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Turning the Tide: Not Without Prisons!
Each year over 30 million men and women spend time in prisons and other closed settings, of whom over one-third are pre-trial detainees. Virtually all of them will return to their community, many within a few months to a year.
Globally, the prevalence of HIV, sexually transmitted infections, hepatitis B, C and tuberculosis in prison populations is 2 to 10 times and up to fifty times higher than in the general population. HIV rates are particularly high among women in detention. Risks affect prisoners, those working in prisons, their family and the entire community. For these reasons, it is essential to provide HIV interventions in these settings, both for prisoners and for those employed by prison authorities.
However, access to HIV prevention, treatment and care programmes is often lacking in prisons and other closed settings. Few countries implement comprehensive HIV prevention, treatment and care programmes in prisons. Many fail to link their programmes in prisons to the national AIDS, tuberculosis or public health programmes. Many fail to provide adequate occupational health services to staff working in prisons. In addition to HIV risk behaviours, such as unsafe sexual activities and injecting drug use, factors related to the prison infrastructure, prison management and the criminal justice system also contribute to the vulnerability to HIV, tuberculosis, and other health risks in prisons. These factors include overcrowding, violence, poor prison conditions, corruption, denial, stigma, lack of protection for vulnerable prisoners, lack of training of prison staff, and poor medical and social services.