In many countries, including Canada, rates of HIV and hepatitis C (HCV) infection among prisoners are significantly higher than those found in the general population.
Despite the evidence and informed opinion supporting harm reduction measures in prisons to reduce the spread of HIV and HCV in prisons, authorities in most jurisdictions have failed to take decisive action. The failure to provide access to essential prevention, care and treatment is a violation of prisoners' right to health as established by international law.
Some countries have implemented programs — peer education, condom distribution, opioid substitution therapy and needle exchange, for example — to reduce behaviours with a high risk of transmitting HIV or HCV. Similar programs are used in the community at large to prevent the spread of these viruses.
But in other countries, the lack of prison needle exchange programs, unprotected sexual intercourse and sexual violence are all factors driving the worsening HIV epidemic in prisons. Higher infection rates ultimately result in greater health-care costs. And, since most prisoners are eventually released back into the community, the public health implications of imprisoning non-violent people who use drugs cannot and should not be ignored.
Both in Canada and internationally, we promote the human rights of prisoners to have access to HIV prevention, treatment and support services equivalent to those available to in the community.