Prisons Emerge as Hotspots for AIDS Pandemic

A toolkit to help governments prevent and treat HIV among prisoners was rolled out by the UN Office on Drugs and Crime during the 18th International AIDS Conference in Vienna. "Health care in prisons should be at least equivalent to that in the community," UNODC stated.

HIV is far more prevalent among the world's 30 million penitentiary inmates than in the general population, UNODC said. The virus is spreading through sex between inmates, injecting drug use, and tattooing. Overcrowding, corruption and limited access to condoms and HIV care exacerbate the problem, scientists told conference attendees.

The situation in African prisons is particularly dire. Zambia has no HIV screening and just 14 health care workers for the 15,300 prisoners in its 86 jails, said Katherine Todrys, who conducted a study of six Zambian jails for Human Rights Watch. The U.S. State Department estimates that in 2008, the proportion of Zambian prisoners who were HIV-positive was 27 percent, twice that of the country's non-incarcerated population.

Nigeria forbids the distribution of condoms among its prison population, reported Emika Chima of the Society of Family Health. "It is prohibited because if you do that you're encouraging sodomy, that's the stance," he said. "In Nigeria, officially, same-sex practices don't exist."

Nevertheless, the Open Society Institute reported that efforts to extend HIV prevention and treatment to inmates can be very successful. A needle-exchange and methadone program introduced by Moldova in the late 1990s now reaches 75 percent of inmates, OSI said.

U.S. research suggests that care for HIV-positive injecting drug users is more effective when begun before a prisoner is released. Methadone programs initiated behind bars also were more effective than post-release referrals to such programs, research indicates.

"This isn't just about prisoners," said Brown University researcher Samuel Dickman, who conducted the study. "This is about communities prisoners return to."

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