Worldwide, around 30 million people enter and leave prison each year. Of these, around 4.5 million have hepatitis C, almost 1 million have HIV and 1.5 million have hepatitis B infections. By Professor Kate Dolan.

21 Jul 2016

In many countries, prisons are underfunded and overcrowded, and injecting drug use is common. Those who enter prison uninfected are at risk of becoming infected, as few countries provide the range of prevention programs required to halt transmission inside.

Once detained, prisoners are often denied access to life-saving treatment for these infections.

This lack of access to treatment and prevention programs is a human rights violation that must be addressed. A series of articles in the Lancet medical journal – released ahead of next week’s AIDS 2016 conference in Durban, South Africa – outlines how.


In the West, more than one-third of inmates have a history of drug injection. In New South Wales, it’s about half of inmates. This is in stark contrast with levels of drug injecting in the general population, which are less than 0.5% in Europe and Australia.

While those in the community may not feel at risk, most inmates are released back to their communities. Many prisoners serve short sentences of about six months or less. And sentences served by women tend to be shorter, three months or so.

As part of the Lancet package, we published a review of prevention programs for prisoners including education, voluntary testing and counselling, needle and syringe programs, methadone, condom provision and antiretroviral therapy for HIV.

Only seven countries – Moldova, Kyrgyzstan, Germany, Luxembourg, Portugal, Spain and Switzerland – provide all six interventions in their prisons. However, the actual level of coverage in these countries remains unknown.

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