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| IDCR and the XVI International AIDS Conference |
| By Jim Montalto, News Editor |
| Published: 10/09/2006 |
In its September issue the Infectious Diseases in Corrections Report reviewed August's XVI International AIDS Conference, "AIDS 2006."More than 25,000 researchers, physicians, advocates and others involved in the fight against HIV/AIDS from more than 170 countries attended the Toronto conference, and according to IDCR accounts the issues of HIV/AIDS in prisons were presented and discussed more than ever before. After a satellite meeting organized by the United Nations Office on Drugs and Crime, the Canadian Public Health Agency and the Correctional Service of Canada debated issues related to HIV/AIDS in prisons. Three UN agencies (the UN Office on Drugs and Crime, the World Health Organization, and UNAIDS) also released a report called "HIV/AIDS Prevention, Care, Treatment and Support in Prison Settings: A Framework for an Effective National Response." (See this week's Editor's Corner for a link to the full report.) This report was considered an important development at AIDS 2006, because it supported conference sessions and presentations. The UN framework emphasizes that "good prison health is good public health," and underscores the fact that the vast majority of prisoners eventually return to society, which makes reducing HIV transmission in prisons a vital element to reducing the spread of infection in communities outside prison. The document stresses, that "people in prison are entitled, without discrimination, to a standard of health care equivalent to that available in the outside community, including preventive measures," and calls upon decision-makers "to acknowledge that high risk behaviors for the transmission of HIV occur within prisons - especially injecting drug use, sexual activity and sexual abuse/violence - and to base decisions affecting prison health on evidence, recognized best practices, and legal and ethical obligations, rather than on public opinion or political expediency." It also urges prisons to implement comprehensive HIV/AIDS prevention and education programs (including condoms and sterile needles and syringes), voluntary counseling, HIV testing, HIV/AIDS care and treatment for prisoners, and drug dependence treatment programs. Conference activities focused mostly on HIV prevention, although efforts to make HIV treatment, including antiretrovirals, available to prisoners in developing countries were also discussed. The plight of those living with HIV infection was a common theme as was the suffering of inmates with HIV. Global AIDS epidemiology was discussed and policy makers and activists made keynote speeches on HIV transmission prevention, the impact incarceration has on the spread of HIV, and the need to provide quality HIV therapy to the imprisoned. Two sessions reflected that the emergence of incarceration is an issue being closely monitored by HIV treatment/prevention communities. According to IDCR, the most important development at the conference was the consensus that sufficient evidence exists for effective prison HIV prevention interventions, and that the corrections and public health communities must now move from evidence to action by implementing these programs. These includes providing condoms, which has been highly debated in the U.S., and instilling needle and syringe programs in prisons, which has been successfully introduced in other countries, but rarely if ever discussed in the U.S. Methadone Maintenance Treatment (MMT) was also discussed as an effective opiate dependence program. MMT has been shown to improve the physical and social wellbeing of a drug user, and has helped reduce illegal drug use, criminal behavior, participation in sex work, unemployment, mortality and HIV transmission. Delegates were able to hear not only from researchers and staff working in prisons, but also from former prisoners, which is a first at the International AIDS conference. Instead of discussing research advancements at oral sessions, as in previous conferences, the U.S. provided a number of poster presentations that highlighted new developments and findings. This was due to conference organizers including more research from developing and transitional countries, particularly in Africa, Eastern Europe and South-East Asia, which face serious HIV/AIDS epidemics in prisons. It was also due to the fact that international experts believe the U.S. lags behind other countries in providing evidence-based prevention interventions in prisons. IDCR, however, did point out in its report that the U.S. continues to do cutting-edge research, including finding interventions to improve access to care, and reducing transmission risk behavior and recidivism in HIV-infected prisoners post-release. Visit the IDCR website to read the entire event review along with a summary of data presented at the conference, and an interview with Dr. John May, who is Chief Medical Officer for Armor Correctional Health Services. |
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