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“The only thing necessary for these diseases to the triumph is for good people and governments to do nothing.”

HIV/AIDS & Hepatitis C:
Correctional Facilities and the Criminal Justice System


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Many State Correctional Facilities have mission statements that state that they are to protect the public through effective management of offenders in controlled environment environments, which are efficient, safe, humane, and appropriately secure, while also providing meaningful work and self-improvement opportunities to assist offenders with community reintegration. Also the highest priority is the protection of the public, staff and inmates through the highest degree of security systems' performance by all staff at all times. What many in the populace does not realize is that these offenders are released back into the general population and many times-they are positive and they have never been informed of their health status by these institutions.

"Although some figures have been published, comprehensive statistics demonstrating the burden of infectious disease among inmates have been lacking. An important 'public health opportunity' in prisons and jails has been identified by some authors. This opportunity has yet to be fully exploited for various reasons, including a lack of statistics as well as the fact that prisoners are generally marginalized, despised, and politically impotent. Political leaders and the public have not recognized the importance of correctional settings for health interventions. Prevention and treatment programs are extremely uneven in quality and quantity and, in some respects, fundamentally inadequate." The Burden of Infectious Disease Among Inmates of and Releasees From US Correctional Facilities, 1997

"For a variety of reasons, many diseases are present at a higher prevalence in prisons and jails. Mental illness, HIV, hepatitis B and C, and drug and alcohol addiction are just a few of the conditions that are common in prisoners entering the correctional system. What is often seen as an overwhelming burden to correctional healthcare systems should more appropriately be seen as a tremendous public health opportunity. The stark truth is that most inmates will eventually be released from prisons and jails. Once released, many of them either do not have access to healthcare or fail to avail themselves of it. In focusing healthcare resources on the incarcerated, society has the opportunity to decrease crime rates (mental illness, addiction), prevent transmission (HIV, hepatitis, other sexually transmitted diseases [STDs]), and lower lifetime costs associated with untreated diseases. " Hepatitis C: A Correctional-Public Health Opportunity

All prisoners have the right to receive health care, including preventive measures, equivalent to that available in the community without discrimination, in particular with respect to their legal status or nationality. The general principles adopted by a national AIDS programme should apply equally to prisoners and to the community.134

The WHO guidelines were publicly supported and endorsed by the Joint United Nations Programme on HIV/AIDS (UNAIDS) in a statement issued in April 1996. The UNAIDS statement explained that ignorance and lack of government support in addressing HIV/AIDS in prison has led to denial, ineffective policies, violence and discrimination.135 Many different policy options have been explored in response to HIV/AIDS in prison with varying results in different countries and contexts. However, an international consensus confirmed by the WHO and UNAIDS has declared that some of the more popular policies are not only ineffective but unnecessary and unjustified. The policies which have been condemned by international bodies include mandatory testing, and segregation. Other policies employed in various prison systems include education, condoms, disinfectant and sterilized needles, and general penal reform." —HIV/AIDS in Prison, Problems, Policies and Potential


Document Name & Link to Document


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1996-1997 Update: HIV/AIDS, STDs, and TB in Correctional Facilities

Report from the US Justice Department-gives most current information about the status of infectious diseases in prisons in addition to what they are doing about thiese issues

562 kb pdf

30 pc of prisoners have hepatitis C One in three inmates of Australian prisons have hepatitis C, new statistics show. A sample of prisoners from Western Australia, NSW, Queensland and Tasmania returned rates of 34 per cent for the blood-borne disease.  

68% rise in AIDS Deaths Among Prisoners

THE number of HIV-infected prisoners in Namibia rose by 68 per cent from 2000 to 2001, a report released this week said.


A Critical Review of HIV-Related Interventions for Women Prisoners in the United States This article reviews the literature on HIV-related interventions for U.S. women prisoners, with a focus on identifying strategies that enabled women to practice safer sex, reduce drug use, and to avoid recidivism. A comprehensive search indicated that only nine such interventions were evaluated in professional journals between 1994 and 2009. These interventions involved behavioral programs for women at risk for HIV and discharge planning for women releasees who were either infected with or at risk for HIV. Four interventions for incarcerated women achieved successful outcomes regarding self-empowerment and safer sex skills  

A Primary Care Approach to Mental Health Care for HIV/Hepatitis-Infected Inmates

The combination of incarceration and chronic illness can be a potent formula for mental health disorders. Even without the burden of a chronic infectious disease, inmates have a high prevalence of mental illness.


Aboriginals, AIDS & Prisons.

Aboriginal or Torres Strait Islander people who are prisoners, and in fact all people who are prisoners, require ongoing information about HIV/AIDS prevention and access to education and the means of protection

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Adverse Effects of US Jail and Prison Policies on the Health and Well-Being of Women of Color

Evidence of the negative impact of incarceration on the health of women of color suggests strategies to reduce these adverse effects. Correctional policies contribute to disparities in health between White women and women of color, providing a public health rationale for policy change.


AIDS & Australian Prisons. Much attention has been devoted recently to the plight of HIV positive prisoners.  The primary reason for this interest is the fear that prisons are 'incubators' for the transmission of the HIV, the accepted cause of AIDS. 57 kb pdf
AIDS and Prisons: List of resources for information  

AIDS in Australian Prisons-What are the Challenges?.

Punishment and imprisonment are also taboo items.  Societies like to see things in black and white, and prisons are the simplistic solution for punishing those who step beyond the conventional view of what is right.  The public at large does not particularly want to explore the grey areas of this issue either.

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AIDS in prison-1996 report

But how many people are aware of the new death row?  The combination of HIV infection, poor medical care, a callous, uncaring prison administration and the day-to-day violence/stress of prison life can make a short prison term -- a death sentence.


Alabama and South Carolina: Stop Segregating HIV-Positive Prisoners


Alabama and South Carolina should immediately change their policy of segregating HIV-positive prisoners from the rest of the prison population, Human Rights Watch and the ACLU National Prison Project concluded in a report released today. Prisoners in the designated HIV units face stigma, harassment, and systematic discrimination that amounts to inhuman and degrading treatment, the report found.  
Canadian prisons will soon feature tattoo parlors Toronto - Correctional Service of Canada plans to set up official tattoo parlors for inmates in the hope that it will decrease the rampant spread of hepatitis C and other communicable diseases through prisons and penitentiaries.  A survey of federal inmates determined that 3,176 prisoners, 26% of the prison population, were infected with hepatitis C. The rate is 30 times that of the general population.  

AIDS in Prisons-information clearing house.

HIV/AIDS has become a major policy and management issue for prison administrators in this country, as in the rest of the world.  It places enormous stress on already overburdened correctional systems

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AIDS in the Victorian Prison System.

As early as 1985 the view was being expressed that prisons would become incubators for the AIDS virus.  Concern was high that ‘at risk; behaviors of prisoners, both prior to imprisonment and during their time in custody, would create an environment that would promote the rapid spread of the virus.

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AIDS in US Prisons & Goals: Epidemiology, Policy and Programs.

Most correctional systems have adopted policies regarding HIV/AIDS.  Concern among correctional systems has shifted significantly from short-term ‘crisis’ matters such as fear of casual transmission to ‘long-term’ issues.

Pdf 59 kb

AIDS, Prison, and Preventative Medicine: Certainly the life of a prisoner is tough, and violence is inevitably present in prison systems where gangs frequently play a prominent role in social organization (Conover 2000). However, misconceptions regarding prisons are numerous, and such misconceptions play an important role in how the AIDS problem in prisons is viewed.  

AIDS Recommendations & Prisons in Australia-WHO.

The privilege of choice carries with it the necessity to evalusate the consequences of the choice made.  Where that choice involves sending a person to prison the risk that the person will tere acquire HIV ought not to be vanished from the mind by ignorance, indifference or resignation

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An opportunity not yet seized Correctional health care providers manage the care of a large number of individuals with communicable diseases in the U.S. A major portion of the nation’s Hepatitis B&C, HIV, STD and TB infected patients pass through prison and jail doors.  Moreover, many of these individuals also have other co-morbid conditions such as psychiatric illnesses, substance abuse and chronic medical conditions that thwart an integrated care approach for these patients in community settings.  

Australia-'Condom Scheme for Safe Jail Sex'

A proposal to put condom-vending machines in Tasmanian prisons is expected to be approved early next year. The Justice
Department's blood-borne virus working party put forth the proposal in an effort to ensure safe sex among inmates.


Australian Institute of Criminology-HIV/AIDS and Prisons

List of article from the internet


Australian Prisons



AIDS in the Victorian Prison System.

Managing HIV Seropositive Prisoners

Management of HIV Infection in Australian


The first national HIV/AIDS in prison conference held in Australia took place in Nov. 1990.  This is a report of that conference.

The first national HIV/AIDS in prison conference held in Australia took place in Nov. 1990.  This is a report of that conference.

The first national HIV/AIDS in prison conference held in Australia took place in Nov. 1990.  This is a report of that conference.

The first national HIV/AIDS in prison conference held in Australia took place in Nov. 1990.  This is a report of that conference.

The first national HIV/AIDS in prison conference held in Australia took place in Nov. 1990.  This is a report of that conference.


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Australian response to HIV in Prison One area of employment that has received increased attention over recent years is occupational health and safety (OH&S). This is largely due to the unacceptably high incidences of industrial injuries and diseases and recognition of the inadequacies of traditional safety legislation.  

Behind Bars-HIV risk taking behavior.

It has recently been estimated that  40-50 per cent of male and female IDU’s in contract with treatment services or research projects may spend considerable periods of their lives in prisons.

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Behind Bars-Risk Behaviors for HIV Transmission.

Whether HIV transmission occurs is a function of the interaction between risk behaviours and prevalence of infection.  To date studies of HIV transmission in prison have occurred in settings where the prevalence of infection has generally been low and the prevalence of risk behaviours unknown.

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Behind Enemy Lines

Recognizing that hepatitis C virus infection is disproportionately high among incarcerated populations, The Centers of Disease Control and Prevention (CDC) recently developed recommendations that provide a framework for identification of persons who would benefit from testing, counseling and medical management to prevent and control hepatitis C infection and its consequences


Bridging the Communicable Disease Gap: Identifying, Treating and Counseling High-risk Inmates

Recent outbreaks of communicable diseases in correctional settings have underscored the importance of identifying communicable diseases, educating inmates and staff, and treating where appropriate. In June 2001, an outbreak of HBV was reported in a state correctional facility in Georgia. In November 2000, the CDC reported an outbreak of TB in a state correctional facility in South Carolina. Concurrent syphilis outbreaks were identified in three Alabama men's state prisons in 1999.


Burden of infectious diseases among inmates Correctional facilities are critical settings for the efficient delivery of prevention and treatment interventions for infectious diseases. Such interventions stand to benefit not only inmates, their families, and partners, but also the public health of the communities to which inmates return.  

Californians Support Needle Exchange, Condoms for Prisoners

"These clearly make sense and the survey indicates strong support that the state should pay for these programs,"


CDC: Test All Inmates At Risk for Hepatitis C

A million hepatitis C-infected inmates are released from US jails each year. The epidemic behind bars affects 16-41 percent of inmates, depending on the state.


Charisse Shumate - The Death of a Woman Warrior Prisoner

Charisse was not only a life term prisoner incarcerated for 16 years at the Central California Women's Facility and a woman dying of complications from sickle cell anemia, cancer and hepatitis C.


Compulsory Testing & Integration.

Prisons are often referred to as incubators for the AIDS virus and many in the community identify these institutions as places emanating danger.  However, rather than being an incubator, the prison is a funnel as many offenders tend to come from high-risk areas in the community.

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Conditions in jail found to violate prisoners' rights

The U.S. Department of Justice's civil rights division has found that conditions at the Baltimore City Detention Center violate the constitutional rights of inmates and appear to have played a role in the deaths of several prisoners, some of whom received little or no medical attention for chronic health problems.


Correctional Services Portfolio Committee 

The problem of HIV/AIDS in prison is a reality which the Department is committed to addressing in consultation with other role players within and outside the government spheres. The HIV/AlDS pandemic is a problem for all corrections worldwide. It is believed HIV infection is high in prison settings than in the general public and that effective strategies need to be implemented if the Correctional Services is to manage this
pandemic effectively.



After blood-to-blood contact with an inmate during a struggle at the Coxsackie Correctional Facility near Albany, N.Y., Walter Wolfe, an AFSCME Local 1264 (Council 82) member, fears he’s contracted a transmissible disease, maybe even AIDS-causing HIV. But Wolfe and his family can’t be sure, because the inmate, exercising his legal rights, refused testing for HIV and other infectious diseases. Now Wolfe is afraid to touch his wife and two small daughters, worrying he could infect them.


Criminal Penalties for Attempted Exposure to Human Immunodeficiency Virus (HIV) by Prison Inmates- Pennsylvania Statutes A person is guilty of this offense if he intentionally or knowingly causes another to come into contact with blood, seminal fluid, saliva, urine or feces by throwing, tossing, spitting or expelling such fluid or material when, at the time of the offense, the person knew, had reason to know, should have known or believed such fluid or material to have been obtained from an individual, including the person charged under this section, infected by a communicable disease, including, but not limited to, human immunodeficiency virus (HIV) or hepatitis B.  

Death Row Prisoners With Hepatitis C Tortured
by the California Department of Corrections (CDC

Russ Heimrich, corrections spokesperson, has been quoted as stating "more than a third of the prison population, 34.6 percent now has the disease."


Developing a Systematic Approach to Hepatitis C for Correctional Systems As guidelines for the diagnosis, evaluation and treatment of chronic hepatitis C virus (HCV) emerge in the community at large, correctional medical communities are wrestling with the challenge of establishing an appropriate and consistent response to an epidemic that disproportionately affects incarcerated populations. Controversies regarding the management of HCV are brought to a head in jails and prisons, where there is a high prevalence of disease (12-35% according to Centers for Disease Control) and a legal obligation to provide access to medical care.   

Disabled in prison.  A new era of prisoners due to irrational laws

While in the SNF, I was subjected to a lack of medical care by the doctor, and nurses and a massive cover-up of neglect by the medical staff – malpractice at its finest.


“Do no harm" or "Do no expense"? Ohio's prisoners are dying from inadequate medical care In August, the Columbus Dispatch and WBNS-TV published a multi-part exposé of the inadequate medical care in Ohio's prisons. The series exposed wrongful deaths, inadequate care and questionable doctors. Almost 2,600 Ohio prisoners are known to be infected with Hepatitis C and health officials estimate the true figure to be closer to 9,000. As of July, the number of prisoners receiving treatment for Hepatitis C was 16. In September, the Prison Reform Advocacy Center in Cincinnati filed a class action lawsuit challenging these conditions.  

DOC (Colorado) Prison Hepatitis C Virus.

Newest CDOC guideline for the diagnosis and treatment of hepatitis C infection

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DOC of Colorado Response to Hepatitis C Virus

Ruling concerning the State of Colorado and the Hepatitis C Virus epidemic within its system

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Drug Use, HIV, and the Criminal Justice System

About 80 percent of prison and jail inmates have serious substance abuse problems. Many also have or are at high risk of having HIV or hepatitis. Substance abuse treatment and HIV services can help inmates and others under correctional control. They also can help inmates’ families, corrections staff, and the community at large.


Drug Users and the Structure of the Criminal Justice System 

The number of injection and other drug users in the criminal justice system has skyrocketed in recent years. The corrections setting presents opportunities for many inmates to obtain education, testing, and treatment services.


Dying inmate's lawyer weighs hepatitis suit-Colorado

Up to 40 percent of prison inmates are suffering from hepatitis C and the state is failing to treat them because of the cost, a lawyer for a dying death-row inmate alleged Wednesday


Educational Strategies & Policy Development.

This paper identifies the major educational stage in this process which have been significant in responding to the AIDS issue; managing AIDS issues in prison, and effecting lasting changes which include breaking down traditional departmental barriers

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End-of-life Resources

Listing of links


Epidemic of Infectious Diseases

As public health researchers have warned for years, the mass incarceration that has been happening across the country since the early 1980s has been accompanied by the mass incubation of infectious diseases in correctional facilities across the US


Evaluation of a prison outreach clinic for the diagnosis and prevention of Hepatitis C

Hepatitis C virus (Hepatitis C Virus) infection is a major public health problem recognised by the UK National Strategy that proposes that a care pathway for assessment, diagnosis, and treatment be established in all prisons, integrated within managed clinical networks. A prison sentence provides the opportunity to focus on traditionally hard to reach patients.


Fight for Hepatitis C education and Treatment in Prison

Hepatitis C Virus is one of the greatest dangers faced by people incarcerated in prisons and jails today

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Florida Corrections Commission 1998 Annual Report: The presence of HIV (Human Inmmuniodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome) has had a profound effect on the cost of health care in the correctional setting. The prevalence of HIV/AIDS in prisons exceeds its prevalence in the general population. As the prison population increases and inmates are being incarcerated longer due to stricter sentencing guidelines, the costs of HIV/AIDS will continue to rise as inmates remain in prison through the later, more costly stages of the disease and new treatment protocols are developed.  

Gender and Inequality in the American Prison System

In the past quarter century, much legal action has been taken to insure equal treatment for men and women incarcerated in jails and prisons in the United States. Historically, because female inmates were so few in number compared to male inmates, it had been considered too expensive by the state to provide them with the same privileges afforded to male inmates.


General Articles

Listing of many articles concerning Prison systems and infectious diseases


GETTING AWAY WITH TORTURE: Deliberate Indifference to the Medical Needs of Incarcerated Individuals

State correctional facilities (jails, prisons, penitentiaries) have an affirmative obligation to provide for the medical care of their charges.2 Once an individual is incarcerated, he is made wholly dependent on the state for all of his needs, such as food, clothing, shelter, and medical treatment. An incarcerated individual has been cut off from all other sources of help, by reason of his or her incarceration. Thus arises the state's affirmative duty. "The rationale for this principle is simple enough: when the State by the affirmative exercise of its power so restrains an individual's liberty that it renders him unable to care for himself, and at the same time fails to provide for his basic human needs e.g., food, clothing, shelter, medical care, and reasonable safety it transgresses the substantive limits on state action set by the Eighth Amendment and the Due Process Clause


Governments' Responsibility in Preventing Prisoners' Exposure to HIV in Prisons Do prisoners have a right to the means that would allow them to protect themselves against contracting HIV and other diseases in prisons? Can prison systems be forced to provide condoms, bleach, and sterile needles? Can and should the law be used to achieve change in prison HIV/AIDS policies?  
Health Care in New York State Prisons “Because the dangers of abuse inherent in the penitentiary are always present, the work of the Correctional Association—an organization of knowledgeable experts unaffected by political forces—is so important” 435 kb pdf
HEPATITIS B IN CORRECTIONAL FACILITIES Incarcerated persons have a disproportionate burden of infectious diseases (1), including hepatitis B virus (HBV) infection. Among U.S. adult prison inmates, the overall prevalence of current or previous HBV infection ranges from 13% to 47%.  
Hepatitis C in Corrections: Testing, Treatment and Co-infection With an estimated worldwide prevalence of 2.2%, hepatitis C virus (HCV) is one of the most prevalent chronic viral infections in the world.1 Incarcerated populations have dramatically higher rates of HCV infection than non-incarcerated populations. Approximately 2.0% of the United States (US) non-incarcerated population has been infected with HCV; 1.3% are chronically infected. In contrast, seroprevalence studies have found HCV infection rates ranging between 16-43%2,3,4 among incarcerated populations; 12-35% of inmates have chronic infection.  
Hepatitis C Testing of 
Offenders in the Indiana
 Department of Correction


The incarcerated population presents health problems related to infectious disease, substance abuse and, frequently, a lifetime of being medically underserved.  In particular, this is a population at very high risk for Hepatitis C virus and HIV.  Prisons and jails offer uniquely important opportunities for improving disease control in the community by providing health care and disease prevention programs to a large and concentrated population of individuals at high risk for disease. 113 kb pdf

Hepatitis C Virus in Corrections: Frontline or Backwater?

Report on Hepatitis C Virus in correctional facilities


Hepatitis C Virus-The Correctional Conundrum

Treatment of Hepatitis C (Hepatitis C Virus) is emerging as the most controversial subject in correctional health care. Much of the controversy around Hepatitis C Virus testing and treatment in corrections is related to delayed recognition of the important role incarcerated individuals play in the transmission of hepatitis in the communities after they are released.


Hepatitis C Virus is substantial in correctional settings While the hepatitis C epidemic is substantial in the country as a whole, it has become a major concern in correctional settings  

Healthcare Behind Bars
California prisoner well-being is a concern for many

On the evening of February 20, the prisoners rights activist group California Prison Focus hosted a "Speak Out" event at the Quaker Meeting House in San Francisco. Activists, former inmates and families of current prisoners spoke to the news media and the public about health-care conditions in California's state prisons.


Health Care Costs Rising as Prison Population Grows

As the prison population increases, ages and increasingly suffers from chronic illnesses such as AIDS and hepatitis, state policy makers must either foot the bill, change the way health care is delivered or rethink the sentencing laws that led to the problem in the first place.

Hepatitis B-Overlooked and Under-treated The prevalence of chronic HBV (HbSAg positive patients) may be lower than Hepatitis C Virus infection in correctional settings, but it is still a threat. In fact, HbSAg positivity rates (up to 47%) are considerably higher than in non-incarcerated populations (5%)(25).  

Hepatitis B, C and HIV: Post-exposure Prophylaxis in Correctional Settings

How should these blood or body fluid exposures be managed in the correctional setting, and what are the infections of concern? Are correctional professionals prepared to manage these exposures?


Hepatitis C (Hepatitis C Virus) at the Central California Women's Facility (CCWF)

Pamela Murphy, aka "PJ," was looking forward to her parole date in April, 2000. Looking forward to spending some quality time with her family. This was especially important, because PJ had AIDS and Hepatitis C Virus, and not much time. Needless to say, she did not make it out of CCWF, and passed away over the Labor Day weekend. 


Hepatitis C Among Offenders-Correctional Challenge and Public Health Opportunity

Prevalence of Hepatitis C Virus infection in prisons is 8- to 20-fold higher than in the community, with infection rates between 16-41 percent and evidence of chronic infection in 12-35 percent (Centers for Disease Control and Prevention, 2003). An estimated one out of three Americans with chronic hepatitis C infection rotate through correctional facilities annually


Hepatitis C Challenges the Prison System- 2000

Many prison systems are starting to tackle the problems of testing and treating Hepatitis C Virus. California, Texas, New York, Florida, Virginia and Pennsylvania have adopted testing policies. The larger and more important issue is treatment guidelines on Hepatitis C Virus.


Hepatitis C Tests, Treatment for New Jersey Prison Inmates Could Cost State More Than $8 Million Per Year

A New Jersey program to pay for hepatitis C tests and treatment for prison inmates could cost between $4.5 million and $8 million this year,


Hepatitis C: A Correctional-Public Health Opportunity

What is often seen as an overwhelming burden to correctional healthcare systems should more appropriately be seen as a tremendous public health opportunity. The stark truth is that most inmates will eventually be released from prisons and jails. Once released, many of them either do not have access to healthcare or fail to avail themselves of it. In focusing healthcare resources on the incarcerated, society has the opportunity to decrease crime rates (mental illness, addiction), prevent transmission (HIV, hepatitis, other sexually transmitted diseases [STDs]), and lower lifetime costs associated with untreated diseases. This article will focus on the challenges and opportunities associated with the treatment of hepatitis C virus (Hepatitis C Virus) in the incarcerated.


Hepatitis C treatment denied Without support from the outside, Hepatitis C Virus will thrive in prisons as Hepatitis C Virus+ and at-risk individuals are arrested and incarcerated in ever increasing numbers. And when they are inevitably released, less than aware (as long as current policies continue), Hepatitis C Virus will be there with them, returning in greater strength. Literal Hepatitis C Virus factories, that's what prisons are becoming  
Hepatitis Education for Inmates PowerPoint Presentation 445 kb
HIV/AIDS in Prison Systems: A Comprehensive Strategy The AIDS crisis is devastating Canadian prisoners.  Inmates are becoming infected with HIV during their incarceration because they do not have the information and resources to protect themselves.  Once infected, their lives are endangered by a lack of access both to doctors specializing in HIV/AIDS and to non-approved treatments and alternative therapies.  And prisoners with HIV/AIDS are maltreated. 252 kb pdf
HIV/AIDS Stigma and Discrimination: Prisoners The low social status of prisoners means that they are marginalized and excluded from the mainstream of society.  They experience stigma and discrimination behind bars and are often regarded as ‘unworthy’ in the general community 219 kb pdf
HIV/AIDS Summary Among the Incarcerated Rates of HIV infection in inmate populations worldwide are much higher than in the general population.  They are generally related to two factors: the proportion of prisoners who injected drugs prior to imprisonment, and the rate of HIV infection among injection drug users in the community.  For females, the number of inmates who were sex workers is an additional factor. Pdf 407 kb

HIV Education Strategies within Correctional.

It has been suggested that prisons provide an environment which can further the spread of HIV/AIDS, not only to those incarcerated, but also to the broader community.  The containment of HIV in prisons is vital in reducing its transmission throughout the community.

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HIV in British Prisons: Problems, Risk Behavior and Prevention.

There is no compulsory testing for HIV in the English prison system.  All inmates identified as having HIV are subjected to Viral Infectivity Restriction.  All such inmates are located in single accommodation or accommodation share with other HIV positive inmates.

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HIV/AIDS in Corrections The presence of HIV (Human Inmmuniodeficiency Virus) and AIDS (Acquired Immune Deficiency Syndrome) has had a profound effect on the cost of health care in the correctional setting. The prevalence of HIV/AIDS in prisons exceeds its prevalence in the general population. As the prison population increases and inmates are being incarcerated longer due to stricter sentencing guidelines, the costs of HIV/AIDS will continue to rise as inmates remain in prison through the later, more costly stages of the disease and new treatment protocols are developed  

HIV in Prisons

Report from the Bureau of Justice Statistics


HIV in Prisons, 2007-08

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This report provides the number of state and federal prisoners who were infected with the human immunodeficiency virus (HIV) or had confirmed acquired immune deficiency syndrome (AIDS) at yearend 2007 and 2008. The number of HIV/AIDS cases is reported by gender and type of infection. Using data from the Deaths in Custody Reporting Program (DCRP), this report presents the number of AIDS-related deaths in state prisons and a profile of inmates who died in 2007 Pdf 1473 kb
HIV IN PRISON HANDBOOK: WHAT EVERY CDC PRISONER SHOULD KNOW This handbook is written for prisoners in the California Department of Corrections, their legal advocates, and their family members. We hope it will be useful not only for those prisoners who are learning to live with HIV, but for other prisoners and legal advocates who want to learn more about HIV. The field of HIV research has advanced rapidly in the past several years and is continuing to progress further. Consequently, the health information in this handbook tends to be more general than specific. Current information on health education and treatment may be obtained by writing to the organizations listed in the Appendix.  
HIV/AIDS in the Male-to-Female Transsexual and Transgendered Prison Population Chronic underfunding of the human rights complaint processes in many provinces has resulted in the inability to investigate a vast majority of complaints laid, long backlogs in hearing cases that are investigated, and a lack of ability of human rights tribunals to enforce judgments. Pdf 226 kb
HIV Infection Among Incarcerated Women: An Epidemic Behind the Walls Even though women are less likely to be incarcerated than men (one in 10 inmates in US prisons and jails is a woman), incarcerated women are three times more likely to be HIV infected than incarcerated men. The proportion of inmates with HIV (US prisons: 2.3% of men and 3.5% of women) is much higher than the proportion of HIV infected persons in the general population (US free population: 0.6% of men, 0.1% of women). This difference is amplified in the Northeast, where HIV prevalence among incarcerated men is 7% and 13% among incarcerated women.  
HIV/AIDS and Hepatitis C in Prisons: The Facts 2004/2005 As in Canada, rates of HIV-infection in prison populations worldwide are much higher than in the general population. They are, in general, closely related to two factors: the proportion of prisoners who injected drugs prior to imprisonment, and the rate of HIV infection among injection drug users in the community. Many of those who are HIV-positive in prison were already living with the virus on the outside. Indeed, the highest rates of HIV infection in prisons can be found in areas where rates of HIV infection are high among injection drug users in the community. Commenting on the situation in the United States, the US National Commission on AIDS stated that “by choosing mass imprisonment as the ... governments’ response to the use of drugs, we have created a de facto policy of incarcerating more and more individuals with HIV infection.”  

HIV infection among Incarcerated Women 

HIV is especially prevalent among women who are incarcerated in New England correctional institutions. Incarceration complicates access to medications, to medical consultations, and impacts on continuity of care. A wide range of barriers to HIV care (patient, provider, and system-related) exist within the correctional environment. Barriers to HIV care may adversely affect quality of life and may lead to higher public health care


HIV Minimisation Strategies for Correctional.

The primary aim of the Project was the prevention of HIV infection among prisoners, ex-prisoners, their families and remandees appearing before the courts.

Pdf 22 kb

HIV Transmission Among Male Inmates in a State Prison System The estimated prevalence of human immunodeficiency virus (HIV) infection is nearly five times higher for incarcerated populations (2.0%) (1) than for the general U.S. population (0.43%) (2). In 1988, the Georgia Department of Corrections (GDC) initiated mandatory HIV testing of inmates upon entry into prison and voluntary HIV testing of inmates on request or if clinically indicated. GDC offered voluntary HIV testing to inmates annually during July 2003--June 2005 and currently offers testing to inmates on request. During July 1988--February 2005, a total of 88 male inmates were known to have had both a negative HIV test result upon entry into prison and a subsequent confirmed positive HIV test result (i.e., seroconversion) during incarceration.  

HIV testing and counselling in prisons and other closed settings

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This document was commissioned by UNODC and WHO in July 2007 to inform discussions about how to scale up access to HIV testing and counselling for prisoners, following the release of the WHO/UNAIDS Guidance on Provider-Initiated HIV Testing and Counselling in Health Facilities (WHO, UNAIDS, 2007). The WHO/UNAIDS Guidance briefly addresses issues related to HIV testing and counselling for prisoners, Pdf 1353

HIV/Aids in Prison, Problems, Policies and Potential

The issue of HIV/AIDS in prisons has become an important topic world-wide, both in countries where HIV prevalence is minimal as well as where the impact of HIV is much more severe. In March 1993, the World Health Organisation (WHO) distributed guidelines on HIV infection and AIDS in prison.


HIV/AIDS in Prison: Problems, Policies, and Potential

Presentation by the Insitute for Security Studies-2003

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HIV/AIDS in Prisons: Final Report Problems are sometimes not recognized. Most prisoners are regarded as relatively fit young persons, with drug dependency as their only health problem. Nurses and doctors who work with prisoners deal well with well-demarcated chronic illnesses such as diabetes, cancer, arthritis, or easily recognized emergencies such as acute myocardial infarction or trauma, but the HIV-positive patient with a low CD4 count, who may look well but not be well, is a challenge. For example, it is difficult for health-care staff to appreciate that the headache of a well-looking prisoner, still able to lift weights, is due to a life-threatening cryptococcal meningitis. This difficulty is enhanced by the fact that some prisoners have a tendency to try to manipulate health-care staff, who as a result can be more reluctant to "believe" the inmate and to intervene immediately by, for example, making referrals or prescribing medication. Problems are likely to increase in the years to come: "unfortunately, the rise in the number of seriously ill patients - with other serious infectious diseases and/or with HIV - coincides with cuts to health-care budgets."  
Incarcerated Women, HIV/AIDS and Hepatitis C: Challenges Inside the Walls and Beyond There is no doubt or disagreement that being an incarcerated woman with HIV/ AIDS and/or Hepatitis C is difficult. But how is being an incarcerated woman with these diseases different from being a man in a similar situation? The answer, say prison and jail healthcare providers, advocates, and formerly incarcerated women: many things are the same, and a few are very different. Pdf 530 kb
INCARCERATED VETERANS ARE ELIGIBLE FOR VA MEDICAL CARE AT VA HOSPITALS AND CLINICS It is important to note that the VA doesn’t permit armed guards at its medical facilities. While there is no bar to unarmed escorts accompanying persons in correctional custody into VA waiting areas, escorts may well have to negotiate physicians’ consents to accompany inmates into examination and treatment rooms. And there would be even more problems with 24-hour-a-day escorts for hospitalized inmates.  
Incarceration is not a solution to mental illness The new welfare law denies the disabled benefits. Despite the fact that prisons cost more and are less effective than treatment, state governments have slashed mental health budgets to build more prisons. The result has been more public demonization and oppression of the mentally ill.  
Incarcerated People and HIV/AIDS While correctional institutions are obligated to provide health care to inmates, security and detainment remain their foremost concerns. The concern for security can be at odds with the provision of health care, leaving those with complex care needs especially vulnerable. In addition, public opinion may not be sympathetic to this population: skeptics decry providing "free" health care to a criminal population when health care for many Americans is costly and out of reach.   

Infections Behind Bars

For a variety of reasons, many diseases are present at a higher prevalence in prisons and jails. Mental illness, HIV, hepatitis B and C, and drug and alcohol addiction are just a few of the conditions that are common in prisoners entering the correctional system.


Infectious Diseases in Corrections Report
Issues related to HIV/AIDS in prisons have traditionally received 
little attention at the International AIDS Conference.  Yet, it is a 
well-known fact that HIV prevalence within prison populations 
tends to be much higher than in the general population both in 
the United States and worldwide.
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Infectious diseases in prison setting-tables Estimated chronic infections with hepatitis viruses among inmates and releasees-1997  
Investing in Health and Justice Outcomes: Mental illness is over-represented in the incarcerated population. As incarcerated populations grow in size and in their representation of mental illness, state and local officials are looking for ways to respond that comply with constitutional requirements and legal mandates, fit the contours of a fragmented public system, which relies increasingly on the private sector, and are affordable. Their affordability is perhaps the most limiting and vexing challenge, especially in contemporary times of huge budget shortfalls. The needs of mentally disordered offenders are complex and multi-dimensional, often including addiction problems, HIV/AIDS, and some form of personality disorder, and they are expensive if managed comprehensively.  
Interventions to reduce HIV transmission related to injecting drug use in prison The high prevalence of HIV infection and drug dependence among prisoners, combined with the sharing of injecting drug equipment, make prisons a high-risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return on their release. We reviewed the eff ectiveness of interventions to reduce injecting drug use risk behaviours and, consequently, HIV transmission in prisons. Many studies reported high levels of injecting drug use in prisons, and HIV transmission has been documented. There is increasing evidence of what prison systems can do to prevent HIV transmission related to injecting drug use. In particular, needle and syringe programmes and opioid substitution therapies have proven eff ective 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 countries with an existing or emergent epidemic of HIV infection among injecting drug users is therefore warranted, as part of comprehensive programmes to address HIV in prisons. Pdf 126 kb

Juveniles & AIDS Policy.

Although adolescents show a relatively low incidence among people in their twenties indicates that HIV is frequently contracted in the teenage years.

Pdf 41 kb


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