U.S. prisons missing opportunities to provide HIV testing, education, prevention, panel says

The U.S. correctional system is missing valuable opportunities to provide HIV testing, educating and prevention to its more than two million state, federal and local inmates, panelists said at a recent briefing on HIV/AIDS in correctional settings, CQ HealthBeat reports.

According to new information from the American Foundation for AIDS Research, prisoners are three times more likely to be HIV-positive than the general population.

The panel said the reasons that HIV rates are higher in prisons include needle sharing for tattoos or drugs among inmates, as well as unprotected sex with multiple partners at high-risk of HIV before and during incarceration. According to CQ HealthBeat, more than 90% of prisoners are eventually released, which leaves communities to deal with "the public health burden of having a high number of HIV-positive people."

Josiah Rich, professor of medicine and community health at Brown University, said that other than prisons and jails in Rhode Island -- the only state that mandates HIV testing for all inmates -- most correctional facilities nationwide do not require HIV testing as part of the entry process. Barry Zack, a correctional health programs consultant, said prisons should provide condoms to inmates -- a practice advocated by the World Health Organization and UNAIDS but implemented in only a few states. However, evidence indicates that even when condoms are available in prisons, inmates rarely use them, according to an amfAR issue brief about HIV prevention and treatment in prisons.

Zack added that prisons should establish needle-exchange programs to stem the spread of HIV. In addition, Zack said that it is crucial to reform the country's prison release system to include providing inmates with access to health care, mental health care, affordable housing and job programs. Panelists said that prisoners preparing for release should be provided with copies of their prison medical records and information about how to access HIV/AIDS treatment (Walker, CQ HealthBeat, 4/22).

A Webcast of the event is available online at kaisernetwork.org.