Prisoners are more likely to have used drugs compared with the general population, and are exposed to various sources of higher risk like injecting, tattooing, unsafe sex. Many prisoners have complex health and social needs and assessment and treatment of drug related problems is important in prison. This highlights the role of the prison setting, in particular as a critical location for addressing problems for high-risk drug users. Significant considerable health and social gains can be won if a good prison care and support is linked with ensured continuation of service delivery.
Example of peer involvement in prison work. The FLEW project (Free to live well with HIV in prison) is the result of collaboration effort between several agencies in Italy. In 2016, 677 people in prison, 107 prison officers, 112 healthcare professionals, 70 educators and office staff, and 28 volunteers were given a questionnaire to assess their knowledge on HIV and HIV transmission. They were also asked to report on the level of stigma attached to HIV among people in prison, prison officers, educators and healthcare professionals.
Hepatitis B virus (HBV) and hepatitis C virus (HCV) are spread through contact with infected body fluids or blood products. These viruses can lead to acute and chronic hepatitis infection, varying from a mild illness to a serious, lifelong illness and death resulting in cirrhosis and predisposing to hepatocellular carcinoma (HCC). Most people with acute HBV or HCV infection do not have any symptoms. Those who develop chronic infection are often asymptomatic until decades after infection when symptoms can develop serious liver damage.
A vaccine is currently available only for HBV. Hepatitis B vaccination programmes are reported to exist in prisons in 16 countries in Europe.
Since active pulmonary TB is highly infectious, screening people at prison admission is advisable so that prevention and control measures (e.g. treatment, isolation) can be taken to avoid onward transmission.
When planning active case finding initiatives for TB in prison settings, it is recommend important to take into consideration the different epidemiological situation of TB across the EU/EEA* the characteristics of the prison population, and existing national/international guidelines and national legislation. Certain population groups, which tend to be overrepresented in prison settings, are at higher risk for TB and LTBI. These may include foreign-born people from high-burden countries, homeless people, and people with substance use disorders.
The "Training manual on HIV and HCV rapid testing in low-threshold settings for people who using drug (PWUD)" is a complete tool to provide staff in low-threshold settings the knowledge, skills and techniques needed for testing people who use drugs for HIV and HCV and linking them to needed care.
If the problem of TB is important in the your country, we recommend to use a TUBIDU Training Outline. It is available in Bulgarian, Estonian, Latvian, Lithuanian, Romanian, Russian and English languages.
Public health guidance on active case finding of communicable diseases in prison settings. EMCDDA Report 2018
Consolidated guidelines HIV prevention, diagnosis, treatment and care for key populations. WHO 2016 update.
Free and open e-learning course "HIV and HCV rapid testing in low-threshold settings for people who using drug (PWUD)" - the course was developed within the EU-funded programme, Joint Action on HIV, Viral Hepatitis and Tuberculosis among People Who Inject Drugs in Europe (HA-REACT).
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