People in prisons need access to HIV prevention and harm reduction services, calls UNAIDS

Drug use is prevalent in prison systems worldwide, and the levels of HIV and hepatitis C, which can be transmitted through drug injection and sex, are also higher among people in prisons than the general population. However, prisons are often overlooked in efforts to combat these epidemics.

People in prisons need access to essential harm reduction services as well as HIV prevention and treatment, according to a call to action by the Joint United Nations Programme on HIV/AIDS (UNAIDS) earlier this month in relation to the International Harm Reduction Day observed every May 7th.

"Access to healthcare, including harm reduction services, is a fundamental human right, and no one should be denied this right because they are in prison," said Eamonn Murphy, UNAIDS Regional Director for Asia and the Pacific, Eastern Europe, and Central Asia, in a press release. "Prisons are too often overlooked in countries' efforts to fight HIV. A multisectoral, comprehensive approach is needed to save lives, which includes access to clean needles and syringes, effective treatment for opioid dependence, and the reduction of stigma and discrimination."

Data presented by UNAIDS in the call to action emphasizes the importance of reaching the prison population:

• In 2021, the estimated number of people in prisons increased by 24% compared to the previous year, reaching approximately 10.8 million individuals.
• People in prisons are 7.2 times more likely to live with HIV than adults in the general population.
• HIV prevalence among people in prisons has increased by 13% since 2017, reaching 4.3% in 2021.

А round a quarter of the total prison population is expected to have hepatitis C. Both drug use and HIV infection are more prevalent among women in prisons than among male prisoners (women who use drugs and engage in sex work are represented in prisons more frequently than men).

Among countries reporting on prisons to UNAIDS in 2019:

• 6 out of 104 countries had needle and syringe exchange programs in at least one prison.
• 20 out of 102 countries had opioid substitution therapy programs in at least one prison.
• 37 out of 99 countries had condoms and lubricants available in some prisons.

UNAIDS cites Moldova, an Eastern European country located near Romania and Ukraine, as an example of the work that can be done within its prison system. Today, harm reduction services (including needle and syringe exchange and opioid agonist therapy) as well as HIV testing, prevention, and treatment are available in all 17 prisons in the country.

As for hepatitis C, it is a virus that can be transmitted through drug injections and sexual contact. Hepatitis refers to inflammation of the liver. If left untreated, it can lead to liver scarring (cirrhosis), liver cancer, the need for liver transplantation, and death. Hepatitis can be caused by several factors, including toxins, excessive alcohol consumption, autoimmune diseases, fatty liver, and viruses, including the three most common ones: hepatitis A, B, and C. On the other hand, HIV attacks the immune system, and over the course of several years, it becomes depleted, leading to an AIDS diagnosis. While there is no cure for HIV, there are many safe and effective medications—often just one pill a day is sufficient. These medications help people living with HIV enjoy long and healthy lives and prevent the transmission of the virus to others.