Treating Prisoners While Jailed Could Stop Disease

More resources for prison medical care would reduce health crises among prisoners and help protect the health of the general population when prisoners are released, researchers said in new study.

"Prisoners act as reservoirs of infection and chronic disease, increasing the public health burden of poor communities," wrote Seena Fazel, of the University of Oxford, and James Baillargeon, of the University of Texas Medical Branch.

The United States has about one-quarter of the world's 10 million prisoners and the world's highest rate of imprisonment, 756 per 100,000 people, compared to 145 per 100,000 worldwide.

The researchers highlighted conditions such as substance abuse and communicable diseases such as HIV and TB, which are far more prevalent in prison populations than in the community as a whole. Key findings include:

*Among 75 low- and middle-income countries, 20 had an HIV prevalence rate greater than 10 percent in their prison populations.

*The proportional share of the US HIV epidemic borne by prisoners dropped 29 percent between 1997 and 2006. Possible explanations include a lower rate of HIV among those entering the prison system, declining HIV infection among intravenous drug users, and more discharge planning programs for HIV-positive prisoners.

*Chronic hepatitis B infects about 1.0 percent to 3.7 percent of US prisoners, compared to 0.4 percent to 0.5 percent of the general population. Hepatitis C among US prisoners is estimated at 23 percent to 34 percent.

*Sexual networks were the predominant means of HIV transmission among one study of US male inmates, though tattooing also was a factor.

*Federal and state prisons in the US had tuberculosis rates of 29.4 and 24.2 cases per 100,000 prisoners, compared to 6.7 cases per 100,000 in the community.

The researchers recommended:

*Increased resources for prison health care
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*Transferring responsibility for prison health care from criminal justice systems to public health systems

*Screening prisoners for physical and mental illness

*Making prison health statistics available to the public

*Developing national prison health care guidelines and policies to alleviate unhealthy living conditions

*Improving discharge planning and linkages to community health resources

*Ending policies that exclude prisoners from clinical studies.

"Finally, the medical profession should take the lead in reforming prison health care, even if this reform means refusing to send prisoners who are in hospital back to prison, where they will suffer inhuman and degrading treatment," the authors wrote.

The study, "The Health of Prisoners," was published in the Lancet (2010; doi:10.1016/S0140-6736(10)61053-7).

The Friends of AIDS Foundation is dedicated to enhancing the quality of life for HIV positive individuals and empowering people to make healthy choices to prevent the spread of the HIV virus. To learn more about The Friends of AIDS Foundation, please visit: http://www.friendsofaids.org.


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