Between April and June 1993 needle-sharing at Glenochil Prison, Scotland resulted in 14 men becoming HIV-positive and a wave of apprehension which is still felt in UK prison system to this day. In 2001 one of the men infected in the outbreak became the first person to be tried and convicted in Scotland of having ‘recklessly endangered’ his former partner by infecting her with HIV.

To understand the behaviour at Glenochil is to understand the potential risks that prisoners and society are facing. Eight HIV seroconversions were detected among inmates at Glenochil prison in Scotland and a further six possibly took place. Drug injecting and needle and syringe sharing were identified as risk factors. At the end of June 1993 intensive HIV testing and counselling was implemented.

There were 636 inmates at Glenochil between 1 January and 30 June 1993. By the time of the intensive HIV testing and counselling 66 had been released and 192 had been transferred to other prisons.

In total 227 men were counselled and 162 (71%) decided to be tested for HIV infection. In total, one third (76) of those counselled had ever injected drugs, and 33 (43%) reported injecting in prison. All twelve men who were found to be HIV-positive were among the 27 in this latter group who were tested for HIV.

The primary objective for the counselling was to prevent the further spread of infection, not to determine HIV prevalence among the prison population.

The prevalence of HIV among the 27 who had injected while in prison and had opted for testing was 44% (12/27). In addition, two other inmates, who did not opt for counselling, also reported having injected while in Glenochil.

In total 34 men who had injected outside prison, but who had not injected while in Glenochil came forward for HIV testing. None of these men were found to be HIV-positive. Being HIV-positive was significantly associated with injecting while in Glenochil prison in the early months of 1993.

Thirteen of the 14 men who were found to be HIV-positive were from Glasgow. HIV prevalence in Glasgow among injecting drug users was 1.8% according to a community survey conducted in 1990. The introduction of needle exchanges in Glasgow in 1988 appears to have prevented the rapid spread of HIV among injecting drug users outside of the prison setting.