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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



We offer a monthly newsletter dealing with the various issues surrounding infectious diseases.  To find out more click HERE.

 

Main topics can be found within the left column; sub-topics and/or research reports can be found near the bottom of this page.  Thank you

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

ADDITIONAL ARTICLES:

Document Name & Link to Document

Description

File Size /pdf

Management Issues-a prison Officers Union.

Some of the fears that officers related were: suffering a needlestick injury whilst carrying out cell searches, being assaulted with an infected syringe, and being taken hostage

Pdf 16 kb

Management of HIV in Corrections.

The role of the Community Correction Officer is to link offenders who are affected by a communicable disease to appropriate resources, and to provide basic information concerning the disease

Pdf 24 kb

Management of HIV Infection in Australian Prisons.

The policy to maintain HIV-infected inmates in the prison mainstream, but with appropriate precautions, was a relatively simple one developed in the light of evolving knowledge about the virus.

Pdf 33 kb

Managing a Therapeutic Community.

As the numbers grew an increasing burden was placed on hospital services, which were not designed to house prisoners on a long-term basis.  In addition, hospital beds were being occupied by persons whose needs were not being meet under a hospital regime

Pdf 29 kb

Managing HIV Seropositive Prisoners: some successes and failures.

Prior to the introduction of compulsory testing, pressure had been building for the segregation of prisoners with communicable disease but, for reasons which will be discussed later; the policy of integration was maintained in South Australia

Pdf 29 kb

Medical Center or Death Camp

Report from the California Prison Focus

  pdf

Medicaid care cutbacks continue Women prisoner advocates warn that health care cutbacks at the Central California Women’s Prison in Chowchilla are life-threatening to women prisoners with HIV, hepatitis C and other serious illnesses.  
Medical inadequacies plague inmates Instead of providing care itself, the prison system ceded that job to the University of Texas Medical Branch in Galveston and Texas Tech University in Lubbock. It has become a $297 million-a-year business, paid for with public money but immune from any meaningful public scrutiny- a system built for secrecy, if not for care.  

Methadone, Prisons & AIDS.

The uses of Methadone and HIV

Pdf 38 kb

Minimizing HIV within Prison System.

Activities engaged in by prisoners may facilitate cross-infection with the HIV virus.  Sexual intercourse between prisoner, ‘institutional sex’ and the sharing of needles and syringes while injecting various drugs intravenously, are common practices and represent high-risk activity in the context of the current AIDS epidemic

Pdf 28 kb

National 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. 21 kb pdf

No Mandatory HIV Testing of State Prisoners in Indiana

Indiana DOC officials estimate that approximately 1% of state inmates are HIV positive but do not know the exact number because Indiana does not have a mandatory testing law for inmates

 

Nursing Behind Bars

Both nurses take us inside a prison. Jane Doe*, MSN, RN, CS, family nurse practitioner (FNP), provides us with a snapshot of a day in her ever-changing environment. Jen Witter, RN (see sidebar), describes her role as a registered nurse (RN) in a prison setting.

 

Occupational Exposure to Blood Borne Pathogens-for correctional employees Significant exposures to correctional staff can occur in the course of providing healthcare, contact with sharps while cleaning or searching cells, during physical altercations, and by intentional “gassing” in which staff members are deliberately exposed to a patient’s body fluids 226 kb pdf

One in 62: Young Injectors

Due to the usual limitations inherent in researching a population as "invisible" as injection-drug users (IDUs), the number of injectors under age 25 is hard to determine. However, it’s common knowledge among adolescent health workers and those operating syringe exchanges in large American cities that use of injection drugs among youth is high and rising.

 

Newsletter -March 2003. Prisons study presented Pdf 140 kb

Overview.

The topic HIV/AIDS and prisons has occasioned much public debate and was the focus of the first national conference

Pdf 24 kb

Prevention & Control of Infections with Hepatitis Viruses in Correctional Settings Report from “The Center for Disease Control:”  person incarcerated in correction systems comprise approximately 0.7% of the US population and have a disproportionately greater burden of infectious diseases, including infections with hepatitis viruses and other infections of public health importance. 482 kb pdf

Perceptions of AIDS in Prisons: Developing Educational Strategies.

Much attention has centered on such controversial issues as: compulsory or voluntary blood testing, isolation versus integration of HIV infected inmates into the prison mainstream, provision of condoms and disposable needles, and effective educational measures for specific groups with the prison

Pdf 94 kb

Portugal-setting up heroin injecting rooms in prison A recently released government report recommends Portugal set up heroin injection rooms in prisons, where widespread drug use is leading to rising HIV rates among the nation's 14,000 inmates  

Pragmatic approach to HIV for Prisoners.

The health sector and the general public have been lead to believe that prisons are incubators for HIV and will progressively infect the rest of the community.  This is not necessarily an irrational belief, although such concern has not been realized.

Pdf 22 kb

Preface.

The first national HIV/AID in prison conference held in Australia took place in November 1990.

Pdf 12 kb

Prevalence and incidence of HIV, Hepatitis B Virus, and Hepatitis C Virus infections among Males in Rhode Island Prisons Concerns exist that jails and prisons could serve as reservoirs that could simplify transmission of infectious diseases in the wider community as inmates who become infected behind bars are released. 99 kb pdf
Prevalence and Incidence of HIV, Hepatitis B Virus, and Hepatitis C Virus The authors evaluated prevalence and intraprison incidence of HIV,
hepatitis B virus (HBV) and hepatitis C virus (HCV) infections among male prison inmates in Rhode Island. They observed intake prevalence for 4,269 sentenced inmates at the Rhode Island Adult Correctional Institute between 1998-2000 and incidence among 446 continuously incarcerated inmates who had been in prison for 12 months or more.
 

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey

To determine the prevalence of antibodies to hepatitis B core antigen, hepatitis C virus, and HIV in entrants to Irish prisons and to examine risk factors for infection.

 

Prevalence of Hepatitis C Among Injection Drug Users in England and Wales: Is Harm Reduction Working?

There is evidence that harm reduction interventions, which include a range of specialized treatment services offering prescription and nonprescription programs as well as needle exchange, have been effective in reducing transmission of HIV among injection drug users

 

Prevalence of hepatitis C in prisons: WASH-C surveillance linked to self-reported risk behaviours

We used cross-sectional willing anonymous salivary hepatitis C (WASH-C) surveillance linked to self-completed risk-factor questionnaires to estimate the prevalence of salivary hepatitis C antibodies (HepCAbS) in five Scottish prisons from 1994 to 1996

 

Prevalence of hepatitis C in prisons: WASH-C surveillance linked to self-reported risk behaviours

We used cross-sectional willing anonymous salivary hepatitis C (WASH-C) surveillance linked to self-completed risk-factor questionnaires to estimate the prevalence of salivary hepatitis C antibodies (HepCAbS) in five Scottish prisons from 1994 to 1996

81 kb pdf

Prevention and Control of Infections with Hepatitis Viruses in Correctional Settings This report consolidates previous recommendations and adds new ones for preventing and controlling infections with hepatitis viruses in correctional settings. These recommendations provide guidelines for juvenile and adult correctional systems regarding 1) identification and investigation of acute viral hepatitis; 2) preexposure and postexposure immunization for hepatitis A and hepatitis B; 3) prevention of hepatitis C virus infection and its consequences; 4) health education; and 5) release planning. Implementation of these recommendations can reduce transmission of infections with hepatitis viruses among adults at risk in both correctional facilities and the outside community.  

Prevention and Control of Viral Hepatitis in Prisons Centers for Disease Control

Alan Franciscus In March 2001, approximately 120 consultants, including prison activists, prison officials, doctors, CDC officials, lawyers, and pharmaceutical representatives gathered in Atlanta, GA. This meeting was sponsored by the CDC to begin the process of establishing recommendations for the prevention and control of viral hepatitis in prisons.

 

Prevention and Treatment of HIV/AIDS and Other Infectious Diseases in Correctional Settings: 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

 

Prisons. Today, prisons are primarily expected to contribute towards reducing crime through the rehabilitation of criminal offenders.  Prisons are not intended to punish offenders, nor are they to serve as warehouses to isolate undesirables from society 1069 kb pdf

Prison AIDS Deaths Grow by 750%

The number of Aids-related deaths in South African prisons was estimated to have grown by 750% since 1995, an Institute for Security Studies (ISS) research consultant said on Tuesday.

 

Prison AIDS Project-Officer Education.

The main source of problems has been the anxieties and fears of the prison officers themselves, having to face the complex issue of managing HIV positive inmates within the prisons system

Pdf 28 kb

Prisons and AIDS
Report from the UN: HIV prevalence in many prisons is already high—higher 
than in the population at large—and still increasing.

It involves the rights to health, security of person, equality before the law and freedom from inhuman and degrading treatment

207 kb pdf

Prison health care is investigated

Yet, in a move rarely seen by the Justice Department, Missouri's prison system has denied the investigators the access they want. The investigators have wanted to see the infirmary and talk to prisoners and staff at the prison, about 70 miles northwest of St. Louis. Prison officials wouldn't allow it, instead telling federal investigators they could talk to prisoners only in the visitation area during normal visiting hours.

 

Prison medical system is in trouble

Ohio prison inmates face long waits for treatment by
physicians who often are overworked and sometimes have histories of disciplinary problems, a newspaper and television station's investigation shows

 

Prisoners It is difficult to provide a comprehensive picture of the HIV epidemic among prisoners in federal and provincial penitentiaries in Canada. There have been a number of studies of prisoners in particular institutions or in certain regions, but one must be cautious in generalizing from one institution or region to another. Nevertheless, the information that is available is cause for grave concern  

Prisoners in 1999.

The total number of prisoners under the jurisdiction of Federal or State adult correctional authorities was 1,366,721

Pdf 151 kb

Prisoners’ knowledge of HIV/AIDS and its prevention in Kerman, Islamic Republic of Iran Knowledge of prisoners regarding HIV/AIDS in Kerman was evaluated. Analysis indicated that the sample (n = 350) of prisoners had relatively high knowledge about HIV/AIDS and its modes of transmission. However, they had a lower level of knowledge about HIV/AIDS prevention. The overall knowledge of men about AIDS was significantly lower than women. Persons aged 46 years and older and illiterate inmates had the least knowledge about modes of transmission. In addition, the knowledge of illiterate prisoners about HIV/AIDS prevention was significantly lower than others. Evaluation of attitudes and practices of prisoners and implementation of educational programmes regarding HIV/AIDS are suggested.  
Prisoner plagues Tens of thousands of prisoners suffering from undiagnosed or untreated communicable disease, chronic disease and mental illness are being released into communities around the nation. And thousands more are scheduled for release in the next few years. The human costs to the health of our neighbors, and the financial well being of states, counties and cities across the country is already threatened. That's the conclusion of a report completed nearly two years ago, but inexplicably held since then by the National Institute of Justice.  
Prisoners’ Health & Human Rights in the HIV/AIDS Epidemic Worldwide, levels of HIV prevalence within inmate populations tend to be much higher than in ht egeneral population.  HIV prevalence among prison populations varies considerably across settings, although several countries have reported rates in the range of 10-25 %.  However, much of the data regarding HIV/AIDS in prisons is from high income countries.  Relatively little information on HIV in prisons is available for developing countries and countries in transition. 579 kb pdf

Prisoners' Suit Says New Jersey Ignored Hepatitis to Save Money

New Jersey was the only one of the 10 most populous states that did not treat prisoners for hepatitis C. But after articles in The Philadelphia Inquirer last July about the spread of hepatitis among prison inmates, state officials announced that New Jersey would begin to pay for hepatitis treatment, which can cost as much as $25,000 per inmate.

 

Prisoners Rights: Treatment, testing accommodation and Privacy of Documents.

The idea of prisoners’ rights is in conflict with policies which give administrative discretion and convenience overriding importance in prison administration.

Pdf 40 kb

Prisons and infectious diseases - time for a robust response

Prevalence of antibodies to hepatitis B, hepatitis C, and HIV and risk factors in entrants to Irish prisons: a national cross sectional survey • Commentary: efficient research gives direction on prisoners' and the wider public health except in England and Wales

1,069 kb pdf

Prisons Break the Taboo Surrounding AIDS It would be wrong to suggest that prisons are inhumane in Swaziland,
but there is much room for improvement to make them safe from HIV
infection, inmate abuse and other ills that are more or less endemic
to African prisons
 
PRISONS HOST AN EPIDEMIC OF INFECTIOUS DISEASES The US policy of mass incarceration with access to inept medical care but without access to information, prophylactics or disinfectants) has led to a steep increase in the number of prisoners with communicable diseases  

Prisons in India

Punishment to a person cannot exceed the sentence awarded to him. If a person Develops an incurable disease like AIDS during internment, it may amount to exceeding the punishment or even inflicting capital punishment on him. It may lead to disastrous consequences for the individual, his family and the society and the social good for which the individual's liberty was seized stands defeated

 

Prisons in India report 2% conversion rate to HIV It may not be very important from a progamme planner's perspective
whether Mr X or Y was seroconverted inside the prison by omission or
commission, but the mere fact that, such thing, if it has happened,
opens a very serious area of action immediately.
 

Prisons plagued with Hepatitis C 

"Right now, to treat everyone would be unaffordable to most state prison systems," said Edward Harrison, president of the National Commission on Correctional Health Care in Chicago. "The legislatures aren't appropriating the dollars, the taxpayers aren't interested in pursuing it."

 

Prisons Plagued with Hepatitis C in Massachusetts

While the rate of HIV infection among prison inmates has remained steady since 1999, a surge in inmates with deadly Hepatitis C has caught the state system off guard. Hepatitis C, a deadly liver disease which can be contracted through intravenous drug use, is being called the new HIV/AIDS epidemic, challenging corrections officials in Massachusetts and nationally to treat and manage the virus with slim budgets.

 

Proposed Inclusion Criteria for Hepatitis Treatment in Prisons Adapted from RI DOC Criteria and California DOC

Criteria for the California DOC

 

Protestors in Harlem want the state to provide better services for inmates with HIV and hepatitis C Members of ACT-UP, the New York AIDS Housing Network and the Parolee Human Rights Project turned out in front of the New York State Building on 125th Street in Harlem Friday, April 30, to protest the lack of HIV and Hepatitis C treatment for inmates in state prisons.  

Providing Palliative Care for Incarcerated Patients

Prisoners have a higher prevalence of HIV infection, hepatitis C infection, tobacco addiction, alcoholism, substance abuse, chronic lung diseases, and musculoskeletal disorders than similarly aged men and women who are not incarcerated.2 Many inmates received inadequate health care prior to incarceration, and therefore present with more sequelae and more advanced forms of their chronic illnesses.

 

Rape and Sexual Assault of Women in Prison, Nationally and in Oregon Until 2005 Oregon did not have a statute criminalizing sexual contact between prison staff and prisoners. It was joined only by Alabama and Vermont. In late June; Oregon’s legislature passed a statute criminalizing custodial sexual misconduct in the first and second degrees. The current statute still leaves many of the problems of custodial sexual misconduct in prison unanswered. Pdf 201 kb

Recommendations for those on the Frontline Against Hepatitis C

The management of Hepatitis C infection (Hepatitis C Virus) was the subject of an expert "consensus panel" discussion at the National Institutes of Health this past June. From the discussions at the meeting, guidelines for testing, treating and preventing Hepatitis C Virus were developed and are now  posted on the internet (www.consensus.nih.gov).

 

Report of the mission to the United States of America on the issue of violence against women in state and federal prisons" In California, the Special Rapporteur visited the California Correctional Women's Facility (CCWF) and Valley State Prison for Women (VSPW) in Chowchilla, California. The Special Rapporteur strongly regretted that she was not able to interview the specific women prisoners she had requested to meet and that she was not allowed to visit the Security Housing Unit at VSPW despite prior assurances that she would be able to visit the prison grounds freely. The Special Rapporteur had clearly indicated in her letter to the California Department of Corrections in May 1998 that she would like to interview women prisoners during her visit. In addition, the California prison authorities refused to discuss openly with her the allegations of mistreatment and abuse at CCWF and VSPW which are reflected in this report…The Special Rapporteur has learned that Mr. Kuykendall, warden of VSPW, has, since her visit, been "walked off the grounds" and suspended from his duties pending an investigation into financial mismanagement. This incident underlines the Special Rapporteur's strong belief that qualified personnel with a sufficient degree of professionalism are required for any effective correctional system.  
Report: Waits lengthy to see prison doc Ohio prison inmates face long waits for treatment by physicians who often are overworked and sometimes have histories of disciplinary problems, a newspaper and television station's investigation shows.  At least two inmates died minutes after being released from prison clinics, and others have gone days without receiving prescribed medicines, according to the three-month investigation reported Sunday by The Columbus Dispatch and WBNS-TV.  
Rethinking Rehabilitation I wish it were otherwise, but scientific evidence is sorely lacking to support the effectiveness of rehabilitation programs for criminal offenders. It is similarly lacking to support the effectiveness of most programs aimed at treating conditions that exacerbate crime, such as substance abuse and dependence. Although a limited menu of behavioral and pharmacological treatments have shown small to moderate effects among offenders when administered under controlled research conditions, those effects tend to decline rapidly soon after criminal justice supervision is withdrawn. Pdf 412 kb

Rights, Duties, AIDS & Corrections.

The interpretation of these duties by prison administrators and consideration of these duties by legislators in framing new laws and regulations are significant to decisions regarding HIV testing programs, segregation and isolation practices, and the provision of health and welfare services for prisoners

Pdf 42 kb

Routine Jail-Based HIV Testing --- Rhode Island, 2000--2007 To determine the number and characteristics of persons with newly identified HIV infection and estimate the proportion of detainees who might not have been tested if testing had been delayed, RIDOC examined jail incarceration and HIV testing data from 2000--2007. A newly identified case of HIV infection was defined in a person with a positive confirmed HIV test at RIDOC who had no record of a previous positive HIV test result according to RIDOH HIV surveillance data. Data from 2000--2007 were selected because reporting of positive HIV test results to RIDOH using unique identifiers began in 2000  
Safer Tattooing & Hepatitis C Rules to live by if you wish to have a tattoo 327 kb pdf
Sex, Sexual Violence and Coercion in Men's Prisons Many correctional administrations have displayed extreme reluctance to acknowledge that sex takes place inside their prisons. In many countries sex in prison is a punishable crime. In some, this is intertwined with an outlawing of homosexual activity in general. Yet sex and sexual violence are generally understood to be common practice behind prison walls. Available material on South African men's prisons confirms that sexual activity certainly takes place but there is little clarity on its nature and extent.1 While sex is not directly outlawed in South African prisons, and the Department of Correctional Services has gone as far as to provide in policy for prisoners to have access to condoms, the subject still represents something of an 'uncomfortable truth' around which there is little real understanding or engagement.  
Sexual Abuse of Women in U.S. State Prisons Our findings indicate that being a woman prisoner in U.S. state prisons can be a terrifying experience. If you are sexually abused, you cannot escape from your abuser. Grievance or investigatory procedures, where they exist, are often ineffectual, and correctional employees continue to engage in abuse because they believe they will rarely be held accountable, administratively or criminally. Few people outside the prison walls know what is going on or care if they do know. Fewer still do anything to address the problem.  
SEXUAL ASSAULT IN PRISON: THE NUMBERS ARE FAR FROM FUNNY The number of prison rapes can be compared with the estimated 135,000 female sexual assaults that occur outside of prison walls every year. The causes which lead an individual into an environment conducive to sexual assaults are without question complex; however, according to the literature, broad generalizations--while keeping their inherent weaknesses in mind--can be made. For instance, the power structure within male prisons are quite dissimilar or non-existent compared with those exclusively housing females; male prisons view coercive sex both as a means to exert one's aggressive dominance in the hierarchy of power as well as a sexual outlet; female prisons tend to lack the explicit display of the power hierarchy, which in turn, can effect the meanings that are placed in sexual acts.  
Sexual Initiation among Adolescent Women and Men: Trends and Differences in Sub-Saharan Africa The risk of unplanned pregnancy and sexually transmitted infections including HIV/AIDS may be affected by the age of sexual debut.  An individual who initiates sexual activity at age 15, will have more exposure to conception over the reproductive span than one who initiates sex at age 21 126 kb pdf

Soaring Rates Of Hepatitis
C Pose Dilemma In US Prisons

Prison officials say that nearly 10,000 inmates in New York and thousands of other prisoners across the region are infected with hepatitis C, an insidious liver infection that is difficult to treat, has no definite cure and, over many years, kills 5 percent of those who contract it. Prison and public health officials are wrestling with how to respond to the alarmingly high rates of infection, trying to figure out both how to contain its spread, and how and when to provide expensive treatment that, in most cases, does not work. Some states are treating hundreds of prisoners infected with hepatitis C, while others are treating none

 

Sociology of Families and Intimate Lives There are two key strands to the ‘trafficking’ debates: one concerns tensions between governments’ obligations to protect and promote human rights, and their desire to restrict irregular forms of migration (which is often regarded as a matter of state sovereignty), and other centres on conflicting views of the relationship between trafficking and prostitution Pdf 245 kb
Special Report on HIV in Prisons Prison conditions in most countries of the world are ideal for the transmission of HIV. "They are frequently overcrowded. They commonly operate in an atmosphere of violence and fear. Tensions abound, including sexual tensions. Release from these tensions, and from the boredom of prison life, is often found in the consumption of drugs or in sex," a UNAIDS "Best Practice" report noted.  

Special Edition of Medicine Chest: Detection and Treatment of Depression

Depression is not unique to any individual or group. Depression can affect the mind, body, mood and behavior of anyone. As in the general population, some HIV-positive patients are at higher risk for clinical depression. Patients with a previous history or family history of depression are at higher risk, as well as those who are dealing with alcohol or substance abuse. Women also are at higher risk, as compared to men.

 

State Cracking Down on Prison Health

The measure would mandate that the Health Department assess the treatment of inmates with AIDS, the HIV virus and hepatitis C in the 70 state prison facilities.

 

Substance Abuse Treatment for Drug Users in the Criminal Justice System

About 80 percent of inmates in correctional facilities have substance abuse problems. Substance abuse treatment in correctional institutions can help them. Many facilities provide treatment and education interventions, but significant gaps remain.

 

The Burden of Infectious Disease Among Inmates of and Releasees From US Correctional Facilities, 1997

During 1997, 20% to 26% of all people living with HIV in the United States, 29% to 43% of all those infected with the hepatitis C virus, and 40% of all those who had tuberculosis disease in that year passed through a correctional facility.

 

The Burden of Infectious Disease Among Inmate. During 1997, 20% to 26% of all people living with HIV in the United States, 29% to 43% of all those infected with the hepatitis C virus, and 40% of all those who had tuberculosis disease in that year passed through a correctional facility. 119 kb pdf

The Correctional Doctor's Dilemma: Hepatitis C Treatment

Given the linkages between Hepatitis C Virus infection and drug use, gender, age, and minority populations, it is not surprising that almost one third (1.4 million) of the 4 million individuals in the United States who are believed to be infected with Hepatitis C Virus pass through correctional facilities each year

119 kb pdf

The Management of End Stage Liver Disease in the Correctional Setting

(large report-increase download time)

Over the past 20 years, correctional healthcare providers have become increasingly important in our nation’s response to tuberculosis and HIV. With one-third of HCV infected individuals in the US passing through our jails and prisons, correctional clinicians are now faced with a new challenge. As we become experts in the antiviral treatment of those with chronic hepatitis, we must also be cognizant of the management of those with ESLD. By doing so, we can decrease ESLD associated morbidity and prolong the lives of our patients suffering with this serious illness. Pdf 3711 kb

The silent killer doing time

What does a person do when a prescribed eight-year prison term turns into a life sentence? State corrections departments are fielding this question throughout the country in dealing with the growing epidemic of hepatitis C (Hepatitis C Virus) in their correctional facilities

 

The Spectrum of Chronic Hepatitis C Virus Infection in the Virginia Correctional System Chronic hepatitis C virus (HCV) is common in the inmate population of the United States. Long-standing HCV can progress to cirrhosis, which can contribute to significant morbidity and mortality. However, those inmates with histologically mild disease are unlikely to develop liver-related morbidity or mortality during their period of incarceration. Our objective was to develop an economic strategy for evaluation and treatment of inmates with chronic HCV.  

The Young and the Restless

According to the Centers for Disease Control and Prevention, approximately 40,000 new HIV infections occur each year in the United States, about a 70% rate among men and 30% rate among women.

 

Transmission of Hepatitis B Virus in Correctional Facilities --- Georgia Incarcerated persons have a disproportionate burden of infectious diseases, 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%. The prevalence of chronic HBV infection among inmates is approximately 1.0%--3.7%, two to six times the prevalence among adults in the general U.S. population. Incarcerated persons can acquire HBV infection in the community or in correctional settings  

Treatment Denied INMATES AND HEPATITIS C

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

 

U.S. prisons report a high rate of AIDS The prevalence of AIDS among prisoners in the United States is five times that of the general population, and the rates for some other sexually transmitted diseases are even higher, scientists said yesterday  
U.S. Report: Rape, Sexual Abuse Rampant in Juvenile Corrections Facilities A shocking 12.1 percent or almost one in eight of the detained youth who participated in the survey reported sexual abuse at their current facility during the previous year. On any given day, there are approximately 93,000 youth confined in juvenile facilities, more than half of whom are 16 or younger.  
U.S. to Seize State Prison Health System A federal judge said Thursday that he would seize control of prison healthcare from the state and place it under a receiver, declaring that "extreme measures" were needed to fix a system that kills one inmate each week through medical incompetence or neglect.  

Viral Hepatitis and the Criminal Justice System

The unique circumstances of the criminal justice environment create opportunities to reach an underserved population with viral hepatitis prevention and treatment services. However, correctional facilities must grapple with several issues, including uncertainty about who will pay for these services, a lack of screening and treatment guidelines, and a need for staff training.

 

Websites from HEPP

Listing of web sites

 

What can Correctional Healthcare Providers Do?

The epidemiology of Hepatitis C Virus makes correctional institutions pivotal sites for US efforts to identify those who are infected with Hepatitis C Virus. 

 

What Is the Role of Prisons in HIV, Hepatitis, STD and TB Prevention

Incarcerated people are our neighbors. Jail and prison populations have doubled in the US in the past ten years. Overcrowding and understaffing are legion in correctional systems. Inmates are admitted and released frequently, making them active participants in the community. As more people pass in and out of jail and prison, so too do problems and infectious diseases associated with incarceration, like HIV, tuberculosis (TB), hepatitis B and C (Hepatitis C Virus) and sexually transmitted diseases (STDs).

 

While the hepatitis C epidemic is substantial in the country as a whole

Prevalence of Hepatitis C Virus infection in prisons is 8- to 20-fold higher than in the community

 

WHO Global Commission, AIDS Recommendations and Prisons in Australia Where that choice involves sending a person to prison the risk that the person will there acquire HIV ought not to be banished from the mind by ignorance, indifference ore resignation.  It is yet another factor in the equation when this mode of punishment is considered. 56 kb pdf
Why is the policy brief on HIV testing and counseling in prisons and other closed settings important, and what are its main goals? The policy aims to ensure that people held in prisons and other closed settings are not left out of countries’ efforts to scale up access to HIV testing and counseling – prisoners and detainees also need greater access to HIV testing and counseling. At the same time, the policy brief aims to ensure that HIV testing in prisons is never undertaken without the informed consent of the person tested – in prisons, as outside, testing without informed consent is not justified.  
women in prison in the Middle East According to an Arab saying, ‘Prison is for real men’ (al-sijn lil-jad’an). But it was also a place for women. The development of female imprisonment sheds light not only on the cultural and social meanings of the prison in the Middle Eastern context, but on how its acculturation intersected with indigenous attitudes towards women and crime.  

Women Offenders-Programming needs and Promising Approaches.

The last decade has seen a surge in both the number and proportion of Incarcerated women in the US

Pdf 66 kb

Women Prisoners & AIDS.

Operating within prisons in NSW are Prisoners’ AIDS committees, whose function is to impart knowledge of HIV/AIDS prevention to other prisoners.

Pdf 12 kb

Women, Injection Drug Use, and the Criminal Justice System

Women inmates have consistently higher rates of drug use and HIV infection than do male inmates. The needs and circumstances of women in prison and jail require increased emphasis and tailored interventions.

 

 

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