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Related Experiment Video

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Prisons: ignore them at our peril.

Adeeba Kamarulzaman1,2, Annette Verster3, Frederick L Altice1,2

  • 1Centre of Excellence on Research in AIDS (CERiA), University of Malaya, Kuala Lumpur, Malaysia.

Current Opinion in HIV and AIDS
|July 26, 2019
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Summary

People with HIV and HCV are highly prevalent in prisons globally. Improved healthcare, screening, and treatment linkage, including medication-assisted therapies, are crucial for effective prevention and care within correctional facilities and upon community reentry.

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Area of Science:

  • Public Health
  • Infectious Diseases
  • Criminal Justice Health

Background:

  • High prevalence of HIV and HCV in criminal justice settings, disproportionately affecting people who inject drugs.
  • Criminalization of drug use contributes to concentrated HIV and HCV infections within prison populations globally.
  • Existing WHO guidelines require adaptation for the specific needs of prisoners.

Purpose of the Study:

  • To review updated HIV and HCV prevention and treatment strategies for incarcerated individuals, with a focus on people who inject drugs.
  • To examine challenges in providing these services within prisons and during community transition.
  • To build upon existing guidelines for the key population of prisoners.

Main Methods:

  • Review of updated prevention and treatment strategies for HIV and HCV within correctional facilities.
  • Focus on people who inject drugs and challenges in service provision.
  • Analysis of transition to community care and linkage to post-release services.

Main Results:

  • HIV and HCV prevalence is significantly higher in prisons than the general population, particularly in regions with high rates of injecting drug use and criminalized drug use.
  • Effective management strategies include routine screening, integrated treatment, medication-assisted treatments for opioid dependence, and syringe services programs.
  • Linkage to post-release treatment remains poor but improves with medication-assisted therapies and overdose management; basic healthcare and HIV prevention are often suboptimal in prisons, especially in low- and middle-income countries.

Conclusions:

  • Substantial improvements in basic healthcare delivery are necessary in global prisons to address HIV and HCV.
  • Effective screening, treatment, and linkage to care, including medication-assisted therapies, are vital within prisons.
  • Enhanced linkage to care and prevention services upon release is critical for long-term health outcomes.