Pubdate: Wed, 3 Feb 1999
Source: Age, The (Australia)
Copyright: 1999 David Syme & Co Ltd
Contact:  http://www.theage.com.au/
Author: Nicole Brady, Social Policy Reporter

HIV BOY SHARES NEEDLES IN JAIL

A teenage boy who authorities knew was HIV positive was last year sent
to a youth training centre where he shared a syringe with six other
inmates.

Sources have told The Age the other boys, who shared a syringe for
about a week, have since tested negative to HIV. But the state's
leading drug and health experts say the incident highlights the deadly
potential within the state's juvenile and adult prisons.

They have called for consideration of trying out needle-exchange
programs in custodial settings.

It is believed the youth has now served his sentence for drug-related
crimes, and has left the Malmsbury youth training centre. That
facility caters for males aged 17 to 20, and it has been estimated
that 90per cent of inmates have been convicted of drug-related offences.

Senior health and juvenile corrections bureaucrats have tried to hush
up the incident since it occurred in the second half of last year.

But sources said the situation was considered to be of such urgency
that a meeting to discuss the problem was chaired by the state's chief
health officer, Dr Graham Rouch.

The Minister for Youth and Community Services, Dr Denis Napthine,
yesterday refused to be interviewed. A spokeswoman said details of the
case could not be discussed, and released a statement that detailed
the State Government's policy on drugs in juvenile justice centres.

It said that a growing number of young people were entering juvenile
justice centres with a background of drug-taking behavior.

"Drug use is prohibited in the state's juvenile justice centres and
actively discouraged through measures including drug rehabilitation
and education programs and random searches," the statement read.

"At the time of intake all young people undergo a health review,
including a risk assessment. According to that detailed review, a
tailor-made program is developed for each client."

But leading drug and health experts said that while authorities had to
continue trying to prevent drugs from being smuggled into prisons,
policies also needed to recognise that adult and juvenile prisoners
were using drugs and sharing needles.

Mr Paul McDonald, the chief executive officer of the Youth Substance
Abuse Service, said governments and the community had to confront the
serious health issues illustrated by the case.

"This is our next great challenge as far as stemming the HIV virus
goes - how to contain it within a prison environment.

"I think we'd have to be naive in the extreme if we didn't think there
were adult prisoners as well as young juvenile detainees who are HIV
positive, who are in our centres and who are intravenously taking
drugs," he said.

"This is the freeway into the general population. If we allow the
virus to spread through intravenous means in the prison, then it will
inevitably spread into the general population."

He called for a top-level working party to be established quickly to
consider various strategies - such as trying out needle-exchange
programs and substitute therapies - in adult and juvenile prisons.

"Governments can't be paralysed by the difficulties, either
politically or healthwise, of this issue. They must start to analyse
what are the objectives, what are the risks and start to move
forward," Mr McDonald said.

"The legacy of such paralysis is that our young people will possibly,
in five or 10 years' time, be dying from such contractions that
they're receiving at the moment."

Professor Margaret Hamilton, the director of Turning Point, Victoria's
leading drug research and policy development centre, said the incident
was extremely concerning.

"The environment in the juvenile situation just heightens the
importance of having policies and procedures, because there's that
extra level of responsibility that the custodial adults take on board
- - not just for the individual who's HIV positive, but for the other
young people in the facility at the time," she said.

"There are major duty-of-care issues in terms of having someone who is
HIV positive in an environment where others who will be injecting
don't have an opportunity for clean equipment. So you have an
environment that is obviously set up perfectly to spread blood-borne
viruses."

Dr Nick Crofts, director of the Centre for Harm Reduction at the
Macfarlane Burnet Centre for Medical Research, said HIV could easily
be transmitted among prisoners sharing needles.

"It's the dynamics of the virus that in the first few weeks after you
get infected that you're most infectious and if you're participating
in a shooting gallery affair in (the suburbs) or up in Malmsbury or
wherever, sharing with lots of other people is an excellent way of
spreading the virus among a lot of people very quickly," he said.

He said the issues relating to the prevention of blood-borne viruses
in prisons were complex, but "if an epidemic took off, they'd have to
deal with HIV on top of everything else. You know, an ounce of
prevention".

Dr Crofts said isolating inmates with HIV would not prevent them from
using drugs and possibly sharing needles.
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