[AIDS patients in Italian prisons: a burning issue with no easy solution]

Some of the problems related to the detention of HIV infected subjects in Italian prisons are discussed, with particular reference to subjects with AIDS. The Italian Department of Penitentiary Administration reported, in 1991, the presence of 3030 HIV infected subjects, out of which 84 with AIDS. These subjects amount to 10% of prisoners annually detained in italian prisons. Recently Italian Government, in order to regulate the management of prisoners with HIV infection, has issued a decree-law (no. 431 of November 12th, 1992). This decree sanctions the unacceptability of detaining people with AIDS or any other severe immune deficiency. Nowadays it is impossible to predict the effects of this regulation. Many factors worsen the situation: structural peculiarities and overcrowding of prisons, prisons staff anxiety, lack of awareness about uselessness of obligatory prisoners' screening. The World Health Organization in 1987, the European Council in 1989 and the Italian Committee against AIDS in many occasions, during the last five years, gave indications for the management of seropositive prisoners and confirmed that individual counselling and confidentiality of information can help the prisoners to accept the HIV test: except for a few cases, the isolation of seropositive prisoners is not justified; prevention plays an essential role.