PrEP in Prisons: HIV prevention in incarcerated populations

Area of Science:

• Public Health
• Infectious Disease Prevention
• Criminal Justice Health

Background:

• Prison populations face disproportionately high HIV infection risks.
• Existing HIV harm reduction strategies in prisons are often limited.
• Pre-exposure prophylaxis (PrEP) is primarily discussed for men who have sex with men (MSM), neglecting other key demographics.

Purpose of the Study:

• To evaluate the feasibility and potential of pre-exposure prophylaxis (PrEP) as an HIV harm reduction intervention within correctional facilities.
• To explore the applicability of PrEP in prisons beyond the context of men who have sex with men (MSM).
• To address common objections to HIV harm reduction in prisons and assess their relevance to PrEP.

Main Methods:

• Analysis of common objections to existing prison-based HIV harm reduction interventions.
• Application of general population PrEP objections to the prison context.
• Examination of the post-incarceration access challenge for PrEP.

Main Results:

• Standard objections to HIV harm reduction in prisons are largely inapplicable to PrEP.
• Common objections to PrEP in the general population are refutable within the prison setting.
• A longitudinal perspective on prisoner HIV risk mitigates concerns regarding post-incarceration PrEP access.

Conclusions:

• PrEP presents a viable and potentially flaw-free HIV prevention tool for incarcerated individuals.
• Addressing post-incarceration access is crucial for successful PrEP implementation in prisons.
• Further research is warranted to explore PrEP's role in improving health equity and combating HIV within and beyond correctional settings.