HIV in prisons The global perspective
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The situation has called for a drastic response, with the UN and the WHO in particular trying to set bench marks for prevention and care in prisons. In February 2004, the Dublin Declaration on HIV/AIDS in Prisons in Europe and Asia stated, “Under national and international law, governments have a moral and ethical obligation to prevent the spread of HIV/AIDS in prison.” This includes the rights of inmates to protect themselves by using preventative measures against HIV transmission.

A wide-ranging study carried out by the Canadian HIV/AIDS Legal Network has shown that needle exchange programmes (NEPs) have been effective in reducing transmission in six countries who have either implemented NEPs fully into their prison system or on a trial basis. Germany, Spain, Moldova, Kyrgyzstan, and Belarus were looked at. Italy Portugal and Greece are considering the move. Canada and Australia have also had NEP trials.

However given the politically volatile issue of inmates and drug use, it will be extremely challenging to implement NEPs and condom distribution in prisons. One recent example of political pressure has been on the UN agency responsible for combating drug abuse and its policy of clean needle replacement where possible. The US has objected to the United Nations Office on Drugs and Crime (UNODC) policy on harm reduction preferring a policy based on enforcement and abstinence (Bright). The US government is opposed to clean needle exchanges, with government agencies uncomfortable with their aid funds being used to fund harm reduction programmes around the world. However it has now been reported that the UNODC has taken a softer stance on NEPs as a solution to drug abuse.