of the overall population thus demonstrating the need for countries to monitor HIV among prison inmates.

HIV and incarceration: prisons and detention.

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.

HIV in prisons: the London experience

The commissioning of health services for all prisoners in publicly run prisons in England was transferred to local Primary Care Trusts in April 2006, pledging to provide an equivalent standard of health care as that in the community. We reviewed our experience of providing a specialist in-reach HIV service by performing a retrospective case notes review of all HIV-positive prisoners who accessed care from the prison genitourinary medicine service in three London prisons. A total of 112 HIV-positive prisoners were seen by the prison health-care service between April 2004 and 2006. This is the first study to look at how well HIV services are being provided during this transitional period of commissioning health services and provides insight into the challenges facing prison health-care providers. Good HIV outcomes are possible in prison but frequent transfers within the prison system and lack of effective HIV training among prison staff represent barriers to good care.

HIV in Prison and Consequences Outside: The Butterfly Effect

HIV in Prison and Consequences Outside: The Butterfly Effect

Tackling HIV/AIDS: more scientific truth, less bureaucracy

Tackling HIV/AIDS: more scientific truth, less bureaucracy

HIV in prison: what are the risks and what can be done?

Prisons are recognised worldwide as important sites for transmission of blood-borne viruses (BBVs). There are two reasons why transmission risks in prison are higher than in the community. First, in most western countries, many prison entrants have histories of injecting drug use, and thus already have high prevalences of BBVs. Second, the lack or under-supply of preventive measures (such as clean needle and syringes or condoms) in most prisons, combined with extreme social conditions, creates extra opportunities for BBV transmission. HIV prevalence in prisoners in more developed countries ranges from 0.2% in Australia to over 10% in some European nations. There are case reports of HIV being transmitted by sharing injecting equipment and sexual activity. Tattooing has been reported as a risk factor for the transmission of BBVs in prison. Access to condoms and needle and syringe programmes in prisons is extremely limited, despite success when they have been introduced. The vast majority of prison inmates are incarcerated for only a few months before returning to the community--thus they are, over the long term, more appropriately regarded as 'citizens' than 'prisoners'. Public health policy must involve all sections of the community, including prison inmates, if we are to reduce transmission of HIV and other BBVs.

The importance of routine HIV testing in the incarcerated population: the Rhode Island experience.

Routine HIV testing in the correctional setting offered to all inmates at entry has played an important role in the diagnosis of HIV in Rhode Island. Diagnosis and treatment of HIV in prisons can further public health goals of HIV control, prevention, and education. Routine HIV testing can be incorporated into primary and secondary prevention programs in correctional facilities. In Rhode Island, where HIV testing is routine at entry into the correctional facility, approximately one third of all persons who test positive are identified in the correctional facility. The proportion of males and females testing positive in the correctional facility versus those testing positive in other facilities has shown a gradual decrease, with positive female HIV tests declining more substantially in recent years. Specific groups, such as males, African Americans, and injection drug users continue to be more likely diagnosed in the state correctional facility than in other testing sites. These differences may reflect barriers to health care access that other community initiatives have failed to address.

Treating prisoners with HIV/AIDS: the importance of early identification, effective treatment, and community follow-up.

The U.S. currently imprisons a larger proportion of its population than does any other country in the world. Drug-related crimes constitute the largest percentage of arrests, and most of these crimes involve possession rather than sales or manufacture. Given the large number of drug users incarcerated in the U.S., it is not surprising that HIV is more prevalent among prisoners than in the general population. This phenomenon presents both a prison health crisis and a public health challenge. Many inmates either are diagnosed with HIV or first receive medical care for HIV while incarcerated. By screening widely for HIV in prisons, educating and treating HIV-infected inmates, and implementing individualized follow-up care upon release, we can use incarceration as an opportunity for important public health interventions. "War on Addicts" As of June 2001, more than 1.96 million people in the U.S. were incarcerated in state or federal prisons or local jails:1 a 62% increase from 1990 to 2001, during which the proportion of sentenced inmates increased from 292 to 472 inmates per 100,000 residents.2 This rise in incarceration rates can in part be explained by initiatives of the National Drug Control Strategy (NDCS), first announced in 1989. These federal initiatives of the "War on Drugs," which emphasize law enforcement, prosecution, and punishment, are intended to decrease the use of illegal substances.3 In the absence of adequate substance-abuse-treatment programs, however, these policies have increased the number of incarcerated drug abusers without addressing the root of the problem. From 1980 to 1999, drug-abuse arrests increased 3-fold, from 580,000 to more than 1.5 million, with more than 80% of these arrests for drug-possession violations.4 From 1980 to 1995, the number of people incarcerated increased by 239% (from 501,886 to 1,700,661), and drug-law violations accounted for 30%, 60%, and 41% of …

Alternatives to Current HIV/AIDS Policies and Practices in South African Prisons

Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants.

Editorial: HIV in Prison; HIV and Killer T Cells

AIDS Patient Care and STDsVol. 14, No. 3 Editorial: HIV in Prison; HIV and Killer T CellsJeffrey LaurenceJeffrey LaurenceSearch for more papers by this authorPublished Online:5 Jul 2004https://doi.org/10.1089/108729100317876AboutSectionsPDF/EPUB Permissions & CitationsPermissionsDownload CitationsTrack CitationsAdd to favorites Back To Publication ShareShare onFacebookTwitterLinked InRedditEmail FiguresReferencesRelatedDetailsCited byPrevalence and knowledge of sexual transmitted infections, drug abuse, and AIDS among male inmates in a Taiwan prisonThe Kaohsiung Journal of Medical Sciences, Vol. 28, No. 12 Volume 14Issue 3Mar 2000 To cite this article:Jeffrey Laurence.Editorial: HIV in Prison; HIV and Killer T Cells.AIDS Patient Care and STDs.Mar 2000.105-107.http://doi.org/10.1089/108729100317876Published in Volume: 14 Issue 3: July 5, 2004PDF download

The use of the condom to protect against the transmission of HIV in prisons

This article rose as a response to a practical moral question about whether or not condoms ought to be distributed to inmates in prisons of England and Wales to protect those who indulge in homosexual, genital encounter from the danger of contagion from the HIV virus. The suggestion has been made that doctors in prison should distribute condoms to those who ask for them.
 The analysis offered here examines a number of presuppositions, some of which are articulated and expressively embraced, others which remains tacit, perhaps never seriously entertained.
 The former includes the efficacy of the condom as a protection against the transmission of the virus through genital encounter, the notion that the role of the State does not extend to interference in the sphere of private morality, and, more explicit in an initial response to the proposal, that people’s consciences ought to be respected. The latter include the opinion that there is, nevertheless, a responsibility attaching to prison authorities for the well-being of inmates, if only to protect them from contagion, that sexuality is a matter of merely private morality, that morality concerns what is consequential upon deliberate action, but not a question of intrinsic good or evil.
 It si argued here that the degree of protection afforded by the condom is over-estimated, that the implicit function of the State and of prisons is to foster the common good, and that this entails a duty of care for prisoners, especially for the weakest and most vulnerable. Although a thorough-going reform of prisoners is not the direct responsibility of prison authorities, it is argued that there is an obligation not to damage them or to facilitate such damage. The impact of what is contemplated upon family and upon society is considered. The proposal envisaged would seem to threaten the well-being of inmates, the stability of prisons, the institution of marriage, and the likelihood of an eventual, successful rehabilitation of prisoners into society.
 To foment a practice which is intrinsically immoral cannot be justified, it is claimed here, even were the lesser evil argument can be invoked. Rights of the conscience and the correlative duty to respect conscience do not legitimate practices which are of their nature wrong. It is argued that the adoption of the policy proposed by bodies with a duty to the State and to society for the common good would in fact undermine the common good by facilitating what is scandalous.

A note on the control of HIV in prisons

This note considers the spread of HIV in a single prison where there is a constant rate of departure and replacement of prisoners. Some of the incoming prisoners will be HIV +, and homogeneous mixing within the prison is assumed. HIV is thus spread sexually or by the sharing of intravenous drug users' needles. A deterministic continuous time prison model is examined, and the number of HIV+ infective prisoners at time t derived. A stochastic analogue of this model is constructed, in the form of a continuous Markov chain, and its embedded chain studied. Finally, a control procedure involving the screening of a proportion of the incoming prisoners, and the quarantining of the HIV+ individuals is proposed. Its consequences are derived for the deterministic model. The proportion to be screened, given a total expenditure for the screening procedure and the medical costs of quarantined and non-quarantined infectives, can be calculated.

A note on the control of HIV in prisons

This note considers the spread of HIV in a single prison where there is a constant rate of departure and replacement of prisoners. Some of the incoming prisoners will be HIV+, and homogeneous mixing within the prison is assumed. HIV is thus spread sexually or by the sharing of intravenous drug users' needles. A deterministic continuous time prison model is examined, and the number of HIV+ infective prisoners at time t derived. A stochastic analogue of this model is constructed, in the form of a continuous Markov chain, and its embedded chain studied. Finally, a control procedure involving the screening of a proportion of the incoming prisoners, and the quarantining of the HIV+ individuals is proposed. Its consequences are derived for the deterministic model. The proportion to be screened, given a total expenditure for the screening procedure and the medical costs of quarantined and non-quarantined infectives, can be calculated. Copyright © 1999 John Wiley & Sons, Ltd.

HIV transmission in a prison system in an Australian State.

To investigate possible HIV transmission among prison inmates. A prison system in an Australian State. 13 ex-prisoners and their prison contacts. Ex-prisoners who claimed to have been infected with HIV in prison and their prison contacts were interviewed about HIV risk behaviour. Entries in prison and community medical records were used by a three-member expert panel to establish the likelihood of primary HIV infection and its possible timing and location. Determination of whether HIV infection probably occurred in prison. There was a very high probability that at least four of 13 ex-prisoners investigated acquired HIV in prison from shared injection equipment. Another two ex-prisoners most probably acquired HIV infection outside prison. The location of infection for the remaining seven could not be determined. HIV transmission in prison has substantial public health implications as most drug-using prisoners soon return to the community. HIV prevention strategies known to be effective in community settings, such as methadone maintenance treatment and syringe exchange schemes, should be considered for prisoners.

The Spread and Quarantine of HIV Infection in a Prison System

This paper is concerned with models for the spread of HIV in prisons. A simple deterministic model for the spread of HIV in a single prison is considered, a discrete-time stochastic analogue of it is then discussed, and some simulations of epidemics are provided. The model is generalized to a two-prison system in both the deterministic and stochastic cases. Finally the possibilities for intervention in a prison are outlined and a simple cost-effectiveness analysis in the context of screening and quarantine is undertaken. The computations for the stochastic models make use of a new technique for bounding variability in a Markov chain with a large state space.

Molecular techniques show transmission of HIV in prison

Molecular techniques show transmission of HIV in prison

AIDS. HIV in prison: the importance of prevention.

Although the prison service aims to give inmates the same quality and range of health care services as those received by the general public, the provision of condoms and materials for cleaning shared injecting equipment is not the norm. These relatively inexpensive measures could, however, save many lives.