PARIS -- Prison health officials from around the world met in private session in Geneva last month to confront "an issue a lot of people wished would go away," said the World Health Organization's Dr. Jonathan Mann. "It won't go away and it needs to be dealt with." The problem is the transmission of AIDS in prison.
After three days of meetings sponsored by WHO, representatives from 26 countries called on their governments to consider making condoms available to prisoners as part of an overall program of AIDS education and complete, compassionate medical care for those in jail. They also suggested that some lower-security prisons study the idea of providing inmates with sterile needles. It is difficult for prison officials to acknowledge that homosexual activity, which is illegal in many countries, and intravenous use of illegal drugs smuggled into inmates are taking place in their prisons.
Some European countries already provide condoms to prisoners to protect against transmission of AIDS. This is the policy of Spain, Sweden, Switzerland, the Netherlands, Austria and certain prisons in Italy. One U.S. state, Vermont, supplies condoms. No one provides needles.
Health officials worry that AIDS in prisoners may form a bridge into the general community. "People don't go into prison and stay there," said Dr. Don Grimes, Australian ambassador to The Hague and chairman of the meeting. "People go in and come out again -- in most countries in just a matter of months. If we are going to do anything about the epidemic outside, we have to do something about the epidemic inside."
French and British officials explain that they cannot give condoms to prisoners because under their laws homosexual acts in public places are illegal, and prisons are considered public places. Providing condoms, they say, would seem to condone or encourage criminal acts.
A survey of prisons in 17 European countries by the Council of Europe found an average AIDS infection rate among inmates of more than 10 percent. But figures varied dramatically from country to country and even from prison to prison. The Spanish prisons surveyed had an infection rate of almost 26 percent, while British prisons had less than 0.1 percent. Spain has an especially high rate of drug addicts in its prisons, which may account for the difference.
The officials meeting in Geneva emphasized that prison authorities are responsible for protecting inmates from AIDS. They said prisoners should be treated as other citizens with access to information about AIDS, testing on request, confidentiality of results and the same medical care.