Prison HCV Treatment Guidelines
The National Hepatitis C Prison Coalition website, www.hcvinprison.org, includes a collection of the Department of Corrections HCV Treatment Guidelines for 20 states, with more anticipated. The website also includes a listing of useful links for hepatitis C information and contact information for coalition members.

Women and HIV/AIDS in Prisons booklet
The National Minority AIDS Council is proud to announce that the Women and HIV/AIDS in Prisons booklet is completed and available today, per request. As a response to the increasing number of women prisoners affected by or infected with HIV/AIDS, NMAC has developed, and published, this informative booklet, which summarizes the impact of HIV/AIDS on women prisoners, as well as describe programs specifically designed to meet their needs. The mission of this booklet is to provide service providers, advocates, community-based organizations (CBOs) and prisoners, themselves, with the information necessary to establish effective and quality services for addressing HIV/AIDS among women prisoners.

Download a copy of Women and HIV/AIDS in Prison http://www.nmac.org/publications/treatpubs/pdf/Women_in_Prison.pdf or to acquire a hard copy of the Women and HIV/AIDS in Prison booklet, and/or any other NMAC publications, contact the Communications Division of NMAC by telephone at (202) 483-6622; or by e-mail publications@nmac.org .

Additional NMAC Prison Publications:

• Incarcerated Youth and HIV/AIDS
  (pre-order available)
• Mental Health and Substance Abuse among Prisoners Living with HIV/AIDS
• Hitting the Bricks: Working with Recently Released Former Prisoners Living with HIV/AIDS
• First Steps: Understanding the Culture of Corrections
• What You Need to Know about HIV and Hepatitis in Prisons
• Pushing for Progress
  (limited quantities available)
• Technical Assistance Publications
  
  

News

Following is news and information regarding incarcerated populations. Links to the Kaiser Daily HIV/AIDS Report summaries at the Kaisernetwork web site and briefly from the CDC HIV/STD/TB Prevention News Update. Note: Links to Kaisernetwork take you outside this site.

Michigan Ends Ban on HIV-Positive Inmates Serving Food
POZ  Newswire (8.23.10)
The Michigan Department of Corrections has officially stopped barring HIV-positive inmates from food service positions, The Michigan Messenger website reports. The policy for years was to deny these positions to HIV-positive inmates because of transmission fears, but the Michigan Department of Civil Rights (MDCR) officials said the policy was illegal. Then corrections officials argued to keep the ban for security reasons, which MDCR deemed legal. Nonetheless, corrections officials in 2009 pledged to revise the policy. Read the Messenger article
 

Routine Jail-Based HIV Testing --- Rhode Island, 2000--2007
The prevalence of human immunodeficiency virus (HIV) infection among incarcerated persons in the United States (1.5%) is approximately four times greater than the prevalence among persons in community settings (0.4%). In 2006, CDC recommended HIV testing in correctional facilities and elsewhere as part of routine medical evaluation. To determine the number and characteristics of persons with newly identified HIV infection and estimate the proportion of detainees who might not have been tested if testing had been delayed, the Rhode Island Department of Corrections (RIDOC) examined jail incarceration and HIV testing data from 2000--2007.

"Justice Department Urged to Finalize Standards to End Rape in US Prisons"
Washington Post , (06.24.2010) Jerry Markon  CDC NPIN Summary
The Justice Department missed its deadline Wednesday for finalizing national standards to end prison rape in the United States, prompting calls from activists and lawmakers for quicker action on the problem. The congressionally appointed National Prison Rape Elimination Commission issued the standards last year; by law, the Justice Department had until Wednesday to approve them. The guidelines recommend steps including regular audits to hold prisons accountable. “It is unacceptable for anyone in the care of our country’s correctional facilities to be sexually assaulted,” said Justice Department spokesperson Hannah August, who added that the department is “working diligently to implement these standards as soon as possible.”

 

"Undiagnosed HIV Infection Among New York City Jail Entrants, 2006: Results of a Blinded Serosurvey"
Journal of Acquired Immune Deficiency Syndromes Vol. 54; No. 1: P. 93-101, (05.01.2010) Elizabeth M. Begier, MD, MPH; Yussef Bennani, MPH; Lisa Forgione, MA; Amado Punsalang, PhD; David B. Hanna, MS; Jeffrey Herrera, BA; Lucia Torian, PhD; Maria Gbur, MD; Kent A. Sepkowitz, MD; Farah Parvez, MD, MPH   CDC NPIN Summary
Among New York City jail entrants, HIV testing has increased four-fold since 2004, when personnel began offering all inmates rapid testing at intake. To help improve services, the current study determined HIV prevalence among jail entrants, including the proportion undiagnosed.

In 2006, remnant serum from routine syphilis testing was salvaged for blinded HIV screening. Before permanently removing identifiers, the authors determined previously undiagnosed HIV infections by referring to HIV surveillance and electronic clinical data. “Undiagnosed” individuals were those who had not been reported to surveillance and denied HIV infection.

Among those entering jail, 68.9 percent (6,411) were tested, and total HIV prevalence was 5.2 percent (4.7 percent of males and 9.8 percent of females). Adjusting for those not in the serosurvey, total estimated prevalence was 8.7 percent (6.5 percent of males and 14 percent of females).

Of HIV infections identified in the serosurvey, 28.1 percent were undiagnosed at intake, of which only 11.5 percent were diagnosed through routine testing. Of those with undiagnosed infection, only 11.1 percent reported injection drug use or being men who have sex with men.

“About 5-9 percent of New York City jail entrants are HIV-infected,” the authors concluded. “Of the infected, 28 percent are undiagnosed; most of whom denied recognized HIV risk factors. To increase inmates’ acceptance of routine testing, we are working to eliminate the required separate written consent for HIV testing to allow implementation of the Centers for Disease Control and Prevention-recommended opt-out testing model.”
 

CALIFORNIA:
"Condoms in Jails: A Controversial Intervention"
KPBS.org (San Diego) , (04.19.2010) Kenny Goldberg  CDC NPIN Summary
San Francisco’s jail houses the only condom machine inside a detention facility in California, through a program started in 1989 in response to the HIV/AIDS epidemic. In 2001, Los Angeles County became the second county to provide a condom distribution program behind bars. Since then, no other county in the state has followed suit.

According to health officials, the HIV rate among incarcerated persons is almost seven times higher than among the general population. San Francisco Sheriff Michael Hennessey said he believes those charged with operating jails have an obligation to educate inmates about the disease, and distributing condoms is an effective way of doing so. However, the idea remains controversial.

Cpt. Dan Pena of the San Diego County Sheriff’s Department, who oversees seven jails and nearly 5,200 inmates, said his department has no plans to give inmates access to condoms. “Primarily the reason for that is sexually activity in jails or prisons is illegal; it’s actually a felony,” he said. “And because of that, we would not want to send a mixed message to the inmate population that knowing this is a crime, here’s a condom.”

Until there is evidence that condom distribution reduces HIV rates in jails, San Diego County will continue its approach of providing HIV education and strict supervision of inmates, said Pena.

San Francisco County officials say evaluation of their program has found it did not increase sexual activity; there were no reports of smuggling using condoms; and inmates reported less high-risk activity.
 

AUSTRALIA:
"Does Opioid Substitution Treatment in Prisons Reduce Injecting-Related HIV Risk Behaviors? A Systematic Review"
Addiction doi:10.1111/j.1360-0443.2009.02826.x, (02..2010) Sarah Larney  CDC NPIN Summary
The current study is a systematic review of the evidence of whether opioid substitution treatment (OST) in prison reduces injecting-related HIV risk behaviors. The review was conducted in accordance with the guidelines of the Cochrane Collaboration. The author is with the National Drug and Alcohol Research Center at the University of New South Wales in Sydney.

Electronic database searches were conducted to identify studies of prison-based OST programs that included assessment of the programs’ effect on injecting drug use, needle/syringe sharing and incidence of HIV. Risk ratios for outcomes of interest were calculated using published data. Due to the low number of studies and differences in study design, risk ratios were not pooled.

The review included five studies. The author noted that follow-up rates were poor in two studies, while in the remaining three the representativeness of the sample was uncertain. The results showed that compared to inmates in control conditions, treated inmates’ risk of injecting drug use was reduced by 55-75 percent, and the risk of needle/syringe sharing was reduced by 47-73 percent. No study reported a direct effect of prison OST on HIV incidence.

"There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required,” the author concluded. “OST should be implemented in prisons as part of comprehensive HIV prevention programs that also provide condoms and sterile injecting and tattooing equipment.”