HIV/AIDS and HCV in Prisons
A Select Annotated Bibliography
Scope, Methods, and Next Steps
Work on this select annotated bibliography started in March 2005 and was completed in November 2005. The document was intended as a background document for the 3rd International Policy Dialogue on HIV/AIDS: HIV/AIDS in Prisons, which took place in Toronto, Canada in October 2005 and was hosted by the Government of Canada and UNAIDS.
 Scope and Methods
The goal is to promote effective responses, based on scientific evidence and respect for human rights, to the issues raised by HIV/AIDS and hepatitis C (HCV) in prisons.
The objectives are
- to increase knowledge of and access to the literature on issues related to HIV/AIDS and HCV in prisons; and
- to increase the capacity of governments, non-governmental organizations, and researchers to respond effectively to the challenges posed by HIV/AIDS and HCV in prisons.
The bibliography did not aim to include all documents ever published on HIV/AIDS and/or HCV in prisons - there simply are too many, some are outdated, while others are very difficult to access. Instead, the author undertook an extensive search of the literature and then selected the most relevant materials according to a set of criteria, including: scope of the material (local, regional, national, or international), date of publication, topic(s) covered, whether the material is accessible, and relevance of the document. The aim was to include those publications that are most relevant in a large number of areas, ranging from prevalence of HIV, HCV, and risk behaviours, to a variety of prevention measures, to HIV and HCV treatment, drug dependence treatment, and legal and ethical issues. A number of newsletters, journals, and websites were also included to allow people using the bibliography to more easily locate new materials that will appear after the publication of this bibliography. Because of resource constraints, studies about tuberculosis and HIV in prisons could not be included in this version of the bibliography. Another important area that could not be included is that of prison reform. As one reviewer stated, "it is difficult to discuss prison health without discussing prison reform." While we added a few resources on prison reform to the first section, it would have been useful to add more resources on the problems of prison in general, to give context to the problems of HIV in prison. We hope to be able to address these shortcomings in the next version of the bibliography.
In some of the larger sections, a list of "essential resources" precedes the list of "other resources." Papers were included in the list of "essential resources" if they were: recent (or still unique); brief (or comprehensive); readable; published by a reputable organization; published as a paper in a high impact factor journal; scientifically rigorous; focused on and relevant to developing or transitional nations; relevant to the selection criteria; and the overall impression of the author was strongly favourable. During the search process for "essential resources," preference was given to documents that are of practical use to advocates, policy makers, program managers and prison practitioners. Finally, a group of peer reviewers was set up to ensure that the selected documents were of a high standard and reflected a global perspective.
Most documents have annotations, but they could not be provided for all entries.
The author reviewed documents published in English, French, Spanish, Portuguese, Italian, and German. A search of the published scientific literature was carried out using electronic databases. Several comprehensive reviews on the effectiveness of certain interventions were also drawn on extensively. Conference abstracts were reviewed, and searches of the Internet were conducted. Attempts were made to access information from developing countries and regions, especially those currently experiencing an HIV epidemic. The 'grey' literature was accessed via a variety of sources including professional contacts, direct contact with known researchers and research centres and the Internet.
Not surprisingly, many resources are from a relatively small number of developed countries - although resources from many developing and transitional countries exist and have been included.
Members of the organizing committee of the 3rd International Policy Dialogue on HIV/AIDS: HIV/AIDS in Prisons provided input throughout all stages of the production of the bibliography. Before finalizing the bibliography, the author obtained comments on a draft from a group of peer reviewers from a large number of countries. The author revised the bibliography taking these comments into account.
Next Steps
This bibliography will be disseminated widely in a variety of formats (hard copy, searchable CD-ROM, and on the Internet on various websites) in order to facilitate access to information on HIV/AIDS and HCV in prisons. Depending on the feedback received and the availability of funding, the bibliography may be updated once yearly in future years.
For Further Information and to Provide Additional Resources...
Further copies of this bibliography can be retrieved from
http://www.hc-sc.gc.ca/ahc-asc/activit/strateg/
intactivit/aids-sida/hivaids-vihsida-pubs_e.html; or ordered through the  Canadian HIV/AIDS Information Centre at tel +1 613 725-3434 (toll free from within Canada: +1 877 999-7740), fax +1 613 725-1205; email: aidssida@cpha.ca, web: www.aidssida.cpha. The bibliography is available in English and French.
If you would like to suggest additional resources for inclusion in the next version of the bibliography, or provide general comments, please contact Ralf Jürgens at rjurgens@sympatico.ca.
Overview Documents, Policies, and Guidelines
This section of the bibliography contains documents (articles, reports, books, and info sheets) that provide an overview about or touch upon many of the issues related to HIV/AIDS (and hepatitis C) in prisons, rather than focusing on one or a limited number of aspects. It also contains policies, guidelines, or declarations on HIV/AIDS in prisons.
Essential Resources
Canadian HIV/AIDS Legal Network. HIV/AIDS in Prisons - Info Sheets. Montreal: Canadian HIV/AIDS Legal Network, 2004 (3rd edition).
Available via www.aidslaw.ca/Maincontent/issues/prisons.htm, in English and French. In 2006, a revised edition will become available in Russian. An earlier edition is also available in Rumanian.
This is an accessible series of 13 info sheets, touching upon most issues relevant to HIV/AIDS in prisons.
Correctional Service Canada (2004). Commissioner's Directive 821: Management of Infectious Diseases. Ottawa: CSC.
Available (in English and French) at
www.csc-scc.gc.ca/text/plcy/cdshtm/821-cde_e.shtml.
This document provides policy direction on the management of infectious diseases in Canadian federal prisons, "reflects public health principles, and incorporates a full range of infectious disease program elements." Its objective is to "contribute to public health and a safe and healthy environment through a comprehensive infectious diseases program." Among other things, the Directive states that:
- "a full range of infectious diseases program elements, including but not limited to screening/testing, immunization, education and training, harm reduction measures, care and treatment, surveillance activities, and partnerships, shall be implemented based on best evidence and public health expertise"
- "approved harm reduction items shall be readily and discreetly accessible to inmates in CSC operational units so that no inmate is required to make a request to a staff member for any item"
- "inmates living with infectious diseases shall be provided with human treatment and support, in an environment free of discrimination"
- "the Institutional Head shall ensure that non-lubricated, non-spermicidal condoms, water-based lubricants, dental dams and bleach are discreetly available to inmates at a minimum of three locations, as well as in all private family visiting units"
- "CSC's Health Services shall ensure that partnerships are established nationally, regionally and locally with other federal departments, provincial and municipal governments, service agencies and stakeholder groups, in order to ensure the sharing of information, best practices, and expertise".
See also the guidelines on bleach (infra, in the secion on "injection drug use - bleach and other disinfectants") and on methadone maintenance treatment (see infra, in the section on "injection drug use - substitution treatment").
Cranstoun Drug Services & European Network on Drugs and Infections Prevention in Prison (8th edition, 2005). Digest of research on drug use and HIV/AIDS in prisons. London: Cranstoun & ENDIPP.
Available via www.endipp.net/index.php?option=
com_remository&Itemid=39&func=selectcat&cat=4.
The 8th edition of the Digest contains 672 abstracts of reports, books and articles, giving information on subjects such as HIV prevalence, drug use and risk behaviours in prison as well as new initiatives in the field, evaluations of drug treatment and harm reduction programs. It is indexed by author, country and key words. It includes both published work as well as 'grey' literature and it is an invaluable tool for all those working in the field. Some of the entries have been incorporated in this annotated bibliography. However, the digest has a greater focus on illegal drug use and drug dependence treatment in prisons, while this annotated bibliography is meant to offer a broader overview.
Dublin Declaration on HIV/AIDS in Prisons in Europe and Central Asia: Prison Health is Public Health (2004). Dublin: Irish Penal Reform Trust.
Available in many languages via www.iprt.ie.
The Declaration focuses on prisons in Europe and Central Asia, but is also relevant for prisons in other countries. It points out that HIV/AIDS is a serious problem for prison populations and that in most countries, rates of HIV infection are many times higher among prisoners than among the population outside prisons. This situation is often exacerbated by high rates of HCV and/or multi-drug resistant tuberculosis. In most cases, high rates of HIV infection are linked to the sharing of injecting equipment both inside and outside prison walls and to unprotected sexual encounters in prison. In a majority of countries, adequate preventive measures have not been introduced in prisons, although they have been successfully introduced in prison systems in some countries and shown to be effective. As a result, people in prison are placed at increased risk of HIV infection, and prisoners living with HIV/AIDS are placed at increased risk of health decline, of co-infection with HCV and/or tuberculosis, and of early death.
The Declaration urges governments to act, and provides a framework for mounting an effective response to HIV/AIDS in prisons, based upon recognized international best practice, scientific evidence, and respect for the human rights of people in prison.
Goyer KC (2003). HIV/AIDS in Prison. Problems, Policies and Potential. Pretoria: Institute for Security Studies (Monograph No 79).
Available via www.iss.co.za/Publications/Monographindex.html
Comprehensively addresses the issues related to HIV/AIDS in prisons in South Africa. Relevant to all prison systems, particularly those in resource-poorer countries.
Goyer KC et al. (2004). HIV/AIDS in Prison: Treatment, Intervention, and Reform. A Submission to the Jali Commission. Johannesburg: AIDS Law Project and Treatment Action Campaign.
Available via www.alp.org.za/.
In this submission to the Jali Commission into prisons, the AIDS Law Project (South Africa) and the Treatment Action Campaign point to the strengths and weaknesses of current policy in South Africa and where changes must be made as well as how implementation can be improved. A supplementary submission to the commission (Meerkotter A, Gerntholtz L. Submission on the early release of prisoners with HIV/AIDS to the Jali Commission) deals with the early release of prisoners with HIV in more detail. Both documents are extremely relevant, particularly for resource-poorer prison systems.
Joint United Nations Programme on AIDS (1997). Prisons and AIDS: UNAIDS Best Practice Collection: Technical Update. Geneva: UNAIDS.
Available via www.unaids.org
Provides a general overview of the factors and conditions that are responsible for the transmission of HIV in prison settings and of the most effective responses. Also included is a suggested list of "key materials" on HIV/AIDS in prisons.
Joint United Nations Programme on AIDS (1997). Prisons and AIDS: UNAIDS Best Practice Collection: Points of View. Geneva: UNAIDS.
Available via www.unaids.org.
Differs slightly in content from the "Technical Update" cited above. The "Points of View" document presents facts and figures on prisons and HIV, and addresses why HIV in prisons is a serious problem for society, how the problem of rising rates of HIV among prisoners has arisen, and what can be done to stop the spread of HIV in prison.
Jürgens R (1996). HIV/AIDS in Prisons: Final Report. Montréal: Canadian HIV/AIDS Legal Network and Canadian AIDS Society.
Available via www.aidslaw.ca/Maincontent/issues/prisons.htm, in English and French.
A comprehensive 150-page report, summarizing the history of HIV/AIDS in prisons in Canada and internationally. Includes sections on prevalence of risk behaviours in prisons, HIV transmission behind bars, needle-exchange programs, methadone maintenance treatment, and more. Argues that prison systems have a moral and legal obligation to act to reduce the risk of further spread of HIV behind bars, and to provide appropriate care, treatment, and support. Includes hundreds of references and a substantial bibliography.
Office of the United Nations High Commissioner for Human Rights and the Joint United Nations Programme on HIV/AIDS (1998). HIV/AIDS and Human Rights: International Guidelines. New York and Geneva: United Nations (HR/PUB/98/1).
Available via www.unaids.org.
Contains an important recommendation regarding HIV/AIDS in prisons (recommendation 29(e).
United Nations Office on Drugs and Crime (2005). HIV/AIDS Prevention, Care, Treatment, and Support in Prison Settings. A Framework for an Effective National Response. Vienna: UNODC.
Prepared by Rick Lines and Heino Stöver for UNODC as a background paper for a consultative meeting on HIV/AIDS prevention, care and support in prison settings held in Vienna in February 2005. Intended to provide a framework for mounting an effective national response to HIV/AIDS in prisons that meets international health and human rights standards, prioritizes public health, is grounded in best practice, and supports the management of custodial institutions.
World Health Organization (1987). Statement from the Consultation on Prevention and Control of AIDS in Prisons (Geneva, 16-18 November 1987). Geneva: WHO Special Programme on AIDS (WHO/SPA/INF/87.14).
The first WHO consensus statement on AIDS in prisons, containing recommendations on how to deal with HIV/AIDS in the prison system. Says that the general principles adopted by national AIDS programs "should apply equally to prisons as to the general community."
World Health Organization (1993). WHO Guidelines on HIV Infection and AIDS in Prisons. Geneva: WHO (WHO/GPA/DIR/93.3).
Available at www.aidslaw.ca/elements/APP5.html.
These 10-page guidelines, written from a public health perspective, propose standards for prison authorities in efforts to prevent HIV transmission and provide care to those with HIV/AIDS in prisons.
World Health Organization, Prison Reform International, Medecins sans Frontières (2001). HIV in Prison. A Manual for the Newly Independent States. Copenhagen: WHO Europe (Russian edition, 2003)
Available via http://www.hipp-europe.org/resources/index.htm, in English and Russian.
A comprehensive manual with chapters on risk behaviours, prevention, and care and treatment.
World Health Organization (2003). Moscow Declaration: Prison Health as part of Public Health. Copenhagen: WHO Europe.
Available in English, French, Russian, and German via www.euro.who.int/prisons/publications/20050610_1
Recognizes the need for a close link between public health and the provision of health care to those in prison.
World Health Organization, UNAIDS, and UNODC (2004). Policy Brief: Reduction of HIV Transmission in Prisons. Geneva: WHO.
Available via www.who.int.
A 2-page summary of the evidence on interventions to prevent the spread of HIV in prisons. Concludes that prison HIV programs should include all the measures against HIV transmission that are carried out in the community outside prisons, including HIV/AIDS education, testing and counselling performed on a voluntary basis, the distribution of clean needles, syringes and condoms, and drug-dependence treatment, including substitution treatment.
World Health Organization (2005). Status Paper on Prisons, Drugs and Harm Reduction. Copenhagen, WHO Europe.
Available in English and Russian via http://www.euro.who.int/prisons/publications/20050610_1
Summarizes the evidence on harm reduction in prisons. Concludes that the public health case for action is strong, and that harm reduction measures can be safely introduced into prisons and can significantly bolster preventing the transmission of HIV/AIDS in communities.
Other Resources
Agence de Prévention du Sida, Ministère de la Santé de la Communauté française de Belgique (1997). Sida et Prison [document in French]. Brussels: The Agency.
Analyzes the situation with regard to HIV/AIDS in the prison system of Belgium and makes recommendations about how to deal with the issues raised. Recommends that a pilot study of distribution of sterile injection equipment be undertaken.
AIDS Advisory Committee (1995). The Review of HIV and AIDS in Prison. London, UK: HM Prison Service of England and Wales.
Contains 39 recommendations in the areas of research, staff and prisoner education, prevention, risk reduction and harm minimization, counseling, psychological and social care, and medical aspects of HIV in prison. Among other things, recommends that cleansing agents (washing-up liquid and Milton sterilizing tablets) and condoms, dental dams, and lubricant be made easily accessible to prisoners.
Anonymous (1998). AIDS in prisons - good intentions, harsh realities in Africa's penitentiaries. AIDS Analysis Africa, 8(3): 12.
At a seminar in Dakar, Senegal, about HIV/AIDS in African prisons, the 250 attendees heard reports of overcrowding, lack of medical facilities, and violence - especially against women and minors. Both male-to-male and heterosexual activity are widespread. Despite these realities, there is strong cultural opposition to making condoms available in Africa's prisons and homosexuality remains a crime in many states. Indicative of the prevailing attitude was a comment made by the head of the detention center in Dakar: "If we introduce condoms into prisons, we are inviting prisoners to do what we otherwise forbid them to do."
Bobrik A et al. (2005). Prison health in Russia: the larger picture. Journal of Public Health Policy, 26: 30-59.
Reviews the available information on the health (including HIV/AIDS) of the imprisoned population in Russia and the factors underlying it.
Bollini P (1997). HIV Prevention in Prisons. A Policy Study in Four European Countries. Final report presented at the Joint WHO/UNAIDS European Seminar on HIV/AIDS, sexually transmitted diseases and tuberculosis in prisons. Warsaw, 14-16 December 1997.
A comparative study of HIV/AIDS prevention policies in the prison systems of Italy, Switzerland, Moldova, and Hungary, with two main objectives: to assess the policies of HIV prevention and care in the prison systems; and to evaluate which factors affected the implementation of the 1993 World Health Organization Guidelines on HIV/AIDS in prisons (see supra) at the country level. The study concluded that "it is the role of international organizations active in this domain to stimulate the debate on controversial issues [such as needle- exchange programs], in order to build consensus and foster a full implementation of the Guidelines. Such effort so far has been insufficient, and it should be expanded through country visits, review of policies, regular monitoring of the results achieved, conferences, exchanges of experiences and international studies." The study further suggests that a strategy that has proven to be successful is to introduce harm-reduction activities into prisons as pilot projects and to duly evaluate them.
Bollini P, Laporte JD, Harding TW (2002). HIV prevention in prisons. Do international guidelines matter? European Journal of Public Health, 12(2): 83-89.
The study had two aims: to assess national HIV prevention policies in prison in a selected group of countries; and to determine which factors influenced such policies at the country level. HIV prevention policies in prison were reviewed comparatively in Moldova, Hungary, Nizhnii Novgorod region of the Russian Federation, Switzerland and Italy. The review of HIV prevention policies in prison was conducted through interviews with government officials, nongovernmental organizations, professionals involved in this field, and visits to selected prisons. Information on the health of prisoners, including tuberculosis, sexually transmitted diseases, and other infectious diseases was also collected. The results indicated that all countries had adopted a policy. The content of the policy mirrored the philosophy and strategies of HIV prevention and care in the community. The 1993 WHO Guidelines were fully implemented only in Switzerland, and partially in Italy and Hungary. The authors concluded that a greater effort aimed at dissemination of information, provision of technical know-how and material resources could be the answer to at least part of the problems identified. In addition, greater national and international efforts are needed to stimulate the debate and build consensus on harm reduction activities in prison.
Braithwaite RL, Hammett TM, Mayberry RM (1996). Prisons and AIDS: A Public Health Challenge. San Francisco: Jossey-Bass.
Provides information about the frequency of sexual contact, drug use, needle sharing, and tattooing in prisons in the US; analyzes existing educational and prevention efforts; and recommends strategies for developing improved prevention programs, including for young offenders and for ethnic-minority inmates. Includes a guide to education and prevention resources in the US.
Brewer TF (1991). HIV in prisons: the pragmatic approach. AIDS, 5: 897.
Correctional Service Canada (1994). HIV/AIDS in Prisons: Final Report of the Expert Committee on AIDS and Prisons. Ottawa: Minister of Supply and Services Canada.
One of the most comprehensive reports on issues raised by HIV/AIDS and by drug use in prisons. It contains 88 recommendations on how to prevent HIV transmission in prisons and on care for prisoners with HIV/AIDS. Also available: HIV/AIDS in Prisons: Summary Report and Recommendations (the summary version of the report); and HIV/AIDS in Prisons: Background Materials (includes a review of Canadian legal cases dealing with issues raised by HIV/AIDS in prison, a summary of the prison policies of Canadian provinces and territories and of selected foreign countries, and an analysis of the legal and ethical issues raised by protecting confidential medical information pertaining to prisoners).
Correctional Service Canada (2003). Infectious Diseases Prevention and Control in Canadian Federal Penitentiaries 2000-01. A Report of the Correctional Service of Canada's Infectious Diseases Surveillance System. Ottawa: CSC.
Available at www.csc-scc.gc.ca/text/pblct/infectiousdiseases/index_e.shtml.
An overview of issues related to prevention and control of infectious diseases in Canadian federal prisons.
Dolan K, Wodak A, Penny R (1995). AIDS behind bars: preventing HIV spread among incarcerated drug injectors. AIDS, 9: 825-832.
Dolan K (2000). Surveillance and prevention of Hepatitis C infection in Australian prisons: A discussion paper. Technical Report No 95. Sydney: National Drug and Alcohol Research Centre, UNSW.
Available via http://ndarc.med.unsw.edu.au/ndarc.nsf/website/Publications.reports.
Dutch National Committee on AIDS Control (1994). AIDS and Detention: The Combat Against AIDS in Penitentiary Institutions in the Netherlands. Amsterdam.
The report expresses concern about the state of HIV/AIDS policy in prisons in the Netherlands. It points out that many prisoners belong to societal groups - such as drug users, prostitutes, marginal youth, migrants - that are especially vulnerable to contracting HIV infection. Prisons are considered as an opportunity to reach these groups with education and prevention activities. According to the authors, AIDS policy in prisons should correspond to AIDS policy in the wider society, as well as with the WHO Guidelines on HIV Infection and AIDS in Prisons (see supra). The report is available only in Dutch, but is accompanied by a brief English summary.
Editor (2005). Prison health: a threat or an opportunity? The Lancet, 366: 1.
Argues that the failure of governments around the world to implement measures that have repeatedly been shown to reduce harm wastes a vital opportunity to improve the health of a population that is often beyond the reach of public-health efforts. "This failure is utterly shameful. Prisoners, a 'caprive group', present a crucial opportunity to address behaviours that pose a high risk of diseases transmission in society in general as well as in prisons, with proven, easy, and cheap harm-reduction measures."
European Network on HIV/AIDS and Hepatitis Prevention in Prisons (1997). Final Report on the EU Project European Network on HIV/AIDS Prevention in Prisons. Bonn and Marseille: The Network.
The proceedings of the first seminar of the European Network for HIV/AIDS and Hepatitis Prevention in Prison, held in Marseille on 20 June 1996, contain a review of literature on HIV risk behaviours in prisons and an overview of the situation in six European countries: Germany, Scotland, France, Italy, the Netherlands, and Sweden. There is also a French report, L'infection à VIH en milieu carcéral: épidémiologie, prévention, aspects éthiques et juridiques.
European Network on HIV/AIDS and Hepatitis Prevention in Prisons (1998). 2. Annual Report - European Network on HIV/AIDS Prevention in Prisons. Bonn and Marseille: The Network.
The second report by the European Network, with detailed information regarding HIV/AIDS and hepatitis in prisons in 16 European countries and an updated European bibliography on HIV/AIDS in prison.
European Network on HIV/AIDS and Hepatitis Prevention in Prisons (1999). European guidelines on HIV/AIDS and hepatitis in prison.
Available at www.hipp-europe.org/EVENTS/MILAN/index.htm.
Fortuin J (ed) (1992). Issues in HIV/AIDS in the Australian Prison System. Canberra: Australian Institute of Criminology.
This book contains six articles on HIV/AIDS in prisons, regarding: education and training; policy trends; management of HIV-infected prisoners; occupational health and safety in prisons; prisons and the law; and research findings and their implications for prevention.
Gatherer A, Moller L, Hayton P (2005). The World Health Organization European Health in Prisons Project after 10 Years: Persistent Barriers and Achievements. Am J Public Health, 95: 1696-1700.
The recognition that good prison health is important to generalpublic health has led 28 countries in the European Region ofthe World Health Organization (WHO) to join a WHO network dedicatedto improving health within prisons. Within the 10 years sincethat time, vital actions have been taken and important policydocuments have been produced. A key factor in making progressis breaking down the isolation of prison health services andbringing them into closer collaboration with the country'spublic health services.However, barriers to progress remain. A continuing challengeis how best to move from policy recommendations to implementation,so that the network's fundamental aim of noticeable improvementsin the health and care of prisoners is further achieved.
Gouvernement du Québec, Ministère de la Sécurité publique, Direction générale des services correctionnels (1997). Les moyens de prévention de la transmission du VIH en milieu carcéral en regard de la clientèle UDI: Rapport du groupe de refléxion. Québec: Direction du partenariat et du conseil en services correctionnels, 19 June 1997.
A working group established by the Québec ministry of public security released this report, recommending better education programs for prisoners and staff in Québec provincial prisons, wider and more discreet access to condoms, increased access to bleach, continuation of methadone maintenance for prisoners who were on such treatment on the outside, and education about safe tattooing techniques.
Goyer KC, Gow J (2002). Alternatives to current HIV/AIDS policies and practices in South African prisons. J Public Health Policy 23(3): 307-323.
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 article argues that prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants. See also above, Goyer, 2003, and Goyer et al., 2004.
Gunchenko AN, Andrushchak LI (2000). The results of a joint project of the State Department of Ukraine on the Execution of Punishments and UNAIDS to decrease the risk of the spread of HIV in the prisons of Ukraine [article in Russian]. Zh Mikrobiol Epidemiol Immunobiol, (4): 95-96.
Between 1987 and 1999, 7,800 cases of HIV infection were detected among the prisoners of the penitentiary institutions of Ukraine. In 1997 the penitentiary system abolished the mandatory testing and isolation of HIV-positive persons. In April 1998 a project aimed at reducing the spread of HIV infection started in the penitentiary system, including information and education of prisoners both during remand and after conviction, as well as of the personnel of penitentiary institutions; availability of condoms and disinfectants; voluntary testing for HIV and pre-and post-test counselling.
Hammett TM (1988). AIDS in Correctional Facilities: Issues and Options. Third Edition. Washington, DC: US Department of Justice.
Hankins C (1988). AIDS and the Correctional System. Proceedings of the Canadian Sex Research Forum Conference, 3(4): 43-46.
An early article addressing the epidemiology of HIV in prisons; sexual activity in prisons; the rights of prisoners to educational programs and to equal treatment in terms of research; sexual assault in prisons; and mandatory testing. Hankins concludes by saying that "[t]he correctional system must move rapidly to address the HIV epidemic and its implications."
Hankins C (1994). Confronting HIV infection in prisons. Canadian Medical Association Journal, 151: 743-745.
Harding TW (1987). AIDS in prison. The Lancet, 2(8570): 1260-1263.
A survey carried out in 17 countries on behalf of the Council of Europe found that prison doctors and administrations have reacted to the AIDS epidemic in ways that are not always scientifically and ethically sound. The article argues that the pressing need to control HIV infection in prison, to counsel and support HIV-positive prisoners alongside caring for prisoners with AIDS and coping with the psychosocial pressures within a closed, authoritarian environment pose a serious challenge to prison medical services. It is far from certain that they have sufficient resources and the professional independence to cope. Nevertheless, failure to react adequately to the AIDS epidemic in prisons would have serious consequences both for the community as a whole and for the ethical position of prison doctors.
Harding T (1990). HIV Infection and AIDS in the Prison Environment: A Test Case for the Respect of Human Rights. In: Strang J, Stimson G (eds). AIDS and Drug Misuse. New York: Routledge, 197-207.
Harding T, Schaller G (1992). HIV/AIDS Policy for Prisons or for Prisoners? In: Mann JM, Tarantola DJM, Netter TW (eds). AIDS in the World. Cambridge, MA: Harvard University Press.
Harding, T, Schaller G (1992). HIV/AIDS and Prisons: Updating and Policy Review. A Survey Covering 55 Prison Systems in 31 Countries. Geneva: WHO Global Programme on AIDS.
Harding TW (1996). HIV/AIDS in Prisons. In: AIDS in the World II. New York: Oxford University Press, 268-272.
Heilpern H, Egger S (1989). AIDS in Australian Prisons - Issues and Policy Options. Canberra: Department of Community Services and Health.
A comprehensive early report on HIV/AIDS in Australian prisons, containing many recommendations.
Hellard M, Aitken C (2004). HIV in prison: what are the risks and what can be done? Sexual Health, 1: 107-113.
Provides an overview of risk activities in prisons and of what can be done to reduce the risk of HIV transmission.
Human Rights Watch (2004). Russian Federation. Lessons Not Learned - Human Rights Abuses and HIV/AIDS in the Russian Federation. New York: HRW.
Available via www.hrw.org/doc/?t=hivaids_pub.
Contains a section on HIV prevention in prison (at 39-44), which highlights many of the problems with regard to the (lack of) access to HIV prevention measures in prisons in Russia, as well as their human rights implications.
Human Rights Watch (2004). Thailand. Not Enough Graves: The War on Drugs, HIV/AIDS, and Violations of Human Rights. New York: HRW.
Available via www.hrw.org/doc/?t=hivaids_pub.
This 60-page report provides evidence of extrajudicial killings, arbitrary arrests and other human rights violations by Thai authorities. The report contains first-hand testimony from relatives of people killed during the drug war, as well as drug users who endured beatings, forced confessions and arbitrary arrests at the hands of Royal Thai Police. It addresses the situation with regard to HIV/AIDS in detention facilities.
Jacob J, Keppler K, Stöver H (eds) (1997). Drogengebrauch und Infektionsgeschehen (HIV/AIDS und Hepatitis) im Strafvollzug. Berlin: Deutsche AIDS-Hilfe.
This book contains a collection of articles on HIV/AIDS and drugs in prisons, ranging from a view from the inside, to methadone provision in prisons in Germany, to the experiment with urinalysis, to a description and discussion of prison-based needle-exchange programs, to prescription of heroin. In German only.
Jürgens R (1994). Sentenced to prison, sentenced to death? HIV and AIDS in prisons. Criminal Law Forum, 5(2-3): 763-788.
An overview of HIV/AIDS in prisons in Canada and internationally, focusing on the recommendations in the 1994 report of the [Canadian] Expert Committee on AIDS and Prisons.
Jürgens R, Riley D (1997). Responding to AIDS and drug use in prisons in Canada. The International Journal of Drug Policy, 8(1): 31-39.
A concise overview of HIV/AIDS and drug use in Canadian prisons, and a discussion of responses to the issues raised.
Jürgens R (1997). Will Prisons Fail the AIDS Test? In: PG Erickson et al (eds). Harm Reduction: A New Direction for Drug Policies and Programs. Toronto: University of Toronto Press, 151-173.
An overview of HIV/AIDS in prisons in Canada and internationally.
Jürgens R, Betteridge G (2005). Prisoners who inject drugs: public health and human rights imperatives. Health & Human Rights, 8(2): in print.
This article examines the human rights and public health implications of injection drug use in prisons with a specific focus on HIV and HCV. The authors argue that prisoners who inject drugs have a right to access harm reduction measures. Moreover, states that fulfil their obligation to provide prisoners with harm reduction measures such as access to bleach, substitution therapy, and sterile injection equipment implement sound public health policy, with a positive impact for a population particularly vulnerable to HIV and HCV. Ultimately, the promotion of health in prisons benefits not only prisoners, but also prison staff and the public, and does not entail lessening of the safety and security of prisons.
Jürgens R, Betteridge G (2005). HIV Prevention for prisoners: A public health and human rights imperatives. Interights Bulletin, 15(2): 55-59.
Details about this publication are available at www.interights.org/page.php?dir=Publication.
Kantor E (2003). HIV transmission and prevention in prisons. HIV InSite Knowledge Base Chapter.
http://hivinsite.ucsf.edu/InSite?page=kb-07&doc=kb-07-04-13
Provides an overview of issues related to HIV/AIDS in prisons.
Kerr T et al. (2004). Harm reduction in prisons: a "rights based analysis". Critical Public Health, 14(4): 345-360.
Throughout most of the world, the primary response to problems associated with illicit injection drug use has been to intensify law enforcement efforts. This strategy has contributed to an unprecedented growth in prison populations and growing concerns regarding drug-related harm within prisons. Despite the presence of international laws and guidelines that call for the protection of the health of prisoners, prison authorities have generally been slow to implement activities that have been proven effective in reducing drug-related harms in community settings. While a limited number of countries have made progress by implementing educational programs, methadone maintenance therapy, bleach distribution and needle exchange, in most areas of the world, a substantially greater effort is needed to ensure that prisoners receive the same level of care offered in community settings. The current emphasis on security and abstinence from drugs within prisons is often regarded as incongruent with the goals and methods of harm reduction. However, available evidence indicates that most harm-reduction programs can be implemented within prisons without compromising security or increasing illicit drug use.
Lawyers Collective HIV/AIDS Unit (no date). Background Paper: Prisoners. Mumbia and New Delhi: Lawyers Collective.
Abstract available via http://www.lawyerscollective.org/lc-hiv-aids/index.htm.
This paper was written by the Lawyers Collective HIV/AIDS Unit as part of the development of draft legislation on HIV/AIDS in India. The paper on prisoners explores the key human rights issues that emerge in the context of prisons and the HIV epidemic through an analysis of case law from around the world.
Lines R (2002). A Call for Action: HIV and Hepatitis C in Irish Prisons. Irish Penal Reform Trust and Merchants Quay Ireland.
Available via www.iprt.ie.
Argues that HIV and HCV have reached epidemic levels in Irish prisons, yet the Irish Prisons Service's provision of HIV and HCV prevention measures and health services falls far short of those available in the community, and of best-practice models in other European and North American jurisdictions. Based on Irish and international research and experience, the report provides 21 recommendations to the Irish government for implementing a comprehensive and compassionate response to HIV and HCV in the prisons. For a summary, see Ireland: Report Calls for Action on HIV and HCV in Irish Prisons. Canadian HIV/AIDS Policy & Law Review 2002; 7(2/3). Available in English and French at www.aidslaw.ca/Maincontent/otherdocs/Newsletter/vol7no2-32003/prisons.htm.
Lines R (2002). Action on HIV/AIDS in Prisons: Too Little, Too Late - A Report Card. Montreal: Canadian HIV/AIDS Legal Network.
Available in English & French at www.aidslaw.ca/Maincontent/issues/prisons/reportcard/toc.htm.
Provides a detailed review of the provision of HIV/AIDS programs and services in Canadian prison systems. Includes a "Harm Reduction Report Card" for each jurisdiction rating its provision of HIV prevention measures.
Lines R (2002). Pros & Cons: A Guide to Creating Successful Community-based HIV/AIDS Programs for Prisoners. Toronto: PASAN.
Available at www.pasan.org.
A comprehensive resource on developing HIV/AIDS prevention and support services for prisoners.
Ministry of Law and Human Right of Republic Indonesia (2005). National Strategy Prevention and Control HIV/AIDS and Drug Abuse Indonesian Correction and Detention, 2005 - 2009. Jakarta: Directorate General Correction.
Recognizes that drug use in Indonesia "has exploded in the past few years," including in prisons. The national strategy covers various efforts aimed at improving the health of prisoners and the general community.
Niveau G (2005). Prevention of infectious disease transmission in correctional settings: A review. Public Health, Aug 26 [Epub ahead of print]
The objective was to review studies defining risk factors for infectious disease transmission in correctional settings, to determine target objectives, and to assemble recommendations for health promotion in prisons and jails. Electronic databases were searched, using a specific search strategy, from 1993 to 2003. The principal risk factors in correctional facilities are proximity, high-risk sexual behaviour and injection drug use. Based on the type of disease transmissions and epidemics reported in the literature, four diseases were targeted for which preventive measures should be implemented: tuberculosis, human immunodeficiency virus, hepatitis and sexually transmitted diseases. Knowledge of risk factors helps define effective preventive measures along five main themes of action: information and education, screening, limiting harm from risk behaviour by distributing condoms and exchanging syringes, treatment and vaccinations. The effectiveness and feasibility of each of these actions have to be assessed in relation to the specificities of the correctional setting.
O'Mahony P (1997). Mountjoy Prisoners: A Sociological and Criminological Profile. Dublin: The Stationery Office.
This report presents the results of a representative sample survey of prisoners in Mountjoy Prison in Ireland undertaken in May and June of 1996. The aim is to provide a profile of Mountjoy prisoners which focuses on their social and family background, health status with particular emphasis on substance abuse problems, criminal and penal history, and to a limited extent on their experience of and views on prison life and the prison regime.
Pagliaro LA, Pagliaro AM (1992). Sentenced to death? HIV infection and AIDS in prisons - current issues and future concerns. Canadian Journal of Criminology, 34(2): 201-214.
The article stresses the need for immediate development of comprehensive strategies aimed at the prevention and control of HIV/AIDS in prisons.
Paredes I et al (2001). HIV/AIDS prevention in prisons: experience of participatory planning. Gaceta Sanitaria, 15(1): 41-47.
Describes the application of participatory methodology in the prison setting (a prison in Valencia, Spain) for the determination of the most appropriate contents and methods of an HIV/AIDS prevention program. Concludes that the participation of the prisoners and staff supplied information that facilitated the design (choice of aims, measures, methods and resources) of an HIV prevention program adapted to the needs and preferences of all the interested parties.
Prison Reform Trust and National AIDS Trust (2005). HIV and hepatitis in UK prisons: addressing prisoners' healthcare needs. London: PRT & NAT.
Available via http://www.nat.org.uk/
A report on HIV and HCV in prisons in the United Kingdom, with many recommendations.
Prisoners with HIV/AIDS Support Action Network (1992). HIV/AIDS in Prison Systems: A Comprehensive Strategy. Toronto: PASAN.
Available via www.pasan.org/PASAN.htm.
A comprehensive strategy to address the issues raised by HIV/AIDS in the federal and provincial prison systems in Canada.
Reddy P, Taylor SE, Sifunda S (2002). Research capacity building and collaboration between South African and American partners: the adaptation of an intervention model for HIV/AIDS prevention in corrections research. AIDS Education and Prevention, 14(5 Suppl B): 92-102.
This article examines a partnership between researchers from the US who are involved in corrections health issues and scientists from South Africa who conduct prison health research. It discusses some of the challenges as well as opportunities for knowledge and skills exchange via capacity building and collaboration strategies; and discusses barriers and benefits of collaboration when forging links between researchers from developed and less developed nations.
Restum ZG (2005). Public health implications of substandard correctional health care. Am J Public Health, 95: 1689-1691.
Argues that US citizens face a growing threat of contracting communicablediseases owing to the high recidivism rate in state and federalprisons, poor screening and treatment of prisoners, and inferiorfollow-up health care upon their release.Insufficient education about communicable diseases - for prisoners and citizens alike - and other problems, suchas prejudice against prisoners, escalating costs, and an unreliablecorrectional health care delivery system for inmates, all contributeto a public health problem that requires careful examinationand correction for the protection of everyone involved.
Stern V (1998). A Sin against the Future: Imprisonment in the World. Boston, MA: Northeastern University Press.
For a review, see http://www.bsos.umd.edu/gvpt/lpbr/subpages/reviews/stern99.html
A comparative examination of imprisonment and prison systems around the world. The thirteen chapters are divided into four parts: Imprisonment Around the World; A Deformed Society: The Prison World; Making Prisons Better; and The Future of Imprisonment. Does not deal with HIV/AIDS specifically, but in many ways, it is difficult to discuss HIV/AIDS in prisons without discussing prison reform.
Stöver H, Lines R (2005). Silence Still = Death: 25 years of HIV/AIDS in Prisons. In: Matic S, Lazarus J, Donoghoe M (eds). HIV/AIDS in Europe: Moving from death sentence to chronic disease management. Geneva: World Health Organization (in press).
The AIDS Council of NSW et al. (1995). Prisons and Blood Borne Communicable Diseases. The Community Policy. Darlinghurst: The Council.
A number of community groups in New South Wales, Australia, joined forces and produced this policy on the prevention and treatment of bloodborne diseases such as HIV and hepatitis C in the prison system. The policy makes a number of recommendations about how to prevent the spread of HIV behind bars, and addresses an issue that underlies many of the problems raised by HIV/AIDS in prisons - current drug laws that result in many drug users being sentenced to prison, where they continue using and run an increased risk of contracting HIV. In order to decrease the number of drug users sentenced to prison, it recommends a variety of changes to drug laws.
Thomas PA (1990). HIV/AIDS in prisons. The Howard Journal of Criminal Justice, 29: 1-13.
Thomas PA, Moerings M (eds) (1994). AIDS in Prison. Aldershot, UK, and Brookfield, Vermont: Dartmouth Publishing Company.
A collection of articles on prison policies and practice in ten countries (Norway, Germany, Poland, England & Wales, the Netherlands, Belgium, Italy, Spain, Canada, USA). The laws and procedures and the extent of their application within the prison systems are reviewed, and issues such as drug use by prisoners, sexual activity in prisons, early release, drug-free units, education, and the availability of condoms and bleach are addressed.
Turnbull P, Dolan K, Stimson G (1991). Prisons, HIV and AIDS: Risks and Experiences in Custodial Care. Avert, Horsham.
United Nations Development Program (2004). HIV/AIDS in Eastern Europe and the Commonwealth of Independent States. Reversing the Epidemic. Facts and Policy Options. Bratislava: UNDP.
Available via www.undp.org/hiv/.
"This report contains a simple message: without an immediate, accelerated and significantly scaled up response by governments and other actors, HIV/AIDS risks undermining and even reversing human development gains across the countries of Eastern Europe and the Commonwealth of Independent States." The report contains a section on prisoners (at 32-35) and the following conclusions and recommendations (at 36-37):
"Fundamental reforms of prison systems are needed, in order to reduce overcrowding, better align punishments with crimes, and help guarantee the rights of prisoners. To the extent possible, the principles of equivalences - under which prisoners receive the same quality health as the rest of the population - should be adopted.
Harm reduction methods should be broadly introduced in all prisons. More generally, prisoners should be seen as places of rehabilitation as well as punishment.
To the extent possible, non-violent drug users should not be incarcerated. One month in prison is enough to get HIV from a shared, infected needle.
The region needs more frank discussion about the socio-economic causes of drug use, homosexuality, the true state of its prisons. ..."
US National Commission on AIDS (1991). Report: HIV Disease in Correctional Facilities. Washington, DC: The Commission.
Vumbaca G (1998). Finding a Better Way. Sydney, Australia, Churchill Fellowship Report.
This report provides a description of the prison and community policies and program responses to HIV, hepatitis, and drug use implemented by Switzerland, the Netherlands, England/Wales, and Canada. It then makes a number of recommendations aimed at reducing the impact of HIV, hepatitis, and drug use on the community as a whole. Some of the recommendations include: the introduction of trial heroin-prescription programs; expansion of methadone and other drug-substitution programs; establishment of drug-free units in prisons; and abandoning urine testing for cannabis in prisons. Includes a good discussion of how harm- reduction strategies can be made more understandable to the general public, and points out that "strategies aimed at breaking the cycle of drug use and imprisonment will in fact provide what most of the general public actually want, that is, a reduced level of crime and a reduced visibility of street based drug use scenes."
Walmsley R (2005). Prisons in Central and Eastern Europe. Helsinki: Heuni Paper No. 22.
Available via www.heuni.fi, together with the larger report entitled, "Further Developments in the Prison Systems of Central And Eastern Europe: Achievements, problems and objectives" by the same author. While not focusing on HIV/AIDS, the paper does address issues related to HIV/AIDS, drug use, and tuberculosis, as well as the underlying factors that put people at risk in prisons.
Winsbury R (1999). AIDS in prisons. AIDS Analysis Africa, 10(3): 10-11.
Discusses issues related to HIV in prisons in Senegal, Africa.
Zack B, Flanigan T, DeCarloP (2000). What is the role of prisons in HIV, hepatitis, STD and TB prevention? San Francisco: Center for AIDS Prevention Studies, UCSF.
Available at www.caps.ucsf.edu/inmaterev.html.
A 4-page info sheet addressing such questions as: What is the impact of infectious disease and incarceration? Are prisoners at risk for disease? What are obstacles to prevention? What is being done? What still needs to be done?
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