Prisoners who inject drugs: Public health and human rights imperatives

Health and Human Rights

Volumn 8, Issue 2, 2004, Pages 47-74

  Jürgens, Ralf ^a   Betteridge, Glenn ^a  

^a Canadian HIV/AIDS Legal Network   (Canada)

Author keywords

[No Author keywords available]

Indexed keywords

HUMAN IMMUNODEFICIENCY VIRUS;

HEPACIVIRUS; HEPATITIS C VIRUS;

EID: 30444442337     PISSN: 10790969     EISSN: None     Source Type: Journal    
DOI: None     Document Type: Review

References (125)

1. United Nations Commission on Human Rights, Fifty-Second Session, Item 8 of the Agenda. HIV/AIDS in Prisons, Statement by the Joint United Nations Programme on HIV/AIDS (UNAIDS, April 1996).
2. T. M. Hammett, AIDS in Correctional Facilities: Issues and Options (Washington, DC: US Department of Justice, 3d ed. 1988), p. 26.
3. US National Commission on AIDS, HIV Disease in Correctional Facilities (Washington, DC: 1991), p.10.
4. Spanish Focal Point, National Report 2001 for the European Monitoring Centre for Drugs and Drug Addiction (Madrid: Government Delegation for the National Plan on Drugs, 2001), p. 84, with reference.
5. For a review of many seroprevalence studies, see Correctional Service Canada, HIV/AIDS in Prisons: Final Report of the Expert Committee on AIDS and Prisons (Ottawa: Minister of Supply and Services Canada, 1994), pp. 15-19;
6. Ibid. HIV/AIDS in Prisons: Background Materials (Ottawa: Minister of Supply and Services Canada, 1994), pp. 47-79;
7. R. Jürgens, HIV/AIDS in Prisons: Final Report (Montréal: Canadian HIV/AIDS Legal Network and Canadian AIDS Society, 1996), appendix 2, with references.
8. M. E. Hellard and C. K. Aitken, "HIV in Prison: What Are the Risks and What Can Be Done?" Sexual Health 1 (2004): pp. 107-113,
9. with reference to A. M. McDonald et al., "HIV Prevalence at Reception into Australian Prisons, 1991-1997," Medical Journal of Australia 171/1 (1999): pp. 18-21.
10. L. M. Maruschak, HIV in Prisons, 2001 (Washington, DC: US Department of Justice, Bureau of Justice Statistics Bulletin, 2004).
11. R. Lines, Action on HIV/AIDS in Prisons: Too Little, Too Late - A Report Card (Montréal: Canadian HIV/AIDS Legal Network, 2002).
12. K. Dolan et al., "Review of Injection Drug Users and HIV Infection in Prisons in Developing and Transitional Countries" (2004). This paper provides the results of a survey undertaken on behalf of the UN Reference Group on HIV/AIDS Prevention and Care among IDUs in Developing and Transitional Countries. The paper is fully referenced and is available at http://ndarc.med.unsw.edu.au/ndarc.nsf/website/ Research.current.cp47publications.
13. A. Bobrik et al., "Prison Health in Russia: the Larger Picture," Journal of Public Health Policy 26 (2005): pp. 30-59.
14. Dolan (see note 9).
15. K. Dolan et al., "Prison-Based Syringe Exchange Programmes: A Review of International Research and Development," Addiction 98 (2003): pp. 153-158, with reference.
16. K. Dolan, The Epidemiology of Hepatitis C Infection in Prison Populations (National Drug and Alcohol Research Centre, University of New South Wales, 1999);
17. G. E. Macalino et al., "Hepatitis C Infection and Incarcerated Populations," International Journal of Drug Policy 15 (2004): pp. 103-114.
18. L. M. Calzavara, A. N. Burchell, J. Schlossberg, T. Myers, M. Escobar, E. Wallace, C. Major, C. Strike, and M. Millson, "Prior Opiate Injection and Incarceration History Predict Injection Drug Use among Inmates," Addiction 98 (2003): pp. 1257-65.
19. UNAIDS, Prisons and AIDS: UNAIDS Point of View (Geneva: 1997), p. 4.
20. See, for example, H. Stöver and C. von Ossietzky, An Overview Study: Assistance to Drug Users in European Union Prisons (Portugal: European Monitoring Centre for Drugs and Drug Addiction, 2001), p. 9.
21. See, for example, A. Taylor et al., "Outbreak of HIV Infection in a Scottish Prison," British Medical Journal 310/6975 (1995): pp. 289-292.
22. European Monitoring Centre on Drugs and Drug Addiction, 2002 Annual Report on the State of the Drugs Problem in the European Union and Norway (Luxembourg: Office for Official Publications of the European Community, 2002).
23. Correctional Service Canada, 1995 National Inmate Survey: Final Report (Ottawa: CSC, Correctional Research and Development, 1996);
24. Correctional Service Canada, 1995 National Inmate Survey: Main Appendix (Ottawa: CSC, Correctional Research and Development, 1996).
25. A. M. DiCenso et al., Unlocking Our Futures: A National Study on Women, Prisons, HIV, and Hepatitis C (Toronto: PASAN, 2003).
26. P. M. Ford, "HIV and Hep C Seroprevalence and Associated Risk Behaviours in a Canadian Prison," Canadian HIV/AIDS Policy & Law Newsletter 4 (2/3) (1999): pp. 52-54.
27. K. Dolan (see note 13), p. 6.
28. R. Jürgens (see note 5), p. 45,
29. referring to N. H. Wright et al., "Was the 1988 HIV Epidemic Among Bangkok's Injecting Drug Users a Common Source Outbreak?" AIDS 8 (1994): pp. 529-532.
30. A. Buavirat et al., "Risk of Prevalent HIV Infection Associated with Incarceration among Injecting Drug Users in Bangkok, Thailand: Case-Control Study," British Medical Journal 326/7384 (2003): p. 308.
31. Médecins Sans Frontières, "Health Promotion Program in the Russian Prison System: Prisoner Survey 2000," cited in Open Society Institute, International Harm Reduction Development. Drugs, AIDS, and Harm Reduction: How to Slow the HIV Epidemic in Eastern Europe and the Former Soviet Union (New York: 2001);
32. R. Jürgens and M. B. Bijl, "Risk Behaviours in Penal Institutions," in P. Bollini (ed), HIV in Prison: A Manual for the Newly Independent States (Médecins Sans Frontières, WHO, and Prison Reform International, 2000).
33. C. Magis-Rodriguez et al., "Injecting Drug Use and HIV/AIDS in Two Jails of the North Border of Mexico" (Abstract for the XIII International AIDS Conference, 2000).
34. Dolan (see note 13), p. 13, with reference.
35. A. Ball et al., Multi-centre Study on Drug Injecting and Risk of HIV Infection: A Report Prepared on Behalf of the International Collaborative Group for the World Health Organization Programme on Substance Abuse (Geneva: World Health Organization, 1995).
36. S. Darke, S. Kaye, and R. Finlay-Jones, "Drug Use and Injection Risk-Taking Among Prison Methadone Maintenance Patients," Addiction 93/8 (1998): pp. 1169-75;
37. M. Malliori, V. Sypsa, M. Psichogiou et al., "A Survey of Bloodborne Viruses and Associated Risk Behaviours in Greek Prisons," Addiction 93/2 (1998): pp. 243-51;
38. J. Long, Prevalence of and Risk Factors for Blood-Borne Viruses Among Prison Inmates and Entrants in Ireland: An Overview (Presented at the conference on HIV, Hepatitis C, and Harm Reduction in Prisons: Evidence, Best Practice and Human Rights, Dublin, Ireland, December 11, 2003).
39. Dolan (see note 13).
40. Dolan (see note 13), p. 6, with reference.
41. Correctional Service Canada (see note 5).
42. A. Taylor and D. Goldberg, "Outbreak of HIV in a Scottish Prison: Why Did It Happen?" Canadian HIV/AIDS Policy & Law Newsletter 2/ 3 (1996): pp. 13-14.
43. Dolan et al. (see note 12), p.153.
44. A. Taylor et al., "Outbreak of HIV infection in a Scottish Prison," British Medical Journal 310 (1995): pp. 289-292.
45. K. Dolan, W. Hall, A. Wodak, and M. Gaughwin, "Evidence of HIV Transmission in an Australian Prison," Medical Journal of Australia 160/11 (1994): p. 734;
46. K. Dolan et al., "A Network of HIV Infections Among Australian Inmates," (XI International Conference on AIDS, Vancouver, July 7-11, 1996), Abstract We.D.3655.
47. R. Jürgens, "HIV/AIDS in Prisons: Recent Developments," Canadian HIV/AIDS Policy & Law Review 7(2/3) (2002): pp. 13-20, p. 19,
48. referring to L. Dapkus, "Prison's Rate of HIV Frightens a Nation," Associated Press (September 29, 2002).
49. Dolan (see note 13).
50. D. Kloeze, "Inmate Sues the Correctional Service of Canada," in R. Jürgens, "HIV/AIDS in Prisons: New Developments," Canadian HIV/AIDS Policy & Law Review 6/3 (2002): pp. 13-19.
51. T. M. Hammett, M. P. Harmon, and W. Rhodes, "The Burden of Infectious Disease Among Inmates of and Releasees from US Correctional Facilities, 1997," American Journal of Public Health 92 (2002): pp. 1789-1794.
52. L. Levinson (Presentation to International Conference on Building Effective National HIV/AIDS and Drug Policy, Dushanbe, Tajikistan, November 2004);
53. "Disease Control in North West Russia," Prison Healthcare News No. 4 (Spring 2003): p. 6.
54. Body of Principles for the Protection of All Persons under Any Form of Detention or Imprisonment, UN GA Res. 43/173, annex, 43 UN GAOR Supp (No 49) at 298, UN Doc A/43/49 (1988), Principles 2, 4, 7.
55. Basic Principles for the Treatment of Prisoners, UN GA Res. 45/111, annex, 45 UN GAOR Supp (No 49A) at 200, UN Doc A/45/49 (1990), Principle 5. This can be expressed as "limited exceptionalism." Significantly, a number of domestic courts have recognized this principle.
56. See, for example, the International Covenant on Civil and Political Rights, International Covenant on Economic, Social and Cultural Rights; European Convention on Human Rights; American Convention on Human Rights.
57. Body of Principles (see note 42).
58. Basic Principles (see note 43).
59. Standard Minimum Rules for the Treatment of Prisoners, adopted August 30, 1955, by the First United Nations Congress on the Prevention of Crime and the Treatment of Offenders, UN Doc. A/CONF/611, annex I, ESC Res. 663C, 24 UN ESCOR Supp (No 1) at 11, UN Doc. E/3048 (1957), amended by ESC Res. 2076, 62 UN ESCOR Supp (No 1) at 35, UN Doc. E/5988 (1977).
60. Recommendation No. R 98(7) to Member States Concerning the Ethical and Organizational Aspects of Health Care in Prison, adopted by the Committee of Ministers on April 8, 1998, at the 627th Meeting of the Ministers' Deputies [hereinafter Council of Europe Recommendation No. R 98(7)].
61. The Basic Principles and the Body of Principles are resolutions of the UN General Assembly. The Council of Europe Recommendation R 98(7) and Standard Minimum Rules [SMR] (see note 47) establish comprehensive and detailed rules for the treatment of prisoners and management of institutions, rather than high-level statements of principle. Council of Europe Recommendation R 98(7), as its name suggests, is only a recommendation and not binding in law on European Union member states. Accordingly, it recommends that "governmnents of member states take into account" the principles and recommendations. The SMR state that the rules and principles "set out what is generally accepted as being good principle and practice in the treatment of prisoners and the management of institutions," and represent "the minimum conditions which are accepted as suitable by the United Nations" [SMR 1, 2]. However, article 2 of the SMR recognizes that "not all of the rules are capable of application in all places at all times," given the great variety of legal, social, economic and geographical conditions of the world. The list of principles and rules relevant to the situation of prisoners in the context of HIV/AIDS should be read with this in mind. Among these instruments only Council of Europe Recommendation No. R 98(7) specifically addresses HIV and other infectious diseases [articles 36 to 42].
62. WHO, WHO Guidelines on HIV Infection and AIDS in Prisons (Geneva: 1993) [hereinafter WHO Guidelines].
63. International Guidelines on HIV/AIDS and Human Rights. UNCHR Res. 1997/ 33, UN Doc. E/CN.4/1997/150 (1997). The state parties who participated in the UNGASS Declaration did not make any specific commitments in relation to prisoners or prisons but did commit to taking action on human rights [article 58] and to reduce vulnerability [articles 62, 64].
64. Ibid., Para. 29(e).
65. R. Hughes, "Drugs, Prisons and Harm Reduction," Journal of Health & Social Policy 18/2 (2003): pp. 43-54,
66. referring to D. Riley et al., "Harm Reduction: Concepts and Practice. A Policy Discussion Paper," Substance Use and Misuse 34/1 (1999): pp. 9-24.
67. Please see Fact Sheet: Understanding Harm Reduction, Centre for Harm Reduction, available at http://www.chr.asn.au/freestyler/gui/files// Understanding_Harm_Reduction.pdf.
68. For more details, see A. Coyle, A Human Rights Approach to Prison Management: Handbook for Prison Staff (London: International Centre for Prison Studies, 2002), pp. 49-58.
69. G. Betteridge, Prisoners' Health and Human Rights in the HIV/AIDS Epidemic Montréal: Canadian HIV/AIDS Legal Network, 2004).
70. See notes 42-44.
71. World Health Organization Europe, Status Paper on Prisons, Drugs and Harm Reduction (Copenhagen: 2005): p. 20.
72. WHO Guidelines (see note 50).
73. Correctional Service Canada, 1994 Final Report of the Expert Committee (see note 5).
74. WHO Guidelines, para. 11 (see note 50).
75. R. Jürgens, "HIV Testing of Prisoners," in HIV Testing and Confidentiality: Final Report (Montréal: Canadian HIV/AIDS Legal Network, 2d ed. 2001), pp. 154-163.
76. T. Ehrmann, "Community-Based Organizations and HIV Prevention for Incarcerated Populations: Three HIV Prevention Program Models," AIDS Education and Prevention 14 (2002): pp. 75-84.
77. R. Muller, K. Stark, I. Guggenmoos-Holzmann, D. Wirth, and U. Bienzle, "Imprisonment: A Risk Factor for HIV Infection Counteracting Education and Prevention Programmes for Intravenous Drug Users," AIDS 9 (1995): pp. 183-90.
78. R. G. Vaz, S. Gloyd, and R. Trindade, "The Effects of Peer Education on STD and AIDS Knowledge among Prisoners in Mozambique," International Journal of STD & AIDS 7 (1996): pp. 51-4.
79. S. Polonsky, S. Kerr, B. Harris, J. Gaiter, R. R. Fichtner, and M. G. Kennedy, "HIV Prevention in Prisons and Jails: Obstacles and Opportunities," Public Health Report 109 (1994): pp. 15-25.
80. G. Godin, H. Gagnon, M. Alary, L. Noel, and M. R. Morissette, "Correctional Officers' Intention of Accepting or Refusing to Make HIV Preventive Tools Accessible to Inmates," AIDS Education and Prevention 13 (2001): pp. 462-73.
81. T. W. Harding and G. Schaller, HIV/AIDS and Prisons: Updating and Policy Review. A Survey Covering 55 Prison Systems in 31 Countries (Geneva: WHO Global Programme on AIDS, 1992).
82. European Network on HIV/AIDS and Hepatitis Prevention in Prisons, Final Report on the EU Project European Network on HIV/AIDS Prevention in Prisons (Bonn and Marseille: 1997).
83. Lines (see note 8).
84. Dolan (see note 13).
85. H. Hagan and H. Thiede, "Does Bleach Disinfection of Syringes Help Prevent Hepatitis C Virus Transmission?" Epidemiology 14 (2003): pp. 628-9; author reply 629.
86. US Department of Health and Human Services, Centers for Disease Control and Prevention, HIV/AIDS Prevention Bulletin (April 19, 1993).
87. Correctional Service Canada. Evaluation of HIV/AIDS Harm Reduction Measures in the Correctional Service of Canada (Ottawa: 1999).
88. See note 33.
89. K. A. Dolan, A. D. Wodak, and W. D. Hall, "A Bleach Program for Inmates in NSW: An HIV Prevention Strategy, "Australian and New Zealand Journal of Public Health 22 (1998): pp. 838-40.
90. See, for example, School of Public Health, University of California, Berkeley, and the Institute for Health Policy Studies, University of California, San Francisco, The Public Health Impact of Needle Exchange Programs in the United States and Abroad. Summary, Conclusions and Recommendations (Centers for Disease Control and Prevention, 1993).
91. T. Kerr and R. Jürgens, Needle Exchange Programs in Prisons: Reviewing the Evidence (Montréal: Canadian HIV/AIDS Legal Network, 2004), with reference.
92. WHO Guidelines; Joint United Nations Programme on HIV/AIDS, Prisons and AIDS - UNAIDS Point of View (Geneva: 1997);
93. Ibid., Prisons and AIDS: UNAIDS Technical Update (Geneva: 1997).
94. R. Jürgens, HIV/AIDS in Prisons: Final Report (Montréal: Canadian HIV/AIDS Legal Network and Canadian AIDS Society, 1996), pp. 52-66.
95. R. Lines et al., Prison Needle Exchange: Lessons from a Comprehensive Review of International Evidence and Experience (Montréal: Canadian HIV/AIDS Legal Network, 2004).
96. Communication with the author, on file.
97. Dolan (see note 12).
98. Lines (see note 81).
99. U. Gross, Wissenschaftliche Begleitung und Beurteilung des Spritzentauschprogramms im Rahmen eines Modellversuchs der Justizbehörde der Freien und Hansestadt (Hamburg, Hannover: Kriminologisches Forschungsinstitut Niedersachsen, Forschungsbericht Nr. 73, 1998).
100. Dolan (see note 12).
101. R. Lines, R. Jürgens, G. Betteridge, H. Stöver, "Taking Action to Reduce Injecting Drug-Related Harms in Prisons: The Evidence of Effectiveness of Prison Needle Exchange in Six Countries," International Journal of Prisoner Health 1/1 (2005): pp. 49-64.
102. H. Stöver and J. Nelles, "10 Years of Experience with Needle and Syringe Exchange Programmes in European Prisons: A Review of Different Evaluation Studies," International Journal of Drug Policy 14 (2003): pp. 437-444.
103. D. R. Gibson, N. M. Flynn, and J. J. McCarthy, "Effectiveness of Methadone Treatment in Reducing HIV Risk Behavior and HIV Seroconversion among Injecting Drug Users," AIDS 13 (1999): pp. 1807-18.
104. O. Blix and L. Gronbladh, "AIDS and the IV Heroin Addicts: The Preventive Effects of Methadone Maintenance in Sweden," Drug and Alcohol Dependence 7: pp. 249-256.
105. D. M. Novick et al., "Absence of Antibody to Human Immunodeficiency Virus in Long-Term, Socially Rehabilitated Methadone Maintenance Patients," Archives of Internal Medicine 150/1 (1990): pp. 97-99.
106. J. R. M. Caplehorn, "Retention in Methadone Maintenance and Heroin Addicts' Risk of Death," Addiction 89 (1994): pp. 203-207.
107. E. Gottheil et al., "Diminished Illicit Drug Use as a Consequence of Long-Term Methadone Maintenance," Journal of Addictive Diseases 12/4 (1993): p. 45.
108. R. G. Newman et al., "Arrest Histories before and after Admission to a Methadone Maintenance Program," Contemporary Drug Problems (1973) (Fall): pp. 417-430.
109. J. Ward et al., Key Issues in Methadone Maintenance Treatment (Sydney: University of New South Wales Press, 1992).
110. D. Shewan, M. Gemmell, and J. B. Davies, "Behavioural Change Amongst Drug Injectors in Scottish Prisons," Social Science & Medicine 39 (1994): pp. 1585-6.
111. K. Dolan and A. Wodak, "An International Review of Methadone Provision in Prisons," Addiction Research 4/1 (1996): pp. 85-97.
112. K. Dolan et al., "Methadone Maintenance Reduces Injecting in Prison," British Medical Journal 312/7039 (1996): p. 1162.
113. WHO Guidelines, para. 23.
114. T. Kerr and R. Jürgens, Methadone Maintenance Therapy in Prisons: Reviewing the Evidence (Montréal: Canadian HIV/AIDS Legal Network, 2004).
115. K. Dolan et al., "A Randomised Controlled Trial of Methadone Maintenance Treatment Versus Wait List Control in an Australian Prison System," Drug Alcohol Dependence 72/1 (2003): pp. 59-65.
116. Correctional Service Canada, Research Report: Institutional Methadone Maintenance Treatment: Impact on Release Outcome and Institutional Behaviour (Ottawa: CSC Research Branch (No. R-119), 2002).
117. UNAIDS, Prisons and AIDS: UNAIDS Point of View (Geneva: UNAIDS, 1997): p. 7.
118. T. F. Brewer, "HIV in Prisons: The Pragmatic Approach," AIDS 5 (1991): p. 897.
119. International Guidelines on HIV/AIDS and Human Rights. UNCHR Res. 1997/ 33, UN Doc. E/CN.4/1997/150 (1997).
120. N. N. Dubler et al., "Management of HIV Infection in New York State Prisons," Columbia Human Rights Law Review 21 (1990): pp. 363-365.
121. D. Shewan, M. Gemmell, and J. B. Davies, "Drug Use and Scottish Prisons: Summary Report," Scottish Prison Service Occasional Paper 5 (1994): p. 24.
122. See, for example, Centers for Disease Control (see note 72), pp. iii-vii;
123. A. Wodak, "Prevention Works! Effectiveness of Prevention of HIV Spread among Injecting Drug Users," International AIDS Society Newsletter 5 (1996): pp. 12-13.
124. M. Lachat, "Account of a Pilot Project for HIV Prevention in the Hindelbank Penitentiaries for Women," Press conference (Berne: Information and Public Relations Bureau of the Canton, May 16, 1994).
125. The Body of Principles, Basic Principle, and SMR emphasize that prisoners are members of the community and that efforts should be made to maintain and foster community contacts. The rationale for this is that such prisoner-community contact fosters rehabilitation and reintegration. Under the SMR, "community agencies should be enlisted wherever possible to assist the staff of the institution" and "steps should be taken to safeguard, to the maximum extent compatible with the law and the sentence, the rights relating to civil interests, social security rights and other social benefits of prisoners" [SMR 61; 80]. The participation and help of social institutions in prisoner reintegration into society is recognized in article 10 of the Basic Principles. The Council of Europe Recommendation R 98(7) contains numerous provisions recommending cooperation and coordination with community and non-prison agencies [Council of Europe Recommendation R 98(7) 7].