Susan Okie, M.D. New England Journal of Medicine-Sex, Drugs, Prisons, and HIV

Categories

• Testing
• Prevention and Sexual Health
• Prisons and Jails
• Racial Justice

Resource Type

Research/Journal Articles  

Description

Critics of U.S. penal policies contend that incarceration has exacerbated the HIV epidemic among blacks, who are disproportionately represented in the prison population, accounting for 40% of inmates. This New England Journal of Medicine article examines the facts, perceptions, and some proposed solutions to the HIV epidemic -- and the behaviors and policies that drive it -- occurring behind bars. As this article discusses, both the World Health Organization (WHO) and the Joint United Nations Program on HIV/AIDS (UNAIDS) have recommended for more than a decade that condoms be made available to prisoners and that measures for clean needles be implemented. Several Western European countries, as well as Canada, Australia, Indonesia, and Iran, have adopted some or all of these harm reduction approaches and have seen no increase in drug use or new cases of HIV infection. The prohibition of condom availability, absence of needle exchange programs, and inadequacy of HIV diagnosis, treatment and programs for reducing high-risk behavior before and after release have resulted in continued rising rates of HIV infection in the U.S. prison system. Theodore M. Hammett of Abt Associates, a Massachusetts-based policy research and consulting firm, is with the Domestic Health, Health Policy, and Clinical Research Division. According to Hammett, adoption of HIV-prevention measures is long overdue. Condoms ought to be widely available in prisonsFrom a public health standpoint, I think theres little question that that should be done. Methadone, also all kinds of drug [abuse] treatment should be much more widely available in correctional settings. As Robert Fullilove of Columbia Universitys Mailman School of Public Health puts it, The issue has never been, do we understand what has to happen to reduce the risks? Its always been, do we have the political will necessary to put what we know is effective into operation?  

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Published

2007-January-11