TORONTO, Aug 15, 2006 (AFP) - The rampant spread of HIV in prisons around the world has been largely ignored or overlooked by officials, activists said Tuesday at the 16th international conference on the deadly disease.
"More than 20 years into the pandemic, the response in prisons is still undecided," said researcher Alick Nyirenda of Zambia. "Demand for services outstrips their availability."
Prisons have become "incubators" for HIV and AIDS due to unchecked gay sex, tattooing with dirty instruments and intravenous drug use, he said.
Overcrowding, guards too burdened with duties to offer sexual health services, and the illegality of homosexuality in some countries has further fueled transmission.
Annie De Groot, editor of the Infectious Diseases in Corrections Report at Brown University in the United States, said inmates are rarely mentioned in discussion about AIDS, but deserve the same help as others.
"There must be a change in attitudes (toward prisoners)," she said.
Rick Ones, director of the Irish Penal Reform Trust, went further, saying HIV prevention in prisons is a human right.
States have an obligation to protect the health of people in detention, he said.
In countries where gay sex is a crime, reporting and open discussions about safe sex are difficult, noted Nyirenda.
"You have to deal with these legal issues," he said.
In Canadian prisons, there are 1,729 known cases of AIDS, according to a February 2006 survey, but figures are believed to be much higher as many inmates do not report their health status over privacy fears, said Connor McCollum of the Prisoners' HIV/AIDS Support Action Network.
Similarly, condoms and lubricants have been available in prisons here since 1992, but bravado in this harsh environment where AIDS is still considered a gay disease means many prisoners don't ask for help, to avoid being outed, he said.
Ukraine has become Europe's epicenter of the AIDS epidemic due largely to wanton drug use.
According to the Joint United Nations Programme on HIV/AIDS (UNAIDS), there are an estimated 600,000 injecting drug users in the former Soviet state, most of whom are young.
A study presented at the Toronto conference found HIV infection rates from 16 percent to 91.5 percent in seven Ukrainian prisons.
Some people jailed for drug crimes continue using drugs in prison. Others start using drugs in prison due to boredom or to escape mentally from violence, said Morag McDonald, editor of International Prisoner Health journal.
The situation is exacerbated by lack of proper medical care and poor nutrition, she said.
Because many of these inmates spend much of their lives in and out of prison, they eventually spread the disease to the wider population, she said.
The first program to provide free needle syringes to inmates was started in Switzerland in 1992. Now there are 50 such programs in eight countries.
In those, there have been no new HIV cases and a decrease in heroine overdoses.
Needles were never used as weapons and there is no evidence their availability led to increased drug use, MacDonald said.
However there is a lack of political will to implement syringe programs and other services, she said.
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