Diagnosis, Treatment, and Prevention of HIV Infection among Detainees: A Review of the Literature

Abstract

Detainees are one of the most vulnerable populations to human immunodeficiency virus (HIV). This is mostly caused by the lack of knowledge on the topic among the inmates; the lack of prophylaxis; the high percentage of risky behaviors in jail, such as sexual abuse, unprotected sexual intercourses, and injective drug use; and the generally low perception of the risk of transmission. It has also been observed that the problem does not cease to exist at the moment of release, but it also may be aggravated by the weak support system or the total absence of programs for people living with HIV/AIDS (PLWHA) to avoid discontinuation of antiretroviral drugs. Difficulty in providing housing and jobs and, therefore, a form of stability for ex-detainees, also contributes to none adherence to antiretroviral therapy. Among the detainees, there are also categories of people more susceptible to discrimination and violence and, therefore, to risky behaviors, such as black people, Hispanics, transgender people, and men who have sex with men (MSM). We reviewed the literature in order to provide a more complete picture on the situation of PLWHA in jail and to also analyze the difficulties of ex-detainees in adhering to HIV therapy.

Access to healthcare for people living with HIV: an analysis of judgments of the European Court of Human Rights from an ethical perspective

“…Reasons for this are a lack of knowledge ( 33 – 36 ), a lack of prophylaxis and often occurring examples of sexual abuse, unprotected sex or intravenous drug use. Moreover, prisoners frequently underestimate the risk of infection and the healthcare system in prisons is often inadequately equipped for their needs ( 37 ). Interestingly, the challenges for PLHIV in receiving adequate healthcare are not limited to the period of incarceration: having been incarcerated has also been shown to be a risk factor for suboptimal access to antiretroviral therapy ( 38 ).…”

Laryngeal leishmaniasis in a HIV‑positive patient: A case report and review of the literature

“…In individuals with a robust immune system, the protective response against Leishmania is characterized by a Th1 cytokine profile, which confers resistance against infection and inhibits disease progression (21). Conversely, susceptibility to Leishmania infection and unfavorable outcomes are linked to a Th-2 cytokine response (22,23). In the context of HIV infection, there is a Th1/Th2 shift provoked by HIV, resulting in unconventional and widespread manifestations (13).…”

Detection of sexually transmitted infections among transvestites and transsexual women in prison in the metropolitan region of Rio de Janeiro, Brazil

“…The health care technologies were: access to male condoms (yes, no); access to lubricant (yes, no); carrying out rapid tests in the last six months (yes, no); and rapid test positivity (yes, no). The variables analyzed were considered factors associated with STIs, with some being used in some studies 15 , 21 .…”