Pubdate: Tue, 17 Dec 2013
Source: Globe and Mail (Canada)
Copyright: 2013 The Globe and Mail Company
Contact:  http://www.theglobeandmail.com/
Details: http://www.mapinc.org/media/168
Author: Camille Bains
Page: S3

STUDY PUSHES FOR HIV CARE IN PRISONS

Harm-reduction methods include supervised injection, needle exchanges
and access to methadone

Needle-exchange programs and increased access to HIV treatment are
essential to curb infection rates among Canadian prisoners, says the
lead author of a new study calling for immediate action.

Dr. M-J Milloy of the B.C. Centre for Excellence in HIV/ AIDS said
other jurisdictions, including some American states, have reduced HIV
rates among inmates and protected public health in the communities
they return to when they're released.

"We are really in favour of collaborating with the prison system to
try and find better ways to deliver harm reduction - whether that's
supervised injection, a needle exchange, improved access to
methadone," Dr. Milloy said on Monday.

"We think scientifically there's a good argument for these sorts of
things and what happens next, I think, is a political question and a
question that should best be answered by the people who are in charge
of our prison system."

The study, published in the journal BioMedical Central Infectious
Diseases, was conducted between May, 1996, and March, 2012, involving
interviews every six months with 657 inmates who were HIV positive and
used injection drugs.

Dr. Milloy said the study found that HIV could be detected in a
prisoner's bloodstream 83 per cent of the time, meaning they're more
likely to pass on the infection.

But when those same people were not behind bars, the study found the
infection rate fell to 62 per cent because they received treatment.

Dr. Milloy said that although some inmates chose not to disclose they
were HIV positive to prevent being stigmatized, others could not
access specific medications they'd started before they were
incarcerated or experienced delays in getting their prescriptions filled.

He said institutions in Rhode Island, Connecticut and Washington,
D.C., have been successful in reducing HIV rates but the strongest
case for change comes from Switzerland, which pioneered
needle-exchange programs 20 years ago before that prevention strategy
was adopted by other countries including Germany, Spain, Iran and
central Asia.

Richard Elliott, executive director of the Canadian HIV/AIDS Legal
Network, said it's long been known that the sharing of drug-injection
equipment by illicit drug users in prisons causes the spread of
blood-borne infections but policies have not changed to protect their
health.

"So far, governments in Canada are unwilling, despite repeated calls
from all over the place, to act to introduce access to sterile
injection equipment in prisons," said Mr. Elliott, adding HIV rates
are 10 times higher in jails and prisons.

In September, 2012, the network launched a lawsuit in Ontario Superior
Court against Corrections Canada, along with several groups including
the Canadian Aboriginal AIDS Network, the Prisoners with HIV-AIDS
Support Action Network and an individual who allegedly contracted
hepatitis C while incarcerated.

"It's not a lawsuit for damages," Mr. Elliott said. "It's a lawsuit
seeking constitutional remedies, seeking recognition that there are
constitutional rights that are being violated here when the government
withholds an essential evidence-based health service from people in
prison."

No one from Corrections Canada was immediately available to comment on
the issue.
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