The prison as breeding ground for
infections
"If there is one thing, more than anything
else,, which should be done, it is that health
in prisons must come under the
responsibility of the public health authorities.
The link between health in the community and
health in prisons must be made as strong as
possible. "
Professor Tim Harding, University Institute for Legal Medicine, Geneva.
AIDS, hepatitis and tuberculosis can be caught
everywhere but as various statistics show, this
possibility often is greater in prison than on the
outside. In 1995, approximately 13% of the
prisoners in Italy were found to be HIV positive.
That year, in a prison in Porto (Portugal), over 15% of prisoners were infected
with HIV. In French prisons, the spread of HIV
is 10 times higher than outside the prison walls.
The occurrence of tuberculosis is three times
higher. In Ireland, 300-500 of the estimated
1600 HIV-infected individuals have been least
once. In the USA, 5.2 AIDS cases per 1000
prisoners were found in 1994. This is almost six
times the country's average. What turns a prison
into a breeding ground for infectious diseases?
Lack of hygiene
In many European prisons, sanitary conditions
are inadequate. This results in an increased risk
of hepatitis A, infections, abscesses, and lice,
fleas and scabies.
Overcrowding
In a large prison in Eastern Europe, sometimes
35 prisoners share one single cell. However,
other European prisons too have problems with
overcrowding. Overcrowding creates
containment problems and at the same time
promotes bad hygienic conditions and infectious
diseases.
Violence
According to a prisoner in Mountjoy Prison:
"There is a lot of tension - we are just waiting
for another riot." Violence creates extra dangers
in terms of direct blood contact and therefore
infections such as HIV, or hepatitis B and C.
Unsafe drug use
Of the 1442 prisoners which were sent to
Lisbon's Central Prison (Portugal) between 1994
and 1996, 63% were found to be drug users. A
study in a German women's prison showed that
approximately one third of the women were
intravenous injectors. One out of twenty was
HIV positive. Among the non-intravenous drug
users, one out of two hundred was found to be
HIV positive.
Though forbidden in the whole of Europe, the
use of drugs within the prison walls continues,
often in dangerous conditions. Due to the lack
of needles, syringes are shared or even contrived
out of ball-point pens. The sharing of nonsterile needles is the quickest way to transmit
HIV and the hepatitis C virus.
Unsafe sex
In prison, sex between men is not uncommon.
However, the men involved will not easily
admit to it, and research statistics therefore
mostly give a distorted picture. Research
findings from prisons in Zambia, Australia,
Canada and England show figures between 6 and
12%. A 1993 study from Rio de Janeiro
(Brazil), however, showed that 73% of the men
had sex with each other. Sex in prisons often is
anal intercourse, whereby men penetrate the
partner'; anus. Rapes take place as well. Anal
sex without condoms, and rapes create
additional infection risks because often not only
semen but blood as well, is involved.
Blood brotherhood
In spite of the AIDS risk, life-threatening rituals
surrounding blood brotherhood are still very
popular in prison.
Tattooing
Tattooing and piercing are also still very much
in demand 'inside'. Here, the infection risk is the
shared use of non-sterile needles.
Source: UNAIDS, Point of view, April 1997