Important note: Information in this article was accurate in November 2003. The state of the art may have changed since the publication date. Dear HEPP subscriber:
In 1988, the World Health Organization established World AIDS Day to focus global attention on HIV/AIDS. Although there have been some successes, 15 years later the pandemic continues to spread virtually unabated in much of the developing world.
Tragically, techniques known to be effective in slowing the spread of HIV are too often underutilized. Funding for proven HIV prevention strategies such as condoms and needle exchange often becomes bogged down in moralistic wrangling. Both within the correctional environment and beyond, homophobia and laws regulating consensual sexual activities can function to deter at-risk individuals from being tested, utilizing effective prevention techniques, and seeking HIV treatment.
Stigmas associated with addiction and illicit drug use also result in policies that limit effective prevention. Inadequate resources allocated to drug treatment and harm reduction strategies create a Hobson’s choice, increasing the likelihood that many of those incarcerated for drug-related crimes will never break free from the cycle of addiction and incarceration. The sexual partners of those with ongoing HIV/hepatitis risk behaviors are also vulnerable, as are children born to mothers who acquire HIV through sharing needles or having unprotected sex with an at-risk partner.
The Centers for Disease Control and Prevention (CDCP) have set a number of straightforward goals for this nation’s approach to the HIV/AIDS epidemic. Among them are: (1) Decreasing the number of persons at high risk for acquiring or transmitting HIV by delivering targeted, sustained and evidence-based HIV prevention interventions, (2) Through voluntary testing, increasing the proportion of HIV-infected people who know they are infected, (3) Increasing the proportion of HIV-infected people who are linked to prevention, care and treatment services, and (4) Strengthening the capacity to monitor the epidemic.
What better place to implement these goals than in jails and prisons? As correctional health care providers, we know firsthand that our patients represent the largest group of HIV-infected and at-risk individuals. In our ongoing effort to provide a forum to address the HIV prevention, diagnosis, and treatment needs of this nation, this month's issue of HEPP Report brings you our Fall 2003 Conference Update. Next month will feature a comprehensive review of the management of end stage liver disease, a spotlight on the growing problem of methicillin resistant Staphylococcus aureus (MRSA) in the correctional setting, and highlights from the annual American Association for the Study of Liver Diseases meeting.
Sincerely,
Joseph Bick, M.D.
031101
HEPP2003-1102
©1997,1998,1999,2000,2001,2002, 2003. The recently formed HIV Education Prison Project (HEPP) is a medical education program that targets a growing population, inmates in correctional facilities, that has been underserved in HIV care. It is part of the Brown University AIDS Program. Permission to use and reproduce portions of this newsletter is hereby granted provided that author and publication are fully credited and both copyright and permission notice appear with reprinted material. Inquiries may be directed to heppnews@brown.edu. Website: HIV Education Prison Project.
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