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Dilemmas in the treatment of HIV and Hepatitis C in Canadian prisons

Dilemmas in the treatment of HIV and Hepatitis C in Canadian prisons. Prevalence. HIV 1.66% of all federal prisoners known HIV positive Provincial rates vary by province- 1.8-2.1% Seroprevalence levels 10 times higher than in the general population. Hepatitis C.

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Dilemmas in the treatment of HIV and Hepatitis C in Canadian prisons

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  1. Dilemmas in the treatment of HIV and Hepatitis C in Canadian prisons

  2. Prevalence • HIV • 1.66% of all federal prisoners known HIV positive • Provincial rates vary by province- 1.8-2.1% • Seroprevalence levels 10 times higher than in the general population.

  3. Hepatitis C • estimated 30% of federal inmates are infected with HCV • Cross provincial rates unknown but as high as 52% in some institutions • HCV prevalence increasing in prisons • Gender difference in infection rates • HCV transmitted much more easily than HIV

  4. Transmission in Prison • -Sharing needles • -Tattoos • -Sexual contact

  5. Prevention in Prison • -Condoms have been readily available since 1992 • -Bleach has been available since 1994 at Federal institutions. • -varied availability in provincial facilities • -Needle exchange programs • -Methadone

  6. Treatment in Prison • HIV- HAART • -many inmates miss doses • -receive incorrect dosing • -meds not reordered • -lock down • -stigma

  7. HCV • Decision to treat is complicated • Federal vs provincial • Acute vs Chronic • Stage of disease • Cost • Side Effects

  8. References • Betteridge, G. “Prisoners’ health and human rights in the HIV/AIDS epidemic” HIV/AIDS Policy and Law Review 9(3)(2004):96-99. Discussions in the legal responsibilities of prison systems. • Betteridge, G. and G. Dias. Hard Time: promoting HIV and Hepatitis C prevention Programming for Prisoners in Canada, Canadian HIV/AIDS Legal Network and PASAN, 2007. • Joint United Nations Programme on HIV/AIDS. HIV/AIDS in prisons- statement by the Joint United Nations Programme on HIV/AIDS to the United Nations Commission on Human Rights. • Webster, P. CMAJ June 12, 2012 vol. 184 no. 9 First published May 7, 2012, doi: 10.1503/cmaj.109-4191

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