Harm Reduction News: Fighting for Prison Health

What do we expect from our prisons? During the last 150 years, the concept of incarceration in many parts of the world has evolved from a penitentiary model—literally a place of penitence where the goal is social rehabilitation—to a penal model that explicitly focuses on punishment. Prisons and jails are used by the state as a means, directly or indirectly, of social control, whereby “undesirable” people, including drug users, sex workers, ethnic minorities, the poor, and mentally ill, are incarcerated at rates far exceeding their proportion of society.

The health and social consequences are staggering. With high rates of injection drug use, risky or coerced sex, and overcrowding, prisons are nearly perfect incubators of HIV, hepatitis C (HCV), and tuberculosis (TB). Violence and corruption in prisons aggravate an already dangerous environment. Major outbreaks of HIV and HCV have been recorded in prisons in many countries, from Russia to Brazil. Many people enter prisons already infected. As the United States National Commission on AIDS has stated: “By choosing mass imprisonment as he...government’s response to the use of drugs, we have created a de facto policy of incarcerating more and more individuals with HIV infection.” Women prisoners, who almost everywhere are locked up for petty drug offenses at a rate much higher than their male counterparts, are particularly vulnerable. In New York State, more than 20 percent of female prisoners are HIV positive, a rate nearly 2.5 times that of men.

The articles in this issue of Harm Reduction News explore the political, social, human rights, and medical problems of drug users in prison, and offer models of action in the fight to improve prisoners’ health.

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