Prisons

Abstract

Purpose of review-People with HIV and HCV are concentrated within criminal justice settings globally, primarily related to criminalization of drug use. This review examines updated prevention and treatment strategies for HIV and HCV within prison with a focus on people who inject drugs and the challenges associated with the provision of these services within prisons and other closed settings and transition to the community. Recent findings-The prevalence of HIV and HCV are several-fold higher in the criminal justice system than within the broader community particularly in regions with high prevalence of injecting drug use, such as Asia, Eastern Europe and North America and where drug use is criminalized. Strategies to optimize management for these infections include routine screening linked to treatment within these settings and medication-assisted treatments for opioid dependence and access to syringe services programs. We build upon the 2016 WHO Consolidated Guidelines through the lens of the key populations of prisoners. Linkage to treatment postrelease, has been universally dismal, but is improved when linked to medication-assisted therapies like methadone, buprenorphine and overdose management. In many prisons, particularly in low-income and middle-income settings, provision of even basic healthcare including mental healthcare and basic HIV prevention tools remain suboptimal. Summary-In order to address HIV and HCV prevention and treatment within criminal justice settings, substantial improvement in the delivery of basic healthcare is needed in many prisons worldwide together with effective screening, treatment and linkage of treatment and prevention services to medication-assisted therapies within prison and linkage to care after release.

Principles of condom provision programs in prisons from the standpoint of European prison health experts: a qualitative study

“…In many countries with condom program in prisons, coverage of the program is either low or unknown [ 19 ]. In other words, it is unclear what proportion of prisoners has access to condoms.…”

Factors influencing compliance with Hepatitis C treatment in patients transitioning from prison to community—A summary scoping review

“…Two studies 4,8 in the review suggested 'decriminalization' policies as a step towards reducing the overall HCV burden in prisons.…”

“…Two studies 4,8 in the review suggested ‘decriminalization’ policies as a step towards reducing the overall HCV burden in prisons. ‘Decriminalization’ describes the removal of criminal sanctions against an act or behaviour.…”

Social Work and Health in Prisons

“…MAT in prison has also been associated with reduced rates of infectious diseases. Adequate MAT has been associated with reduced risk of HCV infection (Dolan et al, 2005;UNODC/UNAIDS, 2006;Dolan et al, 2016;Azbel et al, 2018;Kamarulzaman et al, 2019), whereas inadequate MAT -periods of less than five months in one study, for example -was found to be significantly associated with increased risk of HCV seroconversion (P = 0.01) . People living in prisons receiving MAT with a daily dose of more than 60 mg during their whole prison sentence were found to be the least likely to inject heroin, share needles, and engage in HIV risk-taking behaviour while in prison (Dolan et al, 2003).…”