376  documenti 

|Nel dispositivo penale |  Il raggio della questione | Prevenzione Trattamento |

Nel dispositivo penale


Global Burden of Disease Health Financing Collaborator Network
# Spending on health and HIV/AIDS: domestic health spending and development assistance in 188 countries, 1995–2015
www.thelancet.com/ April 17, 2018
Comparable estimates of health spending are crucial for the assessment of health systems and to optimally deploy health resources. The methods used to track health spending continue to evolve, but little is known about the distribution of spending across diseases. We developed improved estimates of health spending by source, including development assistance for health, and, for the first time, estimated HIV/AIDS spending on prevention and treatment and by source of funding, for 188 countries.


WHO World Health Organization
# Focus on HIV in prisons vital to end AIDS
www.who.int/ 13 December 2017
Globally, more than 11 million people were incarcerated in prisons in 2016. Over-represented among this population are the people most vulnerable to HIV, including people who use drugs, sex workers, men who have sex with men, transgender people, and others who are most marginalized in communities. Prisoners are disproportionately affected by HIV, tuberculosis, viral hepatitis and mental health issues. Despite this fact, comprehensive health services are rarely available within prisons...


# Global AIDS Monitoring 2018. Indicators for monitoring the 2016 United Nations Political Declaration on Ending AIDS
http://www.unaids.org/ 2017


Gabriel J. Culbert, Forrest W. Crawford, Astia Murni, Agung Waluyo, Alexander R. Bazazi, Junaiti Sahar, Frederick L. Altice
# Predictors of Mortality within Prison and after Release among Persons Living with HIV in Indonesia
Res Rep Trop Med. 2017 ; 8: 25–35

Mortality in HIV-infected prisoners is extremely high, despite ART availability in prisons. Unlike high-income countries where drug overdose is the most common preventable cause of death in released prisoners, most deaths among HIV-infected prisoners in Indonesia appear to be a direct consequence of HIV infection and mainly preventable through earlier ART initiation in all prisoners with HIV and prophylaxis for opportunistic infection. Narcotic prisons, where many "people who inject drugs" PWID are concentrated, may be especially high-risk environments for mortality, potentially due to overcrowding and related environmental stressors, although further research is needed to elucidate the pathways through which structural factors influence HIV-related mortality in these settings.


Alessandro Battistella, Fabio Perocco
# L’Hiv in carcere. Risultati di una ricerca-intervento in dieci carceri italiane
Prospettive Sociali e Sanitarie n. 4/2017
La ricerca ha evidenziato come oggi l’Hiv in carcere sia vissuto con minore apprensione di un tempo; questo probabilmente avviene per la minore pressione mediatica sui pericoli dell’infezione, oggi ben curabile con le terapie antiretrovirali disponibili. La minor paura, tuttavia, non deriva da una maggiore conoscenza di come si può contrastare la malattia, né da maggiori conoscenze sulla sostanziale innocuità del virus nella convivenza quotidiana, che invece genera ancora timori per ragioni del tutto errate.


Damiano Aliprandi
# Anche i detenuti nel Piano nazionale per prevenire Aids e Hiv
Il Dubbio, 1 aprile 2017
Si stima che possano essere circa 5.000 i reclusi sieropositivi. All'interno degli Istituti vivono una condizione difficilissima, le terapie in molti casi vengono interrotte a causa dei trasferimenti e molti non sanno di essere ammalati. Il nuovo piano nazionale di interventi contro l'Hiv e l'Aids, redatto dal ministero della Salute e inviato alla conferenza Stato- Regioni, si interessa anche dei detenuti. Un piano molto articolato che parte dalla constatazione del rischio del "sommerso" e della necessità di riparlare della malattia e di come evitarla con comportamenti consapevoli...


Ministero della Salute
# Piano Nazionale di Interventi contro HIV e AIDS (PNAIDS)
Allegato al parere del Consiglio Superiore di Sanità del 7 dicembre 2016 | Ministero della Salute - Nota del 15 marzo 2017

Non sono stati condotti in Italia studi relativi all’incidenza di nuove infezioni e non è quindi noto il tasso annuo di siero-conversione ad anti-HIV in carcere, pur essendo stati riportati singoli casi di siero-conversione durante detenzioni ininterrotte. Ugualmente, è noto come pratiche “a rischio” per la trasmissione del virus HIV quali rapporti sessuali non protetti, utilizzo di aghi usati e tatuaggi siano tuttora comuni all’interno delle prigioni. E’ necessario disporre di dati epidemiologici ufficiali e certi in base ai quali individuare le criticità sanitarie intramoenia ed allocare gli opportuni interventi.


Frederick L Altice, Lyuba Azbel, Jack Stone, Ellen Brooks-Pollock, Pavlo Smyrnov, Sergii Dvoriak, Faye S Taxman, Nabila El-Bassel, Natasha K Martin, Robert Booth, Heino Stöver, Kate Dolan, Peter Vickerman
# The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and
tuberculosis in Eastern Europe and Central Asia

www.ncbi.nlm.nih.gov/ Lancet, 2016 September 17
Despite global reductions in HIV incidence and mortality, the 15 UNAIDS-designated countries of Eastern Europe and Central Asia (EECA) that gained independence from the Soviet Union in 1991 constitute the only region where both continue to rise. HIV transmission in EECA is fuelled primarily by injection of opioids, with harsh criminalisation of drug use that has resulted in extraordinarily high levels of incarceration. Consequently, people who inject drugs, including  those with HIV, hepatitis C virus, and tuberculosis, are concentrated within prisons.


Kate Dolan, Andrea L Wirtz, Babak Moazen, Martial Ndeffo-mbah, Alison Galvani, Stuart A Kinner, Ryan Courtney, Martin McKee, Joseph J Amon, Lisa Maher, Margaret Hellard, Chris Beyrer, Fredrick L Altice
# Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees
www.thelancet.com/ July 14, 2016
The prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV, viral hepatitis, and tuberculosis. We did a comprehensive literature search of data published between 2005 and 2015 to understand the global epidemiology of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and tuberculosis in prisoners. We further modelled the contribution of imprisonment and the potential impact of prevention interventions on HIV transmission in this population...


Adeeba Kamarulzaman, Stewart E Reid, Amee Schwitters, Lucas Wiessing,Nabila El-Bassel, Kate Dolan, Babak Moazen, Andrea L Wirtz, Annette Verster, Frederick L Altice
# Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners
http://www.thelancet.com/ July 14, 2016
Prisoners worldwide have substantially increased prevalence of HIV, viral hepatitis (hepatitis B virus [HBV] and hepatitis C virus [HCV]), and tuberculosis disease relative to the general population. A complex interplay of individual, social, and environmental factors before, during, and after incarceration results in an increased risk of these infections and diseases in prisoners. Particular risk behaviours by key populations include people who inject drugs (PWID), sex workers, men who have sex with men, and transgender people, placing them at an increased risk of these four infections in the community. Laws that criminalise behaviours such as those involving drug use and unprotected sex, concentrate these key populations who might already be living with HIV, HBV, and HCV infection, or tuberculosis disease in prisons...


International Lesbian, Gay, Bisexual, Trans and Intersex Association
# State Sponsored Homophobia 2016: A world survey of sexual orientation laws: criminalisation, protection and recognition
http://ilga.org/ Geneva; ILGA, May 2016


Pamela Das, Richard Horton
# On both sides of the prison walls—prisoners and HIV
www.thelancet.com/ July 14, 2016
Globally, about 10·2 million men, women, and children are in prisons, detention, or some form of government custody at any given time. Annually, an estimated 30 million people pass through some form of detention. This Series describes the unique and complex nature of an HIV epidemic in an understudied and underserved population. No other general medical journal has published such an extensive and in-depth global report on HIV in prisoners.


Kate Dolan, Babak Moazen, Atefeh Noori, Shadi Rahimzadeh, Farshad Farzadfar, Fabienne Hariga
# People who inject drugs in prison: HIV prevalence, transmission and prevention
International Journal of Drug Policy, 26, 2015
The spread of HIV in prison has substantial public health implications as virtually all prisoners return to the community. HIV prevention and treatment strategies known to be effective in community settings, such as methadone maintenance treatment, needle and syringe programs, condoms and antiretroviral therapy should be provided to prisoners as a matter of urgency.


Kate Dolan, Andrea L Wirtz, Babak Moazen, Martial Ndeff o-mbah, Alison Galvani, Stuart A Kinner, Ryan Courtney, Martin McKee, Joseph J Amon, Lisa Maher, Margaret Hellard, Chris Beyrer, Fredrick L Altice
# Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees
www.thelancet.com/ 388: 1089–102, 2016
Of the estimated 10·2 million people incarcerated worldwide on any given day in 2014, we estimated that 3·8% have HIV (389 000 living with HIV), 15·1% have HCV (1 546 500), 4·8% have chronic HBV (491 500), and 2·8% have active tuberculosis (286 000). The few studies on incidence suggest that intraprison transmission is generally low, except for large-scale outbreaks. Our model indicates that decreasing the incarceration rate in people who inject drugs and providing opioid agonist therapy could reduce the burden of HIV in this population. The prevalence of HIV, HCV, HBV, and tuberculosis is higher in prison populations than in the general population, mainly because of the criminalisation of drug use and the detention of people who use drugs. The most eff ective way of controlling these infections in prisoners and the broader community is to reduce the incarceration of people who inject drugs.


World Health Organization
# WHO: People most at risk of HIV are not getting the health services they need
www.who.int/ Geneva 11 July 2014
Failure to provide adequate HIV services for key groups – men who have sex with men, people in prison, people who inject drugs, sex workers and transgender people – threatens global progress on the HIV response, warns WHO.


World Health Organization
# HIV Prevention, Diagnosis, Treatment and Care for Key Populations
http://apps.who.int/ July 2014
The updated evidence reviews for the HIV recommendations for people in prisons and other closed settings reinforced the existing recommendations... There are more than 10 million men and women in prisons and other closed settings, with an annual turnover of around 30 million moving between prison and the community. Globally, the prevalence of HIV, sexually transmitted infections, hepatitis B and C and tuberculosis in prison populations is estimated to be twice to ten times higher than in the general population. Higher HIV prevalence and HIV risk are seen among both prisoners and those working in prisons and their families in many settings...


Lyuba Azbel
# Russia's HIV Epidemic Starts in Its Prisons
www.themoscowtimes.com/ Jul. 14 2014
Police and courts typically treat opioid dependence as a crime rather than a chronic relapsing condition. It is no surprise, then, that many substance users pass through the prison system at some point in their lives. But with basic preventative measures lacking both inside and outside the criminal justice system, a high-risk injection environment is created, further propagating disease. Nor is it a problem isolated to prisons. With one of the highest incarceration rates in the world (470 per 100,000 population), Russia's estimated 300,000 former prisoners released into the community each year pose a serious risk to public health.


Dan Werb
# Estimating the number of potential HIV and HCV cases averted through the introduction of federal prison-based needle exchange programs in Canada
Presented at AIDS 2014 - Melbrourne, Australia

Injection drug use in Canadian federal prisons remains a major source of HIV and hepatitis C virus (HCV) transmission. Evidence suggests that prison-based needle and syringe programs (PNSPs) are highly effective at reducing the use of nonsterile injection equipment among incarcerated people who inject drugs (PWIDs). However, PNSPs in Canadian prisons have not yet been implemented. We sought to estimate the number of HIV and HCV cases potentially averted through the implementation of PNSPs.


Lyuba Azbel, Jeffrey A Wickersham, Yevgeny Grishaev, Sergey Dvoryak, Frederick L Altice
# Correlates of HIV infection and being unaware of HIV status among soon-to-be-released Ukrainian prisoners
Journal of the International AIDS Society 2014
Looking to the future for soon-to-be-released prisoners, the time immediately after release from prison is associated with numerous adverse health consequences, including overdose and death. Effective transitional care during this period is crucial since former prisoners return to unstable environments that trigger substance use relapse and increase drug-related death...


Suzanne Blogg, Budi Utomo, Nurlan Silitonga, Diah Ayu N. Hidayati, Gray Sattler
# Indonesian National Inmate Bio-Behavioral Survey for HIV and Syphilis Prevalence and Risk Behaviors in Prisons and Detention Centers, 2010
SAGE Open January-March 2014: 1–7
This study aimed to measure HIV and syphilis prevalence and risk behaviors among inmates in Indonesia. An integrated HIV and syphilis biological and behavior survey was conducted on random samples of 900 male and 402 female inmates in 2010...HIV prevalence was 1.1% among male and 6.0% among female inmates. Syphilis prevalence was 5.1% for male and 8.5% for female inmates.


Mohammad Javad Zahedi, Sodaif Darvish Moghaddam, Mehdi Hayatbakhsh Abasi, Maryam Parnian, Mostafa Shokoohi
# Hepatitis B, C virus co-infection and behavioral risks in HIV-positive patients in southern Iran
http://jpma.org.pk/ Journal of Pakistan Medical Association, Vol. 64, No. 2, February 2014
Out of the 165 patients, 136 (82.4%) were male and 29 (17.6%) were female. The mean age of the subjects was 40.4±9 years. Positive hepatitis C antibody was found in 122 (73.9%) and positive hepatitis B surface antigen was present in 6 (3.6%). Frequency of all three viruses co-infection was 3 (1.8%). History of imprisonment (OR= 17.5; 95% CI: 7.1-43.1) and drug injection addiction (OR= 15.3; 95% CI: 6.4-36.1) were the most significant risk factors involved in hepatitis C virus co-infection. Conclusion: Seroprevalence of hepatitis C virus and human immunodeficiency virus co-infection was high and it was strongly related to history of imprisonment and drug injection addiction.


Osservatorio europeo delle droghe e delle tossicodipendenze (EMCDDA)
# Relazione europea sulla droga. Tendenze e sviluppi
www.emcdda.europa.eu/ 2013
L’assunzione di stupefacenti per via parenterale continua a essere un importante meccanismo di trasmissione delle malattie infettive, tra cui l’HIV/AIDS e l’epatite C. Secondo i dati più recenti nel lungo periodo il calo delle nuove diagnosi di HIV registrato in Europa potrebbe interrompersi in seguito alle epidemie scoppiate tra i consumatori di sostanze stupefacenti per via parenterale in Grecia e in Romania (Grafico 2.10). Nel 2011, il tasso medio delle nuove diagnosi di HIV segnalate e attribuite all’assunzione di stupefacenti per via parenterale è stato pari a 3,03 per milione di abitanti. Benché queste cifre siano soggette a revisione, nel 2011 sono stati segnalati 1 507 nuovi casi, con un leggero aumento rispetto al 2010, alterando la tendenza generale al ribasso osservata a partire dal 2004.


World Health Organization WHO - Regional Office for Europe

# HIV in prisons

WHO 2013

Prisons are extremely high-risk environments for transmission of HIV, due to overcrowding, poor nutrition, limited access to health care, continued drug use, unsafe injecting practices, unprotected sex and tattooing. In addition, man inmates come from marginalized populations – such as injecting drug users (IDU) – and already experience an elevated risk of HIV. HIV/AIDS is a serious problem for prison populations across Europe and central Asia...


Päivi Viitanen
# The Health, Work Ability and Healthcare Needs of Finnish Female Prisoners
University of Tampere, 2013
In Finland, the health of female offenders has never before appropriately researched. Prison studies elsewhere show that female prisoners often have more health problems than male prisoners. Especially mental disorders, infectious diseases and illicit drug use are common among female inmates. The majority of prisoners are men and most prison studies have not taken gender differences into account. The aims of the present dissertation were as follows: to find out the prevalence of hepatitis and HIV infections and their risk factors among Finnish female prisoners...


Correctional Association of New York
# Correctional Association of NY 2013 Summary of HIV and Hepatitis C Care in NYS Prisons
www.correctionalassociation.org/ October 2013
At some prisons, patients infected with HIV and/or HCV are closely monitored, are receiving timely and appropriate care, and seem to have few complaints about the care they are receiving. In contrast, at other facilities, there is less access to care due to understaffing, patients have much more limited access to specialty care and other services, and patients express significant dissatisfaction with the quality of care they are receiving.


Correctional Association of New York

# Appendix R - Medical Care in DOCCS Prisons Visited by The Correctional Association from 2010-2012

www.correctionalassociation.org/ September 2013

The Prison Visiting Project (PVP) of the Correctional Association of New York (CA) conducted monitoring visits to each of these prisons between 2010 and 2012.In carrying out the CA’s mandate for men’s prisons, PVP conducts monitoring visits to six to ten prisons a year, branching out to all corners of the prison including cellblocks and dormitories, academic classrooms and  vocational shops, mental health and medical areas, and isolated confinement units. PVP interviews incarcerated persons, correction officers, teachers, counselors, and medical staff, obtain data from the facility and DOCCS, and receive surveys from incarcerated persons.


Agnes Binagwaho | Health and Human Rights
# Access to HIV prevention in Rwandan prisons
www.hhrjournal.org/ August 29, 2013
HIV is considered to be a generalized public health issue when you have higher than a 1% prevalence among the population.10 Rwanda has a prevalence of 3%.11 As of 2012, none of the 16 prisons in Rwanda had condoms available for prisoners based on the rule stating that no prisoners may have privacy (and therefore, ability to engage in sexual activity) during visitation. Prisoners are, however, finding ways to engage sexually during their terms—either in prisons, at worksites, or while traveling between locations.


# HIV prevention, treatment and care in prisons and other closed settings: a comprehensive package of interventions
http://www.unodc.org/ June 2013
Globally, the prevalence of HIV, sexually transmitted infections, hepatitis B and C and tuberculosis in prison populations is 2 to 10 times as high, and in some cases may be up to 50 times as high, as in the general population. HIV rates are particularly high among women in detention. Risks affect prisoners, those working in prisons, their families and the entire community. For these reasons, it is essential to provide HIV  interventions in these settings, both for prisoners and for those employed by prison authorities.


Alessandra Cerioli
# La Riduzione del Danno in Carcere - Lo stato dell’Arte nel Mondo
www.lila.it/ 15 giugno 2013
Relazione presentata a Nocera Terinese in occasione della Formazione Nazionale LILA "Riduzione del Danno alle Sbarre", dedicata alle iniziative di Harm Reduction in Carcere.


Federal Bureau of Prisons
# Management of HIV | Clinical Practice Guidelines
http://www.bop.gov/ June 2013
• Voluntary testing is done when the inmate requests testing via an Inmate Request to Staff Member (BP-S148) form, which will be turned into Health Services.  • Mandatory testing is performed when there are indications/risk factors and the test is  clinically indicated and/or surveillance testing is required. Inmates must participate in  mandatory HIV testing programs.  • Involuntary testing is performed following an exposure incident. Written consent of  the inmate is not required. If an inmate refuses testing, testing will be conducted in  accordance with the Program Statement on Use of Force.


Joanna Imad
# Lebanese prisons: changing a "pro-harm" environment through harm reduction
www.ihra.net/ Association Justice and Mercy AJEM June – 2013


National AIDS Trust
# Commission on Sex in Prison - Memorandum from NAT
www.nat.org.uk/ June 2013
1. Attempts to control consensual sexual activity between prisoners risk undermining efforts to promote HIV prevention and improved sexual health in prison populations. 2. Prisons in England and Wales should re-commit to providing safer sex advice, condoms and lubricants to all prisoners in as accessible a manner as possible, as well as access to Post Exposure Prophylaxis where needed...


European Centre for Disease Prevention and Control (ECDC)
# Thematic report: Leadership and resources in the HIV response. Monitoring implementation of the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia: 2012 progress
Stockholm, May 2013
Opioid substitution treatment in prison settings. Although OST is available in at least some prisons in almost all (84%) EU/EFTA countries, it is much less widely  available in countries outside the EU/EFTA (see Figure 3). Only 10 (42%) of these countries have reported providing this service. Opioid substitution therapy is not available in Azerbaijan, Georgia, Kazakhstan, Tajikistan, Turkmenistan, Ukraine or Uzbekistan. No report on the situation in the Russia has been received. It is also reported that substitution therapy is not available in prisons in Montenegro or Turkey.


Corriere della Sera

# Allarme Hiv ed epatite nelle carceri. Uno su tre non sa di essere malato.

14 maggio 2013

La positività per il test di epatite C è del 28% dei detenuti, per l’epatite B del 7%, e il 3,5% per l’Hiv. Nelle carceri italiane due persone su tre sono malate e una persona su tre non è consapevole del proprio stato di salute.


Roy Kilpatrick
# Defusing Scotland's HIV prison timebomb
www.heraldscotland.com/ Friday 8 March 2013

The majority (64%) of people entering prison have used drugs in the previous 12 months, and many (39%) worry that drug use will be problematic on their release. Based on all of the evidence, policy and the real risk of exposure and infection, Scottish prisons must introduce needle exchange schemes to complete its strong harm-reduction approach. It is long overdue, two decades after the notorious Glenochil outbreak.


Department of Health and Social Services, State of Alaska
# Alaska HIV Prevention Plan 2013-2016
www.epi.hss.state.ak.us/ March 2013
According the Alaska Behavioral Risk Factor Survey (BRFSS), in 2011, 46.7% of Alaskan adults aged 18-64 reported ever having had an HIV test. Since 1993, Alaska has had a consistently  higher prevalence of having an HIV test than the national median. In 2009, 50% of Alaska  adults age 18 to 64 years reported ever having an HIV test, compared to 39% of U.S. adults... HIV testing in non-healthcare settings is conducted at venues reaching high-risk negative individuals such as  gay bars, syringe exchange program, correctional facilities, and substance abuse and mental health programs. Condoms are distributed as a component of all funded activities. Condom distribution was established at sites targeting HIV positive and high-risk negative individuals.


113Th Congress - 1st session H. R. 895
# To provide for an effective HIV/AIDS program in Federal prisons.
This Act may be cited as the ‘‘Stop AIDS in Prison 5 Act of 2013’’
In the House of Representatives - February 28, 2013

The Bureau of Prisons shall develop a comprehensive policy to provide HIV testing, treatment, and prevention for inmates within the correctional setting and upon reentry. The purposes of this policy shall be as follows: (1) To stop the spread of HIV/AIDS among inmates. (2) To protect prison guards and other personnel from HIV/AIDS infection. (3) To provide comprehensive medical treatment to inmates who are living with HIV/AIDS. (4) To promote HIV/AIDS awareness and prevention among inmates. (5) To encourage inmates to take personal responsibility for their health. 6) To reduce the risk that inmates will transmit HIV/AIDS to other persons in the community  following their release from prison.


Ryan P. Westergaard, Anne C. Spaulding, Timothy P. Flanigan
# HIV among persons incarcerated in the US: a review of evolving concepts in testing, treatment and linkage to community care
Curr Opin Infect Dis. 2013 February ; 26(1): 10–16
t is clear that pre-trial detention in jails presents unique challenges to HIV testing and treatment when compared to the relatively stable and predictable environments in state and federal prisons. Jails are characterized by rapid turnover, having a median length of stay of only 2–5 days. Caring for acute medical and mental health conditions may be prioritized over screening for infectious diseases and other preventive health care...


A. I. Olugbenga-Bello, O. A. Adeoye, and K. G. Osagbemi | Hindawi Publishing Corporation
# Assessment of the Reproductive Health Status of Adult Prison Inmates in Osun State, Nigeria
International Journal of Reproductive Medicine - Volume 2013

All over the world, numbers of prisoners have being increasing with majority in the sexually active age group; hence diseases such as HIV, Tuberculosis and Hepatitis are more prevalent in prisons than in the community. This study thus aims to provide an overview of the reproductive health status of adult prison inmates in Osun State. Methodology. This is a cross-sectional study among adult inmates in Osun State prison. Data was obtained from 209 selected respondents using pre-tested semi structured questionnaire. Result. Majority of the respondents were in the age group 20–39 years with mean age of 30.9 + 7.5. 73.2% are aware of STIs, 93.3% HIV/AIDS and 81.3% contraception. 54.6% had multiple sexual partners before incarceration and 23.3% of them used condom always. 89.5% were not involved in any sexual practice inside the prison, 9.1% masturbated and 1.4% had homosexual partners. Less than 6% had access to male condoms gotten from prison staffs and prison clinics. Conclusion and recommendation. No comprehensive reproductive health care system to address reproductive health services in prisons. Respondents’ knowledge about STIs, HIV/AIDS and contraception is good, but their condom usage is low compared with the knowledge. Government should put in place specific reproductive health programmes in prisons.


O. Audu, S. J. Ogboi, A.U. Abdullahi, K. Sabitu, E. R. Abah and O. P. Enokela
# Sexual Risk Behaviour and Knowledge of HIV/AIDS among Male Prison Inmates in Kaduna State, North Western Nigeria
International Journal of TROPICAL DISEASE & Health 3(1): 57-67, 2013
SCIENCEDOMAIN international - www.sciencedomain.org

Despite high level of awareness of HIV/AIDS among inmates, there are still misconceptions. Homosexual practices associated with HIV/AIDS transmission is practiced among the male inmates; however, the use of condom which is one of the evidence based strategies for the prevention of sexual transmission of HIV/AIDS is met with a high degree of resistance by inmates. Therefore, there is need for implementation of HIV/AIDS interpersonal communication and counseling programmes for the inmates in Nigeria prisons.


Daneshmand Dana,  Nokhodian Zary, Adibi Peyman, Ataei Behrooz
# Risk Prison and Hepatitis B Virus Infection among Inmates with
History of Drug Injection in Isfahan, Iran

The Scientific World Journal Volume 2013

Hepatitis B virus (HBV) is a health problem among injection drug users (IDUs) in prison. The aim of this study is to evaluate the association of factors of incarceration with HBV infection in prisoners with history of drug injection in Isfahan, Iran... Intravenous drug users (IDUs) are at high risk for infection with several blood-borne pathogens such as HBV, hepatitis C virus (HCV), and human immunodeficiency virus (HIV). IDUs often have coinfections of at least two of these diseases.


Christopher Petrella

# HIV-Positive Inmates Too Expensive for Private Prison Operators?

www.counterpunch.org - February 19, 2013

Though prison officials are obligated under the Eighth Amendment to provide prisoners with adequate medical care irrespective of cost, Corrections Corporation of America’s latest contract with the State of California explicitly exempts the company from paying for “all HIV or AIDS related inpatient and outpatient medical costs and the costs of providing AZT or other medications therapeutically indicated and medically necessary for the treatment of offenders with HIV or AIDS.” Similar language, in fact, appears in a recent contract between CCA and the state of Vermont: “the contractor shall not be responsible for inpatient hospitalization costs, including any surgery and specialty services, associated with the treatment of persons with known AIDS, as defined by the Center for Disease Control…”.
Such an exemption—one produced through the collusion of private prison firms and state departments of corrections—is both ethically and economically disgraceful. How efficient is a privatized system of corrections that willfully omits inmates for whom medical care—especially treatments associated with HIV/AIDS—will be most costly?



# Reparto G14 di Rebibbia per malati di HIV

7marzo 2013

Attualmente nel G 14 ci sono 22 persone, tutte malate di HIV. L’età media è fra i 45 e i 50 anni. Oltre all’HIV, i presenti hanno patologie psichiatriche, l’epatite, cardiopatie e dermatiti. Buona parte dei detenuti è di difficile gestione - negli ultimi 10 giorni si sono registrati tre casi di autolesionismo - sei sono casi psichiatrici conclamati. In tre sono in sciopero della fame e rifiutano i farmaci per motivi di giustizia (attesa liberazione anticipata, permessi premio, ricoveri in ospedale). «Molti - ha detto il Garante - sono, per le loro condizioni, incompatibili con il carcere. Il fisico di ognuno è segnato dalle malattie e dalle dipendenze. Ma a costringerli in una cella sono le posizioni giuridiche, le misure alternative revocate, i cumuli di pena, i nuovi reati o, più semplicemente, il fatto di non avere una dimora. Il vissuto determina l’assenza delle famiglie e i problemi economici, con molti detenuti che dipendono dai nostri operatori, dai volontari anche per le più piccole necessità».


Roberto Monarca, Società Italiana di Medicina e Sanità Penitenziaria
# Hiv in Carcere. Dobbiamo ridurre i rischi
Anlaids ByMail n. 47 - febbraio 2013

I dati epidemiologici di cui disponiamo sono parziali. Dal 2008, infatti, con il passaggio delle competenze relative alla sanità in carcere dal Ministero di Grazia e Giustizia a quello della Salute, non viene più effettuata una raccolta univoca di dati nazionali. I dati recenti sono ricavati dal progetto La salute non conosce confini, condotto dalla Simit e dalla Simspe in collaborazione con Nps e con un grant di Gilead sciences in 18 istituti nazionali; secondo i dati preliminari relativi a 9 istituti, sono stati eseguiti 2991 test Hiv, con una percentuale di accettazione del test del 56%, e di questi il 5,6% è risultato positivo.


Ginny Shubert for the National Minority AIDS Council and Housing Works.

# Mass Incarceration, Housing Instability and HIV/AIDS: Research Findings and Policy Recommendations - a report on the effects of incarceration and HIV/AIDS on marginalized communities.
National Minority AIDS Council and Housing Works, with support from the Ford Foundation
- January 2013

Criminal justice involvement, HIV infection and housing instability are strongly linked risk factors that disproportionally impact minority and lowincome Americans and have a cumulative and compounding affect on HIV vulnerability and health outcomes for affected individuals, their families and their communities... The need to achieve better health outcomes for HIV-infected persons involved with the correctional system is an urgent individual and public health priority. Alternative approaches to criminal justice and incarceration would likely result in profound public health benefits. The focus of this paper is on the more proximate issue of housing status for persons reentering the community from prison and jail – a factor that is shown to be amenable to intervention with a significant impact on HIV health outcomes. Housing assistance is an evidencebased HIV prevention and care strategy to mitigate the disadvantage associated with HIV/AIDS and criminal justice involvement, and by doing so to reduce the impact of poverty, unemployment, intergenerational deprivation, mental illness, harmful substance use and other infectious diseases such as TB.


Tony Butler, Juliet Richters, Lorraine Yap, Basil Donovan
# Condoms for prisoners: no evidence that they increase sex in prison, but they increase safe sex
Sex Transm Infect  2013

Two thousand and eighteen male prisoners participated. The proportion of prisoners reporting anal sex in prison was equally low in NSW (3.3%) and Queensland (3.6%; p=0.8). A much higher proportion of prisoners who engaged in anal sex in NSW (56.8%) than Queensland (3.1%; p<0.0001) reported they had used a condom if they had had anal sex in prison. Sexual coercion was equally rare in both prison systems...


C. E. Albizu-García et al.
# Assessing Need for Medication-Assisted Treatment for Opiate-Dependent Prison Inmates
Substance Abuse, 33:60–69, 2012
Individuals with a history of heroin dependence are overrepresented in American correctional facilities and 75% of inmates with a drug use disorder do not receive treatment during incarceration or after release. Medication-assisted treatment (MAT) with opiate agonists, such as methadone or buprenorphine, constitutes standard of care; to guide planning for an expansion of drug treatment services in correctional facilities, a needs assessment was conducted at the Department of Correction and Rehabilitation (DCR) of Puerto Rico (PR). The authors report on the research process, the findings that informed their recommendations for the DCR to expand MAT for eligible inmates, and lessons learned...

HCV prevalence was reported by 23% of males and 17% of females, and HIV incidence was reported by 2% of males and 7% of females. Almost all respondents used an illegal drug the year prior to the current incarceration (99% of males and females), and nearly three quarters had used opiates in their lifetime (males 79%, females 75%). Injection drug use in prison was reported by 38% of males and 12% of females. A drug overdose was ever experienced by 24% of males and 33% of females. Use of any illegal drug in prison was reported by 63% of males and 47% of females. In response to the treatment readiness scale, 27% of males and 34% of females scored high on readiness


UNODC United Nations Office on Drugs and Crime

#  HIV prevention, treatment and care in prisons and other closed settings: a comprehensive package of interventions

Printed in Austria — July 2012

Each year over 30 million men and women spend time in prisons and other closed settings,* of whom over one third are pretrial detainees. Virtually all of them will return to their communities, many within a few months to a year. Globally, the prevalence of HIV, sexually transmitted infections, hepatitis B and C and tuberculosis in prison populations is 2 to 10 times as high, and in exceptional cases may be up to 50 times as high as in the general population. HIV rates are particularly high among women in detention. Risks affect prisoners, those working in prisons, their families and the entire community. For these reasons, it is essential to provide HIV interventions in these settings, both for prisoners and for those employed by prison authorities.

Prison health is part of public health - The vast majority of people in prisons eventually return to their communities. Any diseases contracted in closed settings, or made worse by poor conditions of confinement, become matters of public health. HIV, hepatitis and tuberculosis and all other aspects of physical and mental health in prisons should be the concern of health professionals on both sides of the prison walls. It is pivotal to foster and strengthen collaboration, coordination and integration among all stakeholders, including ministries of health and other ministries with responsibilities in prisons, as well as community-based service providers.


Jon Cohen

# HIV and the Cell: The Prisoner’s Dilemma

Science 13 JULY 2012 VOL 337

The United States incarcerates roughly 10 million prisoners each year—the most in the world—and people behind bars disproportionately come from the highest risk groups for HIV infection: injecting drug users, heterosexuals who have concurrent relationships, the impoverished, the homeless, and African Americans and Latinos. Some 150,000 HIV-infected people are released from jails and prisons each year. That’s 12.5% of all the infected people in the country


Sheryl L. Catz, Laura Thibodeau, June BlueSpruce, Samantha S. Yard, David W. Seal, K. Rivet Amico, Laura M. Bogart, Christine Mahoney, Benjamin H. K. Balderson, James M. Sosman
# Prevention Needs of HIV-Positive Men and Women Awaiting Release from Prison
AIDS Behav. 2012 January ; 16(1): 108–120
Correctional facilities have been identified by the Center for Disease Control and Prevention (CDC) as key settings for improving HIV prevention efforts because HIV affects a disproportionate number of incarcerated persons. Prevalence estimates indicate that 14% of all HIV-infected persons in the U.S. may be released from a prison or jail in a 1-year period, and AIDS case rates are 3–5 times higher in the U.S. prison population than in the general population. Two-thirds of HIV- positive incarcerated persons are diagnosed and begin treatment for the first time during incarceration, and many return to the community within 2 years. Periods of incarceration and community re-entry can provide a window of opportunity for reducing HIV transmission risk behaviors. Post-release is a time of high risk behavior for many formerly incarcerated people, including those who are HIV-positive...


European Monitoring Centrefor Drugs and Drug Addiction | European Centre for Disease Prevention and Control

# Joint EMCDDA and ECDC rapid risk assessment. HIV in injecting drug users in the EU/EEA, following a reported increase of cases in Greece and Romania
emcdda.europa.eu | ecdc.europa.eu | 2012
Greece collects prevalence data on HIV, hepatitis B and C infection among IDUs from three separate sentinel surveillance systems in treatment facilities screening clients upon entry. For the last decade, HIV prevalence in the sentinel surveillance system for IDUs has remained below 2%, a low level compared to other western European Member States. However, in 2011, all data sources detected a steep increase, reaching 3% to 5% by the end of July 2011


# HIV in Correctional Settings
June 2012

Inmates in jails1 and prisons2 across the United States (US) are disproportionately  affected by multiple health problems, including HIV, other sexually transmitted infections (STIs), tuberculosis (TB), and viral hepatitis. Each year, an estimated 1 in 7 persons living with HIV pass through a correctional facility. Most of them acquired HIV in the community, not while they were incarcerated. Compared with those who have not been incarcerated, incarcerated populations have more risk factors that are associated with acquiring and transmitting HIV, including injection drug and other drug use, commercial sex work, untreated mental illness, and lower socioeconomic status. The Numbers: More than 2 million people are incarcerated in the US. At the end of 2010, 1,612,395 persons were in state and federal prisons. At midyear 2010, 748,728 persons were in local jails. Men and women of color—particularly black men and women—are disproportionately represented in the US correctional system. •• In 2010, black males had an imprisonment rate that was nearly 7 times that of white males and almost 2.5 times that of Hispanic/Latino males. •• That same year, black females had an imprisonment rate that was nearly 3 times that of white females and almost 2 times that of Hispanic/Latino females.


Global Comission on Drug Policy
# The War on Drugs and HIV/AIDS. How the Criminalization of Drug Use Fuels the Global Pandemic
www.countthecosts.org/ June 2012
The global war on drugs is driving the HIV/AIDS pandemic among people who use drugs and their sexual partners. Today, there are an estimated 33 million people worldwide living with the human immunodeficiency virus (HIV), and injecting drug use accounts for approximately one-third of new HIV infections occurring outside sub-Saharan Africa. While the annual number of new infections has been falling since the late 1990s, HIV incidence increased by more than 25 percent in seven countries over this time span, largely as a result of HIV transmission related to intravenous drug use. Five of these countries are in Eastern Europe and Central Asia, where the war on drugs is being aggressively fought and, as a result, the number of people living with HIV in this part of the world has almost tripled since 2000.


Republic of Indonesia
# Country Report on the Follow up to the Declaration of Commitment on HIV/AIDS (UNGASS). Reporting Period 2010-2011

Indonesian National AIDS Commission 2012

A national biological and behavior survey was conducted in Indonesian prisons and detention centers in 2010. This study provided baseline information for the Government of Indonesia about the national HIV and syphilis prevalence in prisoners as well as prisoner knowledge, risk behaviors and access to HIV related services, based on a random selection of prisons and detention centers and male and female prisoners. The HIV prevalence was 1.1% in male and 6.0% in female respondents and the prevalence of  syphilis was 5.1% in male and 8.5% in female respondents. Factors associated with HIV for male respondents included having a history of injecting drugs and for females included testing positive for syphilis and illicit drug use. Of those who had a history of injecting drugs, almost twice the proportion of female respondents (12.0%) tested positive for HIV compared to male respondents (6.7%). Knowledge of the main HIV risk factors was high  although common misconceptions were also high. Half the male and 64% of female respondents had previously received HIV information with a higher proportion of females having comprehensive knowledge of HIV than males...


Republic of Indonesia

#  National HIV and AIDS Strategy and Action Plan 2010 – 2014

Minister for People’s Welfare 2010

In 2010, the Ministry of Law and Human Rights set a target of 96 prisons to implement comprehensive HIV and AIDS prevention programs. As of July 2009 15 prisons had the comprehensive program underway. 4,285 inmates had used VCT services. Four prisons also have methadone services which by the end of 2008 had been used by 1,079 inmates. Fifty three prisons collaborate with referral hospitals to provide inmates with services for ART, TB and opportunistic infections (OI). Prison based programs are implemented in collaboration  with NGOs. There are currently 26 NGOs in 15 provinces that implement prison-based programs, including outreach activities for inmates.


Ministry of Health of Ukraine

#  Ukraine harmonized AIDS response progress report. Reporting period: January 2010- December 2011

Kyiv - 2012

In 2009 second generation surveillance was used for the first time to study HIV prevalence among inmates. Results show that in 2009 HIV prevalence among inmates was 15% (c.i. 13% – 17%). In 2011 the HIV prevalence study was organized again in the same correction facilities using methodology and sampling sizes of the previous study. In that period of time HIV prevalence rates  remained practically the same: 13.7% (c.i. 11.8% – 15.6%). Proportion of HIV positive inmates in penitentiary facilities reflects the number of incarcerated injecting users. In 2011 HIV prevalence among inmates with history of drug use was 22.9% (c.i. 19.5% – 26.7%), among inmates with no history of drug use: 8.1% (c.i. 6.0% – 10.5%).


Laura M. Maruschak, BJS Statistician

#  HIV in Prisons, 2001-2010
Bureau of Justice Statistics -- BJS Bulletin September 2012

At yearend 2010, state and federal prisons held a reported 20,093 inmates who had HIV or AIDS, down from 20,880 at yearend 2009. As a result of this decline, the estimated rate of HIV/AIDS among prisoners in custody dropped from 151 HIV/AIDS cases per 10,000 inmates in 2009 to 146 per 10,000 in 2010. The number of state and federal inmates who died from AIDS-related causes also declined between 2009 and 2010, from 94 to 72 deaths. During the same period, the rate of AIDS-related deaths among inmates with HIV/AIDS declined from 47 deaths per 10,000 inmates to 38 per 10,000.
The 1-year declines between 2009 and 2010 were consistent with trends over the past decade. Between 2001 and 2010, the estimated rate of HIV/AIDS among state and federal prison inmates declined an average of 3% each year. During the same period, the AIDS-related death rate declined an average of 13% per year among inmates with HIV/AIDS and 16% among all prison inmates.


Global fund tb Project – Brazil
# Manual of Environmental interventions for tuberculosis control in Prisons
Departamento Penitenciário nacional, 2012

Epidemiological surveys conducted in three prison units in Rio de Janeiro, with a total of 3,014 PDLs studied, showed that the frequency of TB in these units was 4.6%, 6.3% 8.6%, and around 2% for HIV infection... A similar study carried out in Porto Alegre showed that one in ten PDLs (10%) presented active tuberculosis while one in twenty had been infected by HIV (5%)...  In addition to prison conditions and overcrowding, other factors contribute to the high frequency of tuberculosis in prisons: the high rate of HIV infection, use of drugs, inadequate and difficult to access healthcare, and the high frequency of previous imprisonment and previous treatment for tuberculosis, which implies a higher likelihood of contracting resistant forms of infection due to incomplete  treatment.


UNODC | USAID  - O.M. Balakireva, A.V. Sudakova, N.V. Salabai, A.I. Kryvoruk
#  Analysis of HIV/AIDS Response in Penitentiary System of Ukraine
Ukrainian Institute for Social Research  - United Nations Office on Drugs and Crime in Ukraine (UNODC), 2012

Characteristics of epidemiological situation. According to the data of Ukrainian Centre for AIDS Prevention and Control, 23,779 individuals in places of confinement were tested for antibodies to HIV in 2011. Of them 2,463  individuals were identified as HIV positive, making up 10.4% of those tested. According to the SPSU data, 28,181 prisoners were tested for HIV, of which 2,819 were new infection cases and 881 were AIDS patients. The  number of AIDS-related deaths reached 388 in 2011. The number of HIV infected individuals who were under regular medical check-up at the penitentiary facilities  indicated the gradual growth of this indicator: 5,088 patients were under regular medical check-up as of 01.01.2010; 5,806 – as of 01.01.2011 and 6,322 – as of 01.01.2012.


Georgie J MacArthur, Silvia Minozzi, Natasha Martin, Peter Vickerman, Sherry Deren, Julie Bruneau, Louisa Degenhardt, Matthew Hickman
# Opiate substitution treatment and HIV transmission in people who inject drugs: systematic review and meta-analysis
www.bmj.com/ 2012
Opiate substitution treatment provided as maintenance therapy is associated with a reduction in the risk of HIV infection among people who inject drugs. These findings, however, could reflect comparatively high levels of motivation to change behaviour and reduce injecting risk behaviour among people who inject drugs who are receiving opiate substitution treatment.


Federal Bureau of Prisons - Clinical Practice Guidelines

# Medical Management of Exposures: HIV, HBV, HCV, Human Bites, and Sexual Assaults
www.bop.gov/ October 2012
No document on post-exposure management is complete without emphasizing that the
prevention of exposures is critically important. Regular hand washing, appropriate use of
protective gear such as gloves and face shields, adherence to recommendations for safe handling of sharps, and the strategic use of needle-less devices will prevent many exposure incidents. Risk management also entails systematic reviews of all exposure incidents—identifying contributing factors and then improving infection control policies, procedures, and training methods. It is recommended that each facility develop a PEP packet or notebook that is readily available for emergency use


Federal Bureau of Prisons Clinical Practice Guidelines

# Evaluation and Treatment of Hepatitis C and Cirrhosis
www.bop.gov/ March 2012

Inmates who are significant abusers of substances other than alcohol may have a number of medical issues that can affect or be affected by hepatitis C treatment. Injection drug users are at risk for HIV, HBV, endocarditis, and possible re-infection with HCV. Amphetamine and cocaine abuse may result in cardiovascular complications. Ongoing substance use in the controlled environment of prison or jail is, at best, an indicator that the inmate is not taking adequate responsibility for his or her overall health. Treatment decisions must be individualized where these issues are present.


Ivana Obradovic (OFDT) |Observatoire Francais des Drogues et des Toxicomanies
# Réduction des risques en milieu pénitentiaire. Revue des expériences étrangères
Note n°2012-04, à l’attention de la MILDT (Mission interministérielle lutte contre la drogue et la toxicomanie) Saint-Denis, le 05/10/2012

Les données épidémiologiques internationales montrent que les prisons sont des lieux de haute
prévalence du VIH et des hépatites virales. Selon les sources, ces prévalences varient, en France,
entre 0,6 % et 2,0 % pour le VIH (3 à 4 fois plus qu’en population générale) et entre 4,2 % et 6,9 %
pourle VHC (4 à 5 fois plus). Si la plupart des détenus infectés par le VIH ont contracté le virus avant
d’être incarcérés, le séjour en prison constitue une période à risque. Le risque de contamination en prison est d’autant plus élevé que le partage du matériel d’injection, reconnu comme facteur majeur d’infection par le VIH, constitue une pratique courante. Ces constats soulignent la nécessité d’une politique de réduction des risques infectieux (RDR) efficace et adaptée au milieu pénitentiaire.


Alessandra Cerioli

#  Hiv, i costi della war on drugs
il manifesto 18.07.2012 - 14 COMMUNITY
... i numeri agghiaccianti dell'escalation dell'epidemia da Hiv in Russia, che oggi coinvolge circa un milione di persone, con percentuali di crescita delle nuove infezioni a tre cifre... Globalmente si stima che ci siano 33 milioni di persone che vivono con l'Hiv. Dal 1990, il numero annuo delle nuove infezioni è sceso, ma nello stesso periodo si registra un aumento del 25% in 7 Paesi, 5 dei quali sono in Est Europa e Asia Centrale. L'incremento è dovuto essenzialmente all'uso iniettivo di sostanze...


Alessandra Cerioli
#  Droghe e salute: come ridurre il danno in carcere. Esperienze europee e italiane
Summer School 2012 - Carcere e droghe. Tra retorica “securitaria” e buone pratiche di accoglienza
Tutti i detenuti hanno diritto a ricevere... strumenti di prevenzione pari a quelli disponibili al di fuori del carcere” (OMS, 1993). L’ Italia è terribilmente in ritardo: serve urgentemente fornire accesso a preservativi, a siringhe sterili, al metadone in mantenimento, al test e al trattamento per HIV e HCV su base volontaria, durante la custodia preventiva e la detenzione.


Conferenza Unificata - Presidenza del Consiglio dei Ministri

# Infezione da HIV e detenzione - Documento di indirizzo

15 marzo 2012

I dati del Dipartimento dell'Amministrazione Penitenziaria (D.A.P.), verosimilmente sottostimati per il basso tasso di esecuzione dei test HIV in carcere (29% al 30/06/2009) indicano che nei 207 Istituti per adulti del Sistema Penitenziario Italiano, sui 63.630 presenti alla stessa data, gli HIV positivi erano il 2% rispetto al 0.5% stimato nella popolazione generale. Quando il tasso di esecuzione del test è superiore all' 80%, come in uno studio del 2005, condotto sul 14.6% della popolazione detenuta nello stesso anno, la sieroprevalenza per anti-HIV risulta del 7,5% e cioè più del triplo del dato nazionale ufficiale relativo allo stesso periodo (2,2%)


#  WOMEN OUT LOUD -- How women living with HIV will help the world end AIDS
Joint United Nations Programme on HIV/AIDS (UNAIDS) -- 2012

..Support us, especially when we are most marginalized. We need access to services for lesbian, bisexual and transgender women who use drugs, who do sex work and/or are in prison... Women from key populations, including sex workers, transgender women, women who inject drugs, women in prison, and displaced women, may experience barriers to treatment access and adherence due to stigma and discrimination, the threat of violence or arrest, fear of disclosure, or legal and policy barriers... Economic, food-related, legal, housing, education, social and other services all form a crucial part of our ability to manage our own health-care needs. Different sectors need to create linkages and ensure strong reciprocal links with communities. This also necessitates funding for our community-based work and to strengthen community systems. This is a critical sector to which resources are rarely allocated. Since more than HIV is so often at stake, this cross-sectoral collaboration is even more essential, often including the legal system, the police, magistrates and prisons.


#  World AIDS Day Report
Geneva 2012

Popular opinion in countries with generalized epidemics is that HIV infection is found evenly across the adult population. Evidence points otherwise. For example, modelling studies conducted in Kenya show that 33 out of every 100 new HIV infections occur among sex workers, their clients, people who inject drugs, men who have sex with men and people in prisons...



#  Report on the global AIDS epidemic

ISBN 978-92-9173-592-1 (Digital version) 2012

The urgent, evidence-informed recommendations of the Global Commission on HIV and the Law call on governments to review their legal frameworks and, as needed, repeal or reform laws to support a human rights–based AIDS response. The Global Commission recommended that countries prohibit HIV-related discrimination; refrain from explicitly criminalizing HIV exposure, non-disclosure or transmission; protect women and children in the context of HIV; use the law to ensure access to treatment; and take steps to remove punitive or discriminatory laws and policies regarding key populations at higher risk and vulnerable groups, including people who use drugs, sex workers, men who have sex with men, transgender people, prisoners and migrants.


M. Saeed Anwar, M. Nafees, Uzma Nabi
# Sero-Prevalence of HCV and Associated Infections With HIV and HBV Among Prisoners In Lahore
Biomedica Vol. 27 (Jul. – Dec. 2011)
In total, 783 (15.93%) prisoners were positive for HCV and 105 (2.13%) of all prisoners were registered having co-infection with HIV, HBV or both. Among 783 HCV positive prisoners 72 (9.19 %) had HIV co-infection, HCV / HBV co-infection was observed in 30 cases (3.83%) and triple co- nfection (HCV / HBV / HIV) in three cases (0.38%). Conclusion: The prevalence rate of HCV infection is quite high in the prison population of Pakistan and is mainly complicated with HIV co-infection. It is imperative that HCV, HIV and HBV prevention strategies be intensified in this community.


CRB California Research Bureau

# HIV and AIDS in California: 201 2 Update

December 2012

Approximately one in every seven people living with HIV/AIDS pass through prison or jail each year. While it is unclear how many people contract HIV in prison, high-risk behaviors among prisoners (e.g., unprotected sex, sharing needles for tattoos) present ample opportunity for contracting HIV in prison. Because Black men are incarcerated at rates far higher than other racial groups, this population has a greater risk of contracting HIV. Some studies suggest that the large disparity between Black andWhite infection rates can be almost wholly attributed to the disparity in incarceration rates between Black andWhite men.. MSM AND HIV/AIDS Men who have sex with men (MSM) still make up the majority of people living with HIV/AIDS in California. The number ofMSM living with HIV/AIDS in California is estimated to be 67,960 (65.5 percent of all cases). The number ofMSM who are also intravenous drug users and have HIV/AIDS is estimated to be 8,504 (8.2 percent of all living cases).4 The prevalence rate ofHIV/AIDS among MSM is unknown as the population ofMSM is unknown.


A Pharris, L Wiessing, D Hedrich, A Botescu, A Fotiou, G K Nikolopoulos, M Malliori, M Salminen, J E Suk, P Griffiths, M J van de Laar
# Human immunodeficiency virus in injecting drug users in Europe following a reported increase of cases in Greece and Romania, 2011
www.eurosurveillance.org/ Euro Surveill. 2011
Greece and Romania reported an increased number of HIV cases among injecting drug users (IDUs) during 2011. Most European countries reported no changes in the rate of newly diagnosed cases of HIV or HIV prevalence in IDUs; however, six countries did report increases and several additional countries reported increases in injecting risk indicators or low coverage of prevention services. These indicate a potential risk for increased HIV transmission and future outbreaks unless adequate prevention is implemented.


Joint United Nations Programme on HIV/AIDS UNAIDS

# Criminalisation of HIV Non-Disclosure, Exposure and Transmission: Scientific, Medical, Legal and Human Rights Issues
Prepared as background for the Expert Meeting on the Science and Law of Criminalisation of HIV Non-disclosure, Exposure and Transmission

Geneva, Switzerland 31 August – 2 September 2011

February 2012, Revised Version
Paper prepared by Edwin J Bernard, Catherine Hanssens, Beirne Roose-Snyder, Stephen Scarborough and David Webber: revised version produced for use at the High Level Policy Consultation on Criminalisation of HIV Non-Disclosure, Exposure and Transmission, 14 – 15 February 2012, Oslo, Norway


Positively Aware,

#  Maria Khan, Matthew Epperson, Disconnetted. Incarceration cuts you off from your social network—and HIV thrives on that. by Two Epidemics. Incarceration and HIV. How the criminal justice system can play an effective role in the treatment and prevention of HIV

May + June 2012

Most people are not surprised to learn that HIV infections cluster in jail and prison inmates. At any given time, there are over 2.2 million adults in U.S. jails and prisons, and one of every seven HIV-infected Americans are released from these facilities each year. Correctional facilities are holding places for those among the most economically and socially disadvantaged in the U.S. These populations are disproportionately affected by adverse life circumstances and behaviors, such as drug use, that drive HIV risk. However, the process of incarceration itself may also contribute to infection transmission. Having a history of incarceration or having an intimate partner who has been incarcerated are correlates of HIV risk behaviors and sexually transmitted infection, independent of important factors such as poverty and substance use. There is emerging evidence to suggest that incarceration may lead to HIV risk because incarceration disrupts social and sexual networks, and HIV thrives on network disruption.


AIDS InfoNet


 www.aidsinfonet.org Fact Sheet Number 615 - Reviewed January 23, 2012


Averting HIV and AIDS 2012
#  Prisons, Prisoners and HIV/AIDS


Robbie Brown

#  Alabama to End Isolation of Inmates With H.I.V. The H.I.V. ward of an Alabama women's prison in 2008. The state was ordered to stop segregating inmates with the virus.
The New York Times - December 21, 2012

Alabama is one of two states, along with South Carolina, where H.I.V.-positive inmates are housed in separate prisons, away from other inmates, in an attempt to reduce medical costs and stop the spread of the virus, which causes AIDS. Judge Myron H. Thompson of the Middle District of Alabama ruled in favor of a group of inmates who argued in a class-action lawsuit that they had been stigmatized and denied equal access to educational programs. The judge called the state’s policy “an unnecessary tool for preventing the transmission of H.I.V.” but “an effective one for humiliating and isolating prisoners living with the disease.”


U.S. District Court Judge Myron H. Thompson
# Civil Action No. 2:11cv224-MHT) (WO) | Stop segregating prisoners living with HIV

21st day of December, 2012
It is evident that, while the ADOC’s (Alabama Department of Corrections) categorical segregation policy has been an unnecessary tool for preventing the transmission of HIV, it has been an effective one for humiliating and isolating prisoners living with the disease.”


Verna Gates

# Alabama's segregation for inmates with HIV faces court scrutiny
www.reuters.com/ Mon, Sep 17 2012


Marianne Langlet

#  Dossier - VIH en prison : les soins aux oubliettes ?

Le Journal du SIDA n° 223 avril - mai - juin 2012

échanges de seringues en prison… un mirage ? Les récentes études relèvent un risque infectieux élevé en prison et attestent de pratiques à risque. Pourtant, loin derrière ses voisins européens, la France n’a aucun programme d’échange de seringues en milieu carcéral.

10 ans de non-application. La loi du 4 mars 2002 sur le droit des patients devait, en principe, faire sortir les plus malades des prisons. Dix ans plus tard, le bilan est sombre.... Mourir en prison: « Dix ans après la loi, les malades continuent de mourir en prison »...


Avert International
#  Prisons, prisoners and HIV/AIDS
2012 http://www.avert.org/prisons-hiv-aids.htm
In prisons across the world, the HIV and AIDS epidemic presents a major challenge. HIV prevalence within prisons is often far higher than in the general community, and prisons are a high-risk environment for HIV transmission. However, when it comes to tackling the epidemic, prisoners are often neglected and overlooked...  Prevention programmes that have been shown to reduce HIV transmission are rarely available for inmates, and many prisoners with HIV are unable to access life-saving antiretroviral treatment. In many parts of the world prison conditions are far from satisfactory and HIV positive inmates barely receive the most basic healthcare and food. Furthermore, mandatory testing is enforced by some prison authorities, which is often seen as a breach of human rights.  These issues are not confined to male prisoners; due to the high proportion of injecting drug users within prisons, female inmates have also been severely affected by HIV and AIDS. 


National Association for the Advancement of Colored People NAACP
#  Stop the Spread of HI/AIDS in Us Prisons and Jails. Prison HIV Infection Rate Is Four Times Higher Than the General Population

October 16, 2012

Currently there are 2.4 million people in jail or prison in the United States and roughly 1.5% of inmates in state and federal prisons are living with HIV or AIDS, a percentage about four times higher than the infection rate of HIV in the general population. This is especially important to the NAACP, given the disparate rate of racial and ethnic minorities who currently occupy our nation’s jails and prisons (more than 60% of the people in prison are now racial and ethnic minorities. For African American males in their thirties, 1 in every 10 is in prison or jail on any given day. These trends have been intensified by the disproportionate impact of the so-­‐called  "war on drugs," in which two-­‐thirds of all persons in prison for drug offenses are people of color.) Recognizing that over 700,000 former inmates returned to our communities last year alone further raises the urgency to address this crisis. Being HIV positive unquestionably exacerbates the problems faced by men and women who have left prison or jail and are trying to reenter society.


Scott Spiegler, Emily Keehn
# Mapping the Legal Framework to Prevent Sexual Violence & HIV in South Africa’s Correctional Facilities
Sonke Gender Justice Network | HIV/AIDS, Gender Equality, Human Rights | March 2012
South Africa needs to make HIV and AIDS and sexual violence prevention a priority in the prisons context. Evidence suggests that prison rape fuels a cycle of victimization highlighting “the potential for male rape victims to themselves become violent in the future. So, in its bluntest form, a regularly stated argument is that unless we pay victims the attention they deserve, they will become rapists on the outside in attempt to regain their manhood”. With high infection rates in prisons, the link between sexual violence and HIV cannot be ignored.


Zakaria, Dianne

# Relationships between lifetime health risk-behaviours and self-reported human immunodeficiency virus and hepatitis C virus infection status among Canadian federal inmates.

Research Report R-259. Ottawa: Correctional Service Canada - 2012

For both men and women, those reporting both ever injecting drugs and ever having sex with an injection drug user had an odds of self-reported HCV that was at least 35 times greater than those reporting neither risk-behaviour; an increase more than three times greater than that observed among inmates reporting injection drug use only.


Alessandro Margara

# Il carcere dopo Cristo. Relazione annuale del Garante regionale delle persone sottoposte a misure restrittive della libertà personale

Regione Toscana - Consiglio Regionale - 2012 [in part. par. 4.6 - tab. B - tab. C


ZUM | Otra perspectiva del VIH en España
# El Vih En EsPaña 1981 — 2011. La madurez de una epidemia
Ministerio de Sanidad Política Social e Igualdad, Diciembre de 2011
La infección por VIH en prisiones ha disminuido marcadamente, pero sigue siendo muy superior a la de la población general. La población reclusa sigue concentrando a personas con factores de riesgo para la infección por VIH aunque, afortunadamente, cada vez es menor la prevalencia de la infección al ingreso. Nuestra misión es, además de proporcionar la asistencia y tratamiento adecuados, evitar la transmisión del VIH dentro de la prisión. Las medidas de prevención, los programas de reducción de daños y de educación para la salud, junto con el descenso en el consumo de drogas inyectadas y el cambio en la vía de consumo, han conseguido una drástica disminución de la seroconversión en nuestras prisiones. Actualmente nuestro esfuerzo se dirige, además, a mejorar la adherencia al tratamiento, al control y tratamiento de otras enfermedades concurrentes (hepatitis C, tuberculosis..,) y a incrementar los programas de deshabituación a drogas y de salud mental, así como otros problemas asociados a la cronificación de la enfermedad.


Rosaria Iardino | Simit, Simspe, Nps, Donne in rete, Ministero della Giustizia, Ministero della Salute
# La salute non conosce confini. Campagna d’Informazione e Sensibilizzazione su HIV e altre patologie virali croniche negli Istituti Penitenziari
http://www.npsitalia.net/ 2011


Senate and House of Representatives of the U. S. A. in Congress assembled
# Stop AIDS in Prison Act of 2011
A BILL To provide for an effective HIV/AIDS program in Federal prisons.
December 1, 2011


Simit | Simspe | Network Persone Sieropositive | DonneinRete.met | Gilead

# La salute non conosce confini. Campagna d’Informazione e Sensibilizzazione
su HIV e altre patologie virali croniche negli Istituti Penitenziari

Novembre 2011

In Italia almeno 1 persona detenuta su 2 ha avuto un contatto con un virus fra HIV, HBV, HCV. Il tasso di esecuzione dei Test Sierologici risultava inferiore al 30%. Dal transito delle competenze sanitarie penitenziarie al S.S.N. non sono stati più diffusi dati al riguardo. Rassegna stampa...


DH Department of Health - HPA Health Protection Agency - PIP Prison Infection Prevention Team

# Health protection in prisons: a Report to Offender Health from the Health Protection Agency. Annual Report 2009-2010

London: HPA, Colindale, March 2011


Surveillance data on HIV in prisons are required to develop policies to improve the quality of HIV services and also develop care pathways. Current surveillance systems are inadequate for accurately capturing data on the number of individuals diagnosed with HIV in prison... There is a need to continue to develop appropriate prison-specific educational materials aimed at raising awareness of bloodborne viruses (BBV) among prisoners. These should also result in increased uptake of voluntary testing by prisoners for hepatitis B, hepatitis C and HIV. Prison healthcare providers should develop care pathways for hepatitis C, to provide highquality services for the assessment and treatment of all infected patients. Prisoners should have access to sexual health services in prisons, including access to condoms and lubricant, genitourinary medicine services and the national chlamydia screening programme (NCSP). A mapping exercise of sexual health services will be undertaken to gain a better understanding of service provision in the prison estate, with the aim of developing a sexual health toolkit.


Briefing to the Committee Elimination of All Forms of Discrimination Against
Women on the Sixth periodic report of Italy
#  Drug dependence, HIV/AIDS and the criminal justice system Articles 2 and 12 of the Convention

Submitted jointly by Itaca Association, Associazione Antigone, Associazione Nazionale Giuristi Democratici, Canadian HIV/AIDS Legal Network and Harm Reduction International
www2.ohchr.org | June 2011
Individuals who use drugs do not forfeit their human rights. These include the right to the highest attainable standard of physical and mental health…Drug users suffer discrimination, are forced to accept treatment, marginalized and often harmed by approaches which over-emphasize criminalization and punishment while under-emphasizing harm reduction and respect for human rights UN High Commissioner for Human Rights, Navanethem Pillay...


Federal Bureau of Prisons - Clinical Practice Guidelines

# Management of HIV
www.bop.gov/ June 2011

Many persons with HIV infection are asymptomatic and are unaware of their infection; therefore, consistent with guidelines from the Centers for Disease Control and Prevention and the issued memorandum from the BOP Medical Director, all sentenced inmates should universally be offered HIV testing at the time of incarceration.


Direction générale de la santé
# Enquete PREVACAR. Volet Offre de soins. VIH, hépatites et traitments de substitution en milieu carcéral
www.sante.gouv.fr/ 2011

Les personnes détenues y apparaissent comme une population fragilisée et très vulnérable, caractérisée par une surreprésentation des catégories socioprofessionnelles les plus démunies, ayant un niveau éducatif peu élevé, et particulièrement concernée par des problèmes de logement et de couverture sociale avant même l’incarcération. - Des prévalences et/ou incidences plus élevées qu’en population générale sont relevées pour de nombreuses pathologies telles que les addictions, les  maladies mentales et le suicide, les infections par le VIH, les virus des hépatites, ou encore la tuberculose…


# HIV Treatment Interruptions Is Pervasive After Release From Texas Prisons

March 2011

Nearly all Texas state prisoners who receive antiretroviral therapy while incarcerated experience some treatment interruption following their release, according to a new NIDA--funded study by Dr. Jacques Baillargeon of the University of Texas Medical Branch in Galveston. More than two-thirds of these interruptions last longer than 60 days, during which time ex-prisoners may develop higher virall loads thatt increase their risk of disease progresion and transmission to others.


Mark Velez
# AIDS/HIV+ Inmates: a New Standard to House Infected Inmates Based on Objective, Proactive Criteria That Balances the Needs of the Infected Inmate while Protecting Non-Infected Inmates and Prison Staff
Southwestern Law Review, vol. 41 2011
Unfortunately, the statistics regarding the number of prisoners infected with AIDS/HIV+ is limited and difficult to determine. But, analysis of available data indicates that the number of infected inmates in federal, state, and large city prisons and jails is slowly increasing. For example, in November of 1990, there were 6,985 AIDS cases reported in federal, state, and large city prisons and jails; this is a twenty-nine percent increase in the number of AIDS cases reported in 1989...


Deborah J Konkle-Parker, Angela A Robertson
# HIV discharge planning: from correctional setting to community care in Mississippi.
HIV clinician / Delta Region AIDS Education & Training Center 01/2011; 23(1):1-5.
The transition from dependence and institutional care to autonomy and self-care can be fraught with difficulties. In Mississippi, a discharge planning program has been in place since 2001 to address this very problem. The Statewide HIV Community Service Delivery Network (Network) is a network of clinics that treat HIV disease. These clinics serve 77 of the 82 counties in Mississippi, and include seven community clinics, the state prison facilities, some county jails, and one of the state mental health hospitals. Most of these clinics are Community Health Centers and therefore provide more than HIV care and most receive federal dollars through the Ryan White Care Act.


Brenda van den Bergh and Alex Gatherer WHO Regional Office for Europe - Tomris Atabay and Fabienne Hariga UNODC United Nations on Drugs and Crime

# Women’s health in prison. Action guidance and checklists to review current policies and practices


The checklists in this document are an important tool in ensuring greater safety and better quality medical care for women in prison, and are designed to assist a review of current policies and practices relating to women’s health in prisons. They follow from the Declaration on women’s health in prison: correcting gender inequity in prison health and a background paper on women’s health in prison, published in April 2009 by the World Health Organization Regional Office for Europe and the United Nations Office on Drugs and Crime, and are therefore based on the evidence presented. While the checklists are aimed primarily at decision- and policy-makers, senior prison managers and prison health staff, there are important interconnections between them. They can also be useful for civil society organizations working on or monitoring the situation of women and their health in prison settings.


Laurent Michel et al.
# Limited access to HIV prevention in French prisons (ANRS PRI2DE): implications for public health and drug policy
BMC Public Health 2011,
HIV prevention and risk reduction interventions in prison settings are a major public health concern and a critical political issue. Infectious diseases are more prevalent in prison than in the general population and many reports indicate that prison stay is an independent risk factor for the transmission of blood-borne viruses’. Risky behaviors are frequent while the dramatic prevalence of psychiatric disorders and the prison context (lack of hygiene, promiscuity, sexual violence, overpopulation and violence) exacerbate the risks. Many inmates cycle in and out of prison repeatedly, increasing the likelihood that any infections contracted in prison could soon affect the general community.


Gobierno de España Ministerio del Interior - Segreteria General de Instituciones Penitenciarias - Coordinacion de Sanidad Penitenciaria
#  Casos de SIDA y Prevalencia de VIH en Instituciones Penitenciarias

Bolétin Epidemiològico de Instituciones Penitenciarias Volumen: 16 Número: 13 Del 04/12/11 al 31/12/11

El número de personas VIH positivas (promedio de los dos cortes transversales) en tratamiento con antirretrovirales en 2009 fue de 2.880, lo que supone un 63,4% de los internos VIH positivos ingresados en el momento del corte en los centros penitenciarios y un 4,4% del total de la población ingresada en esas fechas (5,2% en el año 2008).

En el año 2009 se observa un descenso, respecto del año anterior, en la proporción de internos con infección por VIH que reciben tratamiento, en relación con el total de seropositivos ingresados en prisión. Esta proporción fue del 63,4% en el 2009. En relación con la coinfección VIH-VHC en el año 2009 el 89,8% de los internos que eran VIH positivos presentaban a su vez marcadores positivos para el VHC, y el 27% de los internos con marcadores positivos para el VHC estaban infectados por el VIH.


Lorana Bartels

#  Prisons, injecting drug use, and BBVs
HIV Australia | Vol. 9 No. 1 | April 2011
This overview clearly reveals that Australia needs to pay heed to international studies that show the efficacy of prison-based NSP programs, and to Australian studies that highlight the need to target female and Indigenous inmates in prison-based BBV prevention programs. The rate of HIV in prisons may remain low in the general prison population, but data showing increasing rates of injecting drug use among Indigenous and female prisoners should not be ignored.


Thompson J., Zakaria D., Grant B.

# Summary of the 2007 National Inmate Infectious Diseases and Risk-Behaviours Survey for Women

Correctional Service Canada - Ottawa 2011

The self-reported rates of HIV and HCV infections among women, especially Aboriginal women are substantially greater than the Canadian population. Women who have HIV worry about discrimination in federal penitentiaries


F Keramat, P Eini, MM Majzoobi
# Seroprevalence of HIV, HBV and HCV in Persons Referred to Hamadan Behavioral Counseling Center, West of Iran
Iran Red Crescent Med J 2011; 13(1):42-46

52.5% of volunteers referred to the behavioral counseling center and 126 (93.5%) of 135 HCV cases were IDU that confirms IDU is the most prevalent rout of HCV transmission or, in other words, hepatitis C virus is an epidemical event in addict populations of Iran. Also, the second referred groups to the behavioral counseling center were persons with history of prison (40.4%) 68% of whom were HCV infected.


Francesca Magnano di San Lio
# HIV e carcere
Psichiatria, Psicologia e Diritto N. 4 - Gennaio 2011
L’art. 275 del codice di procedura stabilisce l’incompatibilità con il regime carcerario per i soggetti affetti da Sindrome da Immunodeficienza Acquisita, o da accertata grave insufficienza immunitaria, ovvero da altra malattia particolarmente grave. Viste le caratteristiche della patologia HIV-relata, lo psichiatra, per quanto di sua competenza, deve oggi valutare la presenza di “malattia particolarmente grave” in questi soggetti, e tenere in considerazione la presenza di patologie che, precedenti all’acquisizione dell’infezione, ne sono diventati fattori di rischio, ovvero che, susseguenti ad essa, ne costituiscano l’effetto. Alcune entità nosologiche HIV-relate di competenza psichiatrica si configurano, infatti, come incompatibili con la detenzione nel rispetto dell’art. 27, III comma della costituzione, secondo il quale "Le pene non possono consistere in trattamenti contrari al senso di umanità e devono tendere alla rieducazione del condannato".


Presidenza del Consiglio dei Ministri - Dipartimento Politiche Antidroga

# Relazione Annuale al Parlamento 2011. Sull'uso di sostanze stupefacenti e sulle tossicodipendenze in Italia. Dati relativi all'anno 2010 - Elaborazioni 2011

La popolazione dei tossicodipendenti in carcere risulta quasi esclusivamente di genere maschile, in prevalenza di nazionalità italiana, con un’età media di circa 33,8 anni. La maggior parte degli adulti tossicodipendenti in carcere associa il consumo di più sostanze (policonsumatori)... Va sottolineato come sia necessario prestare una maggior attenzione alle patologie infettive correlate all’uso di droghe che ad oggi appaiono molto trascurate, almeno dal punto di vista della diagnosi precoce. Questo problema, infatti, più volte segnalato alle Regioni e Provincie Autonome, non ha ancora trovato soluzione e potrebbe essere in grado di incidere molto negativamente nei prossimi anni su un corretto controllo dell’epidemia da HIV, HBV, HCB...


Timothy P. Flanigan, Nickolas Zaller, Curt G. Beckwith, Lauri B. Bazerman, Aadia Rana, Adrian Gardner, David A. Wohl, Frederick L. Altice
# Testing for HIV, Sexually Transmitted Infections, and Viral Hepatitis in Jails: Still a Missed Opportunity for Public Health and HIV Prevention
J Acquir Immune Defic Syndr Volume 55, Supplement 2, December 15, 2010
Jails provide an underutilized public health opportunity for screening for HIV, sexually transmitted infections (STIs), and viral hepatitis, and for such other infectious diseases as tuberculosis. Incarcerated individuals are more likely to be men, poor, persons of color, and at high risk for HIV. The vast majority of jails in the United States do not screen routinely for HIV or STIs, thereby missing an opportunity for HIV and STI diagnosis, treatment, and prevention. Nesting HIV testing within STI testing and treatment in conjunction with testing and treatment for other infectious diseases, as appropriate based on community prevalence, provides a public health opportunity and will enhance HIV prevention. HIV testing and linkage to care, both within corrections and in the community, comprise an important component of the ‘‘seek and treat’’ strategy to further prevent HIV infection. Jail-based screening of infectious diseases, especially for HIV and STIs, in conjunction with treatment and linkage to community care has thus far been a neglected component of HIV prevention among high-risk communities.


Erni J. Nelwan, Reinout van Crevel, Bachti Alisjahbana, Agnes K. Indrati, Reiva F. Dwiyana, Nisaa Nuralam, Herdiman T. Pohan, Ilham Jaya, Andre Meheus, Andre van der Ven
# Human immunodeficiency virus, hepatitis B and hepatitis C in an Indonesian prison: prevalence, risk factors and implicationsof HIV screening
Tropical Medicine and International Health, december 2010

Screening was performed in 679 incoming prisoners, of whom 639 (94.1%) agreed to betested, revealing a seroprevalence of 7.2% (95% CI 5.2–9.2) for HIV, 5.8% (95% CI 3.9–7.6) forHBsAg and 18.6% (95% CI 15.5–21.6) for HCV. Of 57 resident prisoners tested, 29.8% were HIV-positive. HIV infection was strongly associated with injecting drug use (IDU; P < 0.001), but not with ahistory of unsafe sex. Screening of incoming prisoners was responsible for diagnosing and treating HIVin 73.0%, respectively, and 68.0% of HIV-positive individuals.conclusions HIV and HCV are highly prevalent among incoming Indonesian prisoners and almostentirely explained by IDU. Our study is the first to show that voluntary HIV counselling and testingduring the intake process in prison may greatly improve access to ART in a developing country


Ann Avery - Dorothy Murphy

# Enhancing Linkages to HIV Primary Care and Services in Jail Settings Initiative: HIV Testing in Correctional Facilities

Emory Rollins School of Public Health -- Spring 2010, Issue 1 , Vol . 1

Effective treatment of HIV in prisons has dramatically decreased AIDS- related mortality. Identification of HIV offers cost savings to correctional facilities by avoiding costly complications and hospitalizations of individuals with unrecognized and untreated disease. HIV testing in correctional facilities offers at risk individuals the opportunity to address a treatable chronic disease both while incarcerated as well as upon release to the community.


Curt G. Beckwith, Tao Liu, Lauri B. Bazerman, Allison K. DeLong, Simon F. Desjardins, Michael M. Poshkus, Timothy P. Flanigan
# HIV Risk Behavior Before and After HIV Counseling and Testing in Jail: A Pilot Study
J Acquir Immune Defic Syndr. 2010 April 1; 53(4): 485–490

Jail incarceration represents an opportunity to deliver HIV counseling and testing (C&T) services to persons at increased risk of infection. However, jails can be chaotic with rapid turnover of detainees. We conducted a pilot study to investigate the feasibility of comparing the effect of different approaches to HIV counseling and testing (C&T) in jail on subsequent HIV risk behaviors among persons testing HIV-negative... Jail incarceration represents an important public health opportunity to deliver HIV C&T. This study demonstrated (1) feasibility in delivering rapid HIV testing combined with individualized counseling to jail detainees, (2) improved test result delivery rates, and (3) success with evaluating risk behaviors during the transition from jail to the community. Further research is needed to determine the optimal approach to HIV C&T in jail with the goal of increasing awareness of HIV serostatus and decreasing HIV risk behavior.


UNODC United Nations Office on Drugs and Crime - European Monitoring Centre for Drugs and Drug Addiction

# HIV in prisons. Situation and needs assessment toolkit [Advance Copy]

2010 - The development of this toolkit was possible thanks to the financial support of the Swedish-Norwegian Regional HIV/AIDS Team for Africa based in Lusaka, Zambia.


Human Rights Watch
# Unjust and Unhealthy. A Call to Action on Zambian Prison Health
www.hrw.org/ April 27, 2010
Zambia’s prison system is in crisis. built to accommodate 5,500 prisoners before Zambian independence in 1964, the country’s prisons housed 15,300 in 2009. Conditions are deplorable, abusive punishments commonplace, and tuberculosis (tb) and hiV a constant threat. there are almost no medical services available: the prison system employs just one physician for 86 prisons. exacerbating overcrowding and furthering injustice is the fact that the Zambian criminal justice system leaves inmates unnecessarily and wrongfully imprisoned, through arbitrary arrests, unavailability of bail, lack of non-custodial alternatives, restrictions on parole, and delays in the trial and appeal processes.


Jacques G. Baillargeon et al.

# Enrollment in Outpatient Care Among Newly Released Prison Inmates with HIV Infection

Public Health Reports / 2010 Supplement 1 / Volume 125 - ©2010 Association of Schools of Public Health


Dianne Zakaria, Jennie Mae Thompson, Ashley Jarvis, Jonathan Smith
# Testing and Treatment for Human Immunodeficiency Virus and Hepatitis C Virus Infections among Canadian Federal Inmates
Correctional Service of Canada
- Research Report - August 2010

The overall rate of HIV (4.6%) and HCV (31.0%) infections among tested inmates were substantially greater than Canadian population rates. The rates were also greater among women inmates (HIV 7.9%, HCV 37.0%) than men inmates (HIV 4.5%, HCV 30.8%), but this gender differential was driven by the high rates of self-reported infections among Aboriginal women. Specifically, the rate of self-reported HIV infection among Aboriginal women (11.7%) was more than two times greater than the rate among non-Aboriginal women (5.5%) and all men (4.5%). Similarly, the rate of self-reported HCV infection among Aboriginal women (49.1%) was more than 50% greater than the rate among non-Aboriginal women (30.3%) and all men (30.8%). These data highlight the need to ensure that culturally appropriate, effective interventions that decrease risk-behaviours and increase utilization of harm-reduction measures are offered to meet the needs of Aboriginal women. The proportion of HIV-positive inmates currently receiving anti-retrovirals (53%) may be less than that reported in the general community. Among HCV-positive inmates, however, treatment (33%) and efficacy (51%) rates compared favourably with those reported for the general community.


Eric Mykhalovskiy, Glenn Betteridge, David Mclay
# HIV Non-Disclosure and the Criminal Law: Establishing Policy Options for Ontario
A report funded by a grant from the Ontario HIV Treatment Network - August 2010

The large number of recent criminal cases of HIV non-disclosure involving Black male defendants is a particular concern given research evidence documenting discrimination against Blacks that operates at all levels of Ontario’s criminal justice system including prison admissions, imprisonment before trial, charge management, within court proceedings, imprisonment after conviction and community policing. Whether Black men are over-represented in these cases relative to their proportion of all HIV-positive heterosexual available data.


Unità Operativa 1 : Dipartimento Scienze Giuridiche dell'Università degli Studi di Torino
Unità Operativa 2: Associazione Gruppo Abele ONLUS, ANLAIDS, Caritas Italiana, CICA, CNCA, CNV, LILA, NPS

#  Studio sull’efficacia dei programmi di prevenzione rivolti alle persone sieropositive o malate di AIDS ristrette in carcere 2010
Aprire un confronto in merito alle raccomandazioni di OMS e UNAIDS relative alla introduzione di programmi di distribuzione di siringhe e alla disponibilità di preservativi all’interno degli istituti di pena. Occorre ricordare a tal proposito, che l’OMS ha raccomandato la disponibilità di preservativi e siringhe all’interno delle carceri a partire dalle linee guida del 1993 e che, laddove queste disposizioni sono state seguite, non si sono verificati problemi di sicurezza, né di aumento dei comportamenti a rischio...


Hernández-Fernández, JM Arroyo-Cobo.
#  Resultados de la experiencia española: una aproximación global al VIH y al VHC en prisiones

Rev Esp Sanid Penit 2010; 12: 86-90 45
La prevalencia de VIH ha disminuido 3,5 veces y la de del VHC se ha reducido a la mitad en los últimos diez años. Las tasas de seroconversión dentro de la prisión han descendido un 85% en VIH y un 71% en VHC. La incidencia de tuberculosis y de sida han descendido un 85% y un 93,7% respectivamente. Los programas de reducción de daños, mantenimiento con metadona e intercambio de jeringuillas, han aumentado de forma progresiva sus usuarios hasta que empezó a disminuir el número de UDIs en las prisiones, mientras que el de mediadores en salud se ha implantado en la práctica totalidad de los centros...


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, and Farah Parvez, MD, MPH

# Undiagnosed HIV Infection Among New York City Jail Entrants, 2006: Results of a Blinded Serosurvey

J Acquir Immune Defic Syndr Volume 54, Number 1, May 1, 2010


J Ryan, D Voon, A Kirwan, M Levy and L Sutton

# Prisons, needles and OHS
J Health Saf Environ 2010, 26(1): 63-72
A 2004 report by the Australian Institute of Criminology found that, for 14% of female prisoners and 10% of male prisoners, the most serious offence for which they were convicted was drug-related. The 2004 National Prison Entrants’ Bloodborne Virus Survey showed that 59% of screened prison entrants had a history of injecting drug use, and 38% had injected drugs during the one-month period before entering prison. The demand for drugs is high inside prisons. Despite a strict prohibitionist approach to drugs, they still find their way into prisons. A 2003 survey conducted in New South Wales found that, of the 789 prisoners from 27 correctional centres, 44% reported a history of injecting drug use and, of these, close to half reported that they had injected while in prison. The Australian Needle Syringe Program Survey reported that, of the 254 people who indicated that they had been in prison the year before, 37% said that they had injected while in prison.


Dianne Zakaria, Jennie Mae Thompson, Frederic Borgatta
# A Comparison of Drug-Related and Sexual Risk-Behaviours in the Community and Prison for Canadian Federal Inmates
Research Report - Correctional Service of Canada July 2010

Health risk-behaviours, such as injection drug use and unprotected sex, occur at a high rate among offenders entering the correctional system. Such risky behaviour increases the risk of acquiring blood-borne and sexually transmitted infections, as evidenced by the high rate of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infections among inmates compared to the general population. For example, studies involving Canadian federal inmates have estimated the overall seroprevalence of HIV at 2% and HCV at 26% to 33%. Conversely, the prevalence of HIV is estimated at 0.3% (UNAIDS, 2006) in the Canadian adult population (15-49 years old), and the prevalence of HCV is estimated at 0.8% in the Canadian population as a whole.


Weidong Zhang, Xinya Wang, Xi Chen and Fan Lv [National Center for AIDS/STD Control and Prevention, Chinese Center for Disease Control and Prevention, Beijing, PR China]
#  HIV/AIDS knowledge in detention in Hunan province, China
BioMed Central BMC Public Health 2010

This study gives us an overview about HIV/AIDS knowledge in detention in Hunan province, and all detention sites in the study provided HIV/AIDS intervention services among detainees that focused on HIV/AIDS knowledge, attitude, and health behaviors. These efforts are likely to require an infrastructure that not only provides operational and financial support, but also creates an environment in which at-risk populations feel comfortable and safe in seeking help and non-discrimination.


Human Rights Watch -- ACLU American Civil Liberties Union

#  Sentenced to Stigma. Segregation of HIV-Positive Prisoners in Alabama and South Carolina

Copyright © 2010 ACLU National Prison Project and Human Rights Watch


Ziyad Mahfoud, Kassem Kassak , Khalil Kreidieh, Sarah Shamra, Sami Ramia
# Prevalence of antibodies to human immunodeficiency virus (HIV), hepatitis B and hepatitis C and risk factors in prisoners in Lebanon
J Infect Dev Ctries 2010; 4(3):144-149
People admitted to correctional facilities often have a history of risky behaviours which frequently lead to transmission of blood-borne viruses, such as human immunodeficiency virus (HIV), hepatitis B virus (HBV) and hepatitis C virus (HCV). Our aim was to determine the prevalence of HIV, HBV and HCV infections among prisoners in Lebanon. Methodology: Conducted between August 2007 and February 2008 in Roumieh Prison, Lebanon, the study included a total of 580 male prisoners aged 16 and above who were randomly selected from four prison blocks. Peripheral blood was collected by a finger prick, blotted onto high-quality filter paper, dried and later eluted to be tested for markers of HIV, HBV and HCV infections.


Laura M. Maruschak

# HIV in Prisons, 2007-08
U.S. Department of Justice - Office of Justice Programs - BJS Bureau of Justice Statistics

Bulletin December 2009 Revised 1/28/2010


Ravi Kavasery, Duncan Smith-Rohrberg Maru, Laurie N. Sylla, David Smith, Frederick L. Altice
# A Prospective Controlled Trial of Routine Opt-Out HIV Testing in a Men’s Jail
PLoS ONE | www.plosone.org 1 November 2009

Approximately 10 million Americans enter jails annually. The Centers for Disease Control and Prevention (CDC) recently recommended implementing routine opt-out HIV testing in all  healthcare settings, including jails. This presents both a challenge and an opportunity in correctional settings to expand access to HIV services to correctional inmates, a population disproportionately affected by HIV.


Ravi Kavasery, Duncan Smith-Rohrberg Maru, Joshua Cornman-Homonoff, Laurie N. Sylla, David Smith, Frederick L. Altice
# Routine Opt-Out HIV Testing Strategies in a Female Jail Setting: A Prospective Controlled Trial
PLoS ONE | www.plosone.org 1 November 2009
If an HIV testing strategy is to be implemented, it is important that reasons for refusal are properly addressed to optimize uptake of HIV testing among those who might be at highest risk or may not recognize their risk at all. A major strength of the present study design was that it enabled us to accurately assess realistic acceptance for HIV testing in an ethical manner. Socially marginalized individuals, such as prisoners, may be leery about participating in research in coercive places like jails...


Curt G. Beckwith et al.
#  Opportunities to Diagnose, Treat, and Prevent HIV in the Criminal Justice System
NIH Public Access Author Manuscript - Published in final edited form as: J Acquir Immune Defic Syndr. 2010 December 1; 55(Suppl 1): S49–S55


# Handbook on Prisoners with special needs -- CRIMINAL JUSTICE HANDBOOK SERIES

New York 2009

All prisoners are vulnerable to a certain degree. When the liberty of a group of individuals is restricted and they are placed under the authority of another group of people, and when this takes place in an environment which is to a large extent closed to public scrutiny, the abuse of power has proven to be widespread. Even where no abuse exists, prison conditions themselves in a large majority of countries worldwide are harmful to the physical and mental well-being of prisoners, due to overcrowding, violence, poor physical conditions, isolation from the community, inadequate prison activities and health care. This is why a range of international and regional instruments have been adopted by the United Nations and regional bodies to ensure that the fundamental human rights of prisoners are protected. It is also why such instruments provide for a variety of mechanisms to safeguard these rights, such as the independent oversight of prisons both by international and national bodies. However, there are certain groups that are in a particularly vulnerable position in prisons and who therefore need additional care and protection. Some people may experience increased suffering due to inadequate facilities and lack of specialist care available to address their special needs in prison. The prison environment itself will exacerbate their existing problems. These include prisoners with mental health care needs, prisoners with disabilities and older prisoners. Some are at risk of abuse from other prisoners and prison staff, due to prejudicial attitudes and discriminatory perceptions entrenched in society itself, which are more pronounced in the closed environment of prisons. Such groups may suffer from humiliation, physical and psychological abuse and violence, due to their ethnicity, nationality, gender and sexual orientation.


# HIV testing and counselling in prisons and other closed settings
www.unodc.org/ October 2009
Prison systems should review and, if necessary, change prison policies and practices that discriminate against HIV-positive prisoners, recognizing that increasing access to HiV testing and counselling must go hand in hand with greater protection from HiV-related discrimination and abuse. in particular, policies that provide for segregation of HiV-positive prisoners or their exclusion from any programmes or other activity should be repealed and the confidentiality of prisoners’ medical information should be protected. UNoDc, WHo and UNAiDS do not support mandatory or compulsory HIV testing of prisoners  on public health grounds. Therefore, countries should review and, if necessary, change their laws, regulations, policies and practices to prohibit mandatory or compulsory HiV testing of prisoners... Prison systems should ensure that health-care providers: " offer HiV testing and counselling to all prisoners during medical examinations; " recommend HiV testing and counselling if a prisoner has signs, symptoms or medical conditions that could indicate HiV infection, including tuberculosis, and to female prisoners who are pregnant to assure appropriate diagnosis and, for those testing positive, access to necessary HiV treatment, care and support.


Centers for Disease Control and Prevention CDC
# HIV Testing Implementation Guidance for Correctional Settings
January 2009

Correctional facilities can play a vital role in contributing to both state and national HIV and AIDS surveillance activities because these facilities provide HIV testing to high-risk persons who may not have accessed these services in the community... Inmates who are taking HIV medications should continue taking their medications after release from custody, unless a community HIV care provider advises otherwise. Since interruptions in HIV therapy can increase the chance of HIV resistance to the medications, correctional facilities should dispense enough medication upon release to bridge the gap until the patient can see a community HIV provider.


Human Rights Watch

# Discrimination, Denial, and Deportation. Human Rights Abuses Affecting Migrants Living with HIV

June 2009


David L. Rosen, PhD, Victor J. Schoenbach, PhD, David A. Wohl, MD, Becky L. White, MD, Paul W. Stewart, PhD, and Carol E. Golin, MD

# Characteristics and Behaviors Associated With HIV Infection Among Inmates in the North Carolina Prison System
June 2009, Vol 99, No. 6 | American Journal of Public Health


Robin Macgowan, Andrew Margolis, April Richardson-Moore, Terry Wang, Marlene Lalota, P Tyler French, James Stodola, Jennifer Mckeever, Jack Carrel, Jolene Mullins, Michelle Llanas, Sean David Griffiths
# Voluntary Rapid Human Immunodeficiency Virus (HIV) Testing in Jails
Sexually Transmitted Diseases, February Supplement 2009, Vol. 36, No. 2
From December 2003 through May 2006, rapid HIV testing was provided to 33,211 inmates, more than 99.9% of whom received their test results. Most of the inmates tested were male (79%), black (58%), and less than 35 years of age (60%). A total of 440 (1.3%) rapid HIV tests were reactive, and 409 (1.2%) of the results were confirmed positive. The testing programs identified 269 (0.8%) previously undiagnosed cases of HIV infection. In the multivariate analyses, new HIV diagnoses were associated with race/ ethnicity, report of risky behaviors, and with no report of HIV risk behavior. Almost 40% of diagnoses were for inmates whose only reported risk was heterosexual contact. Conclusions: Rapid HIV testing in jails identified a considerable number of previously undiagnosed cases of HIV infection. Rapid HIV testing should be available to all inmates, regardless of whether inmates reported HIV risky behaviors.


Emily Hilyer Gaskin
# A Prison within a Prison: Segregation of HIV Positive Inmates and Double Stigma
Anthropology Theses, Paper 31, 2009
Although the majority of state prison systems have made the move away from segregated housing for HIV positive inmates, a few still continue this practice. The purpose of this study was to learn more about the experiences of women who have carried the double stigma of being HIV positive prisoners who were segregated within the prison system because of their illness. Drawing on interviews with HIV positive women who served time in a segregated facility and  are now released, I was able to explore how double stigma and segregation affect identity and daily life. By asking these women questions about their experiences as inmates who were further segregated because of their HIV status, I call attention to the strong association between power, authoritative knowledge, and policy


Ministero della Giustizia

# Misura alternativa o di comunità alla detenzione nei confronti dei soggetti affetti da aids conclamata o da grave deficienza immunitaria

Aggiornamento 10 aprile 2009


Jacques G. Baillargeon et al.

# Accessing Antiretroviral Therapy Following Release From Prison

JAMA, February 25, 2009—Vol 301, No. 8 (Reprinted) - American Medical Association


Human Rights Watch

#  Returned to Risk. Deportation of HIV-Positive Migrants.

Copyright © 2009 Human Rights Watch


National Minority AIDS Council

#  Mental Health and Substance Abuse Among Offenders with HIV/AIDS

Washington 2009

Introduction - Following the deinstitutionalization of mentally ill people—their release from psychiatric facilities into the community—the number of occupied state hospital beds were reduced from 339 per 100,000 population in 1955 to 21 per 100,000 in 1998. The promised increase in alternative community-based care, however, never materialized and prisons and jails have largely taken the place of state hospitals as the largest repository of mentally ill people in the U.S... Understanding the Connections: Mental Health Disorders, Substance Abuse Disorder, and HIV/AIDS... Co-Occurring Disorders—Dual and Triple Diagnosis. The most common cause of mental illness relapse is substance abuse. The most common cause of substance abuse is mental illness... Depression and other psychiatric illnesses may impair a person's ability to adhere to antiretroviral treatment regimens and thus may complicate efforts to treat HIV/AIDS...


Open Society Institute - UNDP 2008

#  10 motivi per opporsi alla criminalizzazione della trasmissione o esposizione al virus dell’hiv


#  Dix raisons de s’opposer à la criminalisation de l’exposition au VIH ou de sa transmission


#  10 razones para oponerse a la penalización de la exposición al y la transmisión del VIH


#  10 razões para se opor à criminalização da exposição ou transmissão do HIV


#  10 аргументов против уголовного преследования за заражение


WHO Europe - UNODC

Andrej Kastelic, Jörg Pont, Heino Stöver
# Opioid Substitution Treatment in Custodial Settings. A Practical Guide
BIS-Verlag der Carl von Ossietzky Universität Oldenburg 2008

In many parts of the world, Europe, Asia, and North America opioid dependent people are over-represented in prisons. In these regions they represent about one third of the prison population and up to 80% in some countries such as in Central Asia. In sub-Saharan Africa, the problem is emerging, while in Latin America the main dependency is to cocaine. Prisons are not the right place for treating drug dependent men and women, and countries should develop policies for alternatives to imprisonment. As long as these alternatives have not been developed and implemented, prison authorities are faced with this specific population, in need of treatment, care and support. Research has shown that substitution therapy is the most effective way to treat opioid dependence, to reduce the risk of HIV and hepatitis C transmission, and to reduce the risk of overdose. Like all persons, prisoners are entitled to enjoy the highest attainable standard of health. This right is guaranteed under international law in Article 25 of the United Nations Universal Declaration of Human Rights and Article 12 of the International Covenant on Economic, Social, and Cultural Rights. The international community has generally accepted that prisoners retain all rights that are not taken away as a fact of incarceration, including the right to the highest attainable standard of physical and mental health. Loss of liberty alone is the punishment, not the deprivation of fundamental human rights.


Canadian HIV/AIDS Legal Network
# HIV and Hepatitis C in Prisons
http://www.aidslaw.ca/ 2008
HIV infection levels are high in many prison systems. In Western Europe, particularly high seroprevalence has been reported in Portugal (11 percent), Spain (14 percent), Switzerland (4 to12 percent) and Italy (7.5 percent). In Eastern Europe, research indicates roughly 7 percent of Ukrainian prisoners and 15 percent of Lithuanian prisoners are HIV-positive. In South Africa, 41 percent ofprisoners are reported to be HIV-positive. In Latin America, high HIV seroprevalence has been reported in Brazil (10.9 to 21.5 percent) and Honduras (7 percent).


Anish P. Mahajan, Jennifer N. Sayles, Vishal A. Patel, Robert H. Remien, Daniel Ortiz, Greg Szekeres, Thomas J. Coates
# Stigma in the HIV/AIDS epidemic: A review of the literature and recommendations for the way forward
AIDS. 2008 August
Although stigma is considered a major barrier to effective responses to the HIV/AIDS epidemic, stigma reduction efforts are relegated to the bottom of AIDS program priorities. The complexity of HIV/AIDS related stigma is often cited as a primary reason for the limited response to this pervasive phenomenon. In this paper, we systematically review the scientific literature on HIV/AIDS related stigma to document the current state of research, identify gaps in the available evidence, and highlight promising strategies to address stigma. 


ARASA AIDS Rights Alliance for Southern Africa - Open Society Institute - UNDP United Nations Development Programme
# 10 Reasons to Oppose Criminalization of HIV Exposure or Transmission
Copyright © 2008 by the Open Society Institute

Negli ultimi anni abbiamo assistito alla nascita di nuove e specifiche leggi che sanzionano la trasmissione e/o esposizione al virus dell’hiv, in particolare in alcune parti dell’Africa, Asia, dell’America Latina e dei Caraibi. Allo stesso tempo, in particolare in Europa e Nord America, sempre più spesso viene fatto ricorso a leggi già esistenti per perseguire penalmente quegli individui accusati di aver trasmesso l’hiv o di aver esposto altri al rischio di contrarre l’infezione... Questo documento contempla 10 motivi per cui l’applicazione del diritto penale in questi casi rende la “public policy” ingiusta e inefficace, tranne in quei casi di trasmissione intenzionale, ossia quando qualcuno lo fa con l’intento di danneggiare altri. In tali casi, le leggi già esistenti possono e dovrebbero essere utilizzate. In aggiunta, i governi dovrebbero perseguire penalmente tutti quei casi di violenza sessuale e assicurarsi che i casi di stupro avvenuti all’interno del matrimonio siano considerati reato. Tuttavia, laddove le persone sieropositive non agiscono con il chiaro intento di recare danno ad altri, il diritto penale non dovrebbe essere applicato. Piuttosto, gli stati dovrebbero adottare delle misure – basate sulle evidenze - per incrementare gli sforzi in materia di prevenzione, sul fronte delle terapie antiretrovirali e ridurre la vulnerabilità delle donne all’hiv.


amfAR - The Foundation for AIDS Research

# HIV in Correctional Settings: Implications for Prevention and Treatment Policy

Issue Brief No. 5 - March 2008 [... 2 tabelle ...]


Srdan Matic, Jeffrey V. Lazarus, Stine Nielsen, Ulrich Laukamm-Josten (eds)
# Progress on Implementing the Dublin Declaration on Partnership to Fight HIV/AIDS in Europe and Central Asia
World Health Organization 2008
Background on HIV/AIDS in prisons in Europe and central Asia In many of the countries in the European Region, rates of HIV infection in prison populations are much higher than those found in the general population outside of prisons, a fact primarlily related to unsafe drug injection practices, both in and outside of prisons, and also to unprotected sexual contacts in prisons. Furthermore, criminal justice approaches that result in the mass incarceration of people who use drugs also play a significant role in increasing the likelihood of high-risk injecting practices in prisons and the concomitant risk of transmission of blood-borne viruses.


Chris Tapscott
# An Assessment of the Impact of HIV/AIDS on Correctional System governance with Special Emphasis on Correctional Services Staff
CSPRI Research Report No. 16 - 2008
The incidence of HIV/AIDS infection in South African prisons has been extensively documented in recent years. This research has focused variously on the geographic and demographic spread of the disease and on the rights of inmates to prophylactics and to appropriate treatment and  care. In contrast, littleresearch has been directed towards the incidence and impact of the pandemic amongst correctional officials. From this research it is evident that whilst the Department of Correctional Services (DCS) has developed a fairly coherent (albeit unevenly implemented) programme for the prevention and treatment of HIV/AIDS amongst inmates, and notwithstanding the recent launch of a “Framework for the Implementation of a Comprehensive HIV and AIDS Programme” it has yet to develop and implement systematic measures to manage the disease amongst its own staff.


Lukas Muntingh
# The prevalence of HIV in South Africa's prison system: some, but not all the facts, at last SA Prisons at a glance
CSPRI (Civil Society Prison Reform Initiative) Newsletter n. 26 May 2008
UNAIDS refers to prisons as 'incubators' of HIV infection and other diseases, such as Hepatitis C and tuberculosis. Even though AIDS has been known in Africa for more than 20 years, very little is known about the epidemic in prisons, prevalence rates, how it is transferred, the effectiveness of interventions, the link between prison and community, and the management of AIDS patients in prison. Prevalence figures cited are often based on research that was done only in one locality, making it difficult to obtain a system-wide view of the problem. The announcement in 2006 by the South African Department of Correctional Services (DCS) that it will conduct a national HIV and syphilis prevalence survey amongst its staff and prisoners, was therefore welcome indeed. The results of this survey were released at the end of January 2008 in a report entitled: Department of Correctional Services HIV Prevalence Survey (2006)...


Tony Butler and Cerissa Papanastasiou
National Drug Research Institute | National Centre in HIV Epidemiology and Clinical Research University of New South Wales

# National Prison Entrants’ Bloodborne Virus & Risk Behaviour Survey 2004 & 2007

National Drug Research Institute, Curtin University of Technology
September 2008

Prisoner populations are characterised by engagement in a range of risk behaviours, most notably injecting drug use. Consequently they are at an increased risk of exposure to bloodborne viruses such as hepatitis B, hepatitis C  and HIV. Previous Australian research had shown that hepatitis C is up to forty times higher in prisoners compared with the general community. Monitoring this population for the presence of blood-borne pathogens and trends in risk behaviours is important in planning effective prevention strategies for this population. This is
the second prison entrants’ survey to have been conducted; the first was undertaken in 2004.


Carrie Oser, Jennifer Havens, Michele Staton-Tindall, Conrad Wong, Carl Leukefeld, Michael Prendergast
# HIV Sexual Risk Behaviors among Ketamine and Non-Ketamine Using Criminal Offenders Prior to Prison Entry
Addict Res Theory. 2008 ; 16(3): 289–302
The purpose of this study is to examine the relationship between illicit ketamine use and engagement in high-risk sexual behaviors prior to incarceration among a sample of drug users undergoing prison-based drug abuse treatment in the United States. Drug using criminal offenders whose repertoire includes having ever used ketamine at least once in their lifetime will be defined as ‘ketamine users.’ It should be noted that while the extent and context of ketamine use is unknown, this study is a first step in understanding the association between ketamine use and unprotected sexual behaviors in a criminal offending population.


Megan McLemore
# Access to condoms in U.S. prisons
HIV/AIDS Policy & Law Review | Vol. 13, N. 1, July 2008

Despite overwhelming evidence that condom use prevents the transmission of HIV, U.S. prison officials continue to limit the availability of condoms to incarcerated persons. Fewer than one percent of correctional facilities provide condoms to inmates, though those that do include some of the nation’s largest urban prisons.... Some corrections officials have expressed concern that condom distribution would negatively affect institutional security. This concern has proved unfounded in studies from Canada and Australia.


Ministero della Salute -- Commissione Nazionale per la Lotta contro l'AIDS

#  Aggiornamento delle conoscenze sulla terapia dell'infezione da HIV -- Infezione da HIV e condizioni di detenzione, Febbraio 2008


UNODC United Nations Office on Drugs and Crime - UNAIDS - World Bank
# HIV and Prisons in sub-Saharan Africa: Opportunities for Action

October, 23, 2007

1. Data on HIV in African prisons are limited; 2. High-risk sexual and other risky behavior in prisons increase the spread of HIV and sexually transmitted infections; 3. Most prisoners come from a high risk segment of the population; 4. There is a high risk of transmission between prison and non-prison populations; 5. Overcrowding leads to rape and sexual violence in prisons; 6. Tuberculosis is more readily spread in prisons; 7. Adequate policies and interventions to address HIV among prisoners are seldom implemented; 8. Criminal justice reform could support HIV prevention


World Health Organization -- United Nations Office on Drugs and Crime -- UNAIDS

#  Evidence for Action Technical Papers. Effectiveness of Intervention to Address HIV in Prisons
Geneva, 2007


Rucker C. Johnson - Steven Raphael (Goldman School of Public Policy - University of California, Berkeley)
#  The Effects of Male Incarceration Dynamics on AIDS Infection Rates among African-American Women and Men

July 2007

Coincident with the large increase in black male incarceration rates is a pronounced increase in AIDS infections among African-American women and men. Between 1970 and 2000, the proportion of black men incarcerated increased from 0.03 to 0.08, with a much larger increase in the proportion that has ever been to prison. There is no comparable increase among non-Hispanic white men. Concurrently, the HIV/AIDS infection rate among African-American women went from zero during the pre-epidemic period to an annual rate of 55 per 100,000 between 2000 and 2003, a figure nineteen times higher than that for non-Hispanic white women. For African-American men, this rate exceeds 100 per 100,000, in contrast to less than 15 per 100,000 among non-Hispanic white men. Moreover, African-Americans (12 percent of the overall population) accounted for half of the AIDS cases reported in 2002.


Sheryl B. Lyss, Bernard M. Branson, Karen A. Kroc, Eileen F. Couture, Daniel R. Newman, Robert A. Weinstein
# Detecting Unsuspected HIV Infection With a Rapid Whole-Blood HIV Test in an Urban Emergency Department
J Acquir Immune Defic Syndr Volume 44, Number 4, April 1, 2007

HIV counseling and testing have been the cornerstones of the publicly funded prevention strategy in the United States for nearly 20 years, yet 24% to 27% of the 925,000 to 1,025,000 persons infected with HIV are unaware that they are infected1 and 39% of infected persons do not receive a diagnosis until late in the course of disease.2 Of persons with positive results from publicly funded testing, 18% to 38% fail to receive their results.


Elaine C. Stewart
# The Sexual Health and Behaviour of Male Prisoners: The Need for Research
The Howard Journal Vol 46 No 1. February 2007
Sexually transmitted infections (STIs) are a major public health problem in the United Kingdom (UK) and the limited data available may suggest high prevalence rates (especially of HIV, hepatitis B and C) in the escalating male prison population. Sex, rape and injecting drug use are a part of prison life, yet screening for STIs does not routinely take place and there are inconsistencies in the availability of condoms and other harmreduction devices. Numerous characteristics of male prisoners (for example, social disadvantage, drug dependency, younger age, black ethnic origin, on remand), their offences (drug, sex, violent) and overcrowded prisons (for example, sharing cells, staff shortages, enforced idleness, transfers) are also considered ‘high risk’ from a sexual health perspective, especially the spread of STIs between prisoners and into the wider population when they are released. There is, therefore, an urgent need for research so that sexual health information and HIV/STI prevention initiatives can be successfully targeted.


World Health Organization WHO UNAIDS UNODC
# Effectiveness of Interventions to Manage HIV in Prisons – HIV care, treatment and support
World Health Organization 2007
HIV hit prisons early and hit them hard. The rates of HIV infection among prisoners in many countries are significantly higher than those in the general population. HCV seroprevalence rates are even higher. While most of the prisoners living with HIV in prison contract their infection outside the institutions before imprisonment, the risk of being infected in prison, in particular through sharing of contaminated injecting equipment and unprotected sex, is great. Outbreaks of HIV infection have occurred in a number of prison systems, demonstrating how rapidly HIV can spread in prison unless effective action is taken to prevent transmission.


Harm Reduction Coalition

# Syringe Exchange in Prisons: The International Experience
January 2007 - www.harmreduction.org
Syringe exchange programs have been successfully implemented in a diverse range of prison settings using a variety of effective models. Evidence overwhelmingly shows that prison syringe exchange programs reduce HIV and hepatitis C risk and prevent disease transmission, increase referrals to substance abuse treatment, and do not result in increased drug use nor pose problems with security or violence.


ENDIPP - European Network on Drugs and Infections Prevention in Prison

Heino Stöver, Morag MacDonald, Susie Atherton
# Harm Reduction in European Prisons. A Compilation of Models of Best Practice
BIS-Verlag der Carl von Ossietzky Universität Oldenburg 2007


Deborah Kacanek, Gloria D. Eldridge, Jill Nealey-Moore, Robin J. MacGowan, Diane Binson, PhD, Timothy P. Flanigan, Christine C. Fitzgerald, James M. Sosman
# Young Incarcerated Men’s Perceptions of and Experiences With HIV Testing
American Journal of Public Health | July 2007, Vol 97, No. 7
We analyzed incarcerated men’s perceptions of and experiences with HIV testing. Interviews were conducted with 105 men, aged 18 to 29 years, in 4 states. Most men had received an HIV test while incarcerated because it was convenient or free or because they thought it was mandatory. At most sites, men believed they were HIV-negative because they never received test results. Some men did not know the diseases for which they had been tested. Some men avoided HIV testing outside prison because they lacked time, lacked resources, feared knowing the results, or perceived themselves to not be at risk. HIV testing programs for young men inside or outside prison should address barriers to HIV testing, communicate the meaning and extent of testing, and improve notification of those with HIV-negative results.


AIDS Action Policy Brief
#  The Criminal Justice System and HIV/AIDS
October 2007


Human Rights Watch

#  Chronic Indifference. HIV/AIDS Services for Immigrants Detained by the United States

Volume 19, No. 5(G), December 2007


#  HIV/AIDS Prevention, Care, Treatment and Support in Prison Settings. A Framework for an Effective National Response
Co-published with the World Health Organization and the Joint United Nations Programme on HIV/AIDS - 2006

Prisoners are entitled, without discrimination, to a standard of health care equivalent to that available in the outside community, including preventive measures. This principle of equivalence is fundamental to the promotion of human rights and best health practice within prisons, and is supported by international guidelines on prison health and prisoners’ rights,as well as  national prison policy and legislation in many countries...

Many prisoners will have contracted sexually transmitted infections (STIs) outside of prison, and often come from populations lacking access to reproductive and sexual health services. Unprotected sex also takes place in prisons, thereby increasing the risk of transmission of STIs amongst prisoners, and if left untreated, to sexual partners in the community. The presence of untreated STIs also increases the risk of HIV transmission. Therefore prevention and regular screening and treatment of STIs increases the effectiveness of HIV prevention and treatment efforts.


Robert B. Greifinger

#  Inmates as Public Health Sentinels
Journal of Law & Policy 2006, Vol. 22:253

Inmates need to be prepared for reentry. Community reintegration depends in large part on successful connections with community providers for the treatment of chronic diseases, mental illnesses, and communicable diseases. For communicable diseases, collaboration with public health departments is obligatory. It does not make sense to treat conditions in correctional facilities without a plan for continuity of care once prisoners are released. Continuity of medication is especially critical for those with diseases like tuberculosis and HIV, where medication lapses can cause drugresistance, and for mental illnesses where medication lapses can lead to mental decompensation and subsequent reincarceration. Correctional systems, public health departments, and community organizations can redirect energy into building these connections. If they chose to, states could extend Medicaid benefits to reentering inmates to provide continuity of medication and affordable access to health care. After spending so much money to incarcerate and treat prisoners, wouldn’t it be sensible to provide these community connections and health care coverage?


Department of Correctional Service (DCS) |LIM’UVUNE Consulting | South Africa
# DCS HIV Prevalence Survey 2006. Executive Summary
cspri.org.za/ 2006
The researcher can, with 90% confidence, conclude that the total number of HIV positive personnel within the 38268 personnel population of Department of Correctional Services is between 2588 (lower limit) and 5392(the upper limit) with the more likely number being 3775. The researcher can, with 90% confidence conclude that the total number of HIV positive offenders in the 113567 offender population of Department of Correctional Services is between 20909 (lower limit) and 25744(the upper limit) with the more likely number being 23258.


Andrew A. Adjei, Henry B. Armah, Foster Gbagbo, William K. Ampofo, Isaac K. E. Quaye,
Ian F. A. Hesse, George Mensah

# Prevalence of human immunodeficiency virus, hepatitis B virus, hepatitis C virus and syphilis among prison inmates and officers at Nsawam and Accra, Ghana
Journal of Medical Microbiology (2006), 55, 593–597

We recommend that all individuals who are jailed must be screened to determine their status with regards to the listed infections, so one can draw a line between the relative spread from within and what is carried in from outside. Our data indicate that all four infections, HIV, HBV, HCV and syphilis, are problems for the prisoners as well as the officers. We were particularly surprised at the high prevalence of HCV, which has received very little attention in our educational agenda for curtailing infectious diseases in Ghana.


Robin MacGowan, Gloria Eldridge, James M. Sosman, Rizwana Khan, Timothy Flanigan, Barry Zack, Andrew Margolis, John Askew, Christine Fitzgerald, the Project START Study Group
# HIV Counseling and Testing of Young Men in Prison
Journal of Correctional Health Care, Volume 12 Number 3, July 2006 203-213
HIV counseling and testing are the first steps to diagnosing and managing HIV infection. This article describes factors associated with HIV testing and counseling in prisons with different policies for HIV testing (voluntary, during medical evaluation; voluntary, during peer-led class; mandatory) and counseling (all counseled, or pretest counseling not required and posttest for positive only). Prisoner testing rates were 46% “voluntary, peer- led”, 78% “mandatory”, and 86% “voluntary, medical.” Less than 50% received any counseling. Results suggest the potential value of coordinating HIV and STD/hepatitis services across all policies. Risk behaviors or demographic factors were only associated with one testing or one counseling policy. Prisons can achieve high rates of HIV testing by routinely offering voluntary HIV testing during the medical intake process, and this may result in increased diagnosis of HIV infection.


Theodore M. Hammett, Abigail Drachman-Jones
# HIV/AIDS, Sexually Transmitted Diseases, and Incarceration Among Women: National and Southern Perspectives
Sexually Transmitted Diseases, July supplement 2006, Vol. 33, No. 7, p.S17–S22
Given the concentrations of rural black women with HIV/AIDS and STDs in southern correctional facilities, it is important to recognize that prisons and jails are critical settings in which to deploy programs for the prevention, diagnosis, and treatment of infectious diseases and other health problems. Such interventions, as well as interventions focused on the rural communities themselves, would benefit not only inmates and releasees, but also the larger public health...


Rick Lines, Ralf Jürgens, Glenn Betteridge, Heino Stöver, Dumitru Laticevschi, Joachim Nelles
# Prison Needle Exchange: Lessons from a Comprehensive Review of International Evidence and Experience
Canadian HIV/AIDS Legal Network 2004 - 2006(2)

Worldwide, rates of HIV-infection in prison populations tend to be much higher than those found in the general population. Canada is no exception. Much of the data regarding HIV/AIDS in prisons come from developed, high-income countries; relatively little information is available for developing countries and countries in transition. Even within highincome countries, the precise number of HIV-positive prisoners is difficult to estimate. This difficulty is attributable to different testing protocols (voluntary testing, testing of all new prisoners, testing where there are outbreaks of infection). The general applicability of infection rates determined by studying populations in a particular prison or region may also be a poor reflection of national prison prevalence, given that the burden of HIV infection may vary from region to region within a country.


Prison Reform Trust and the National AIDS Trust

# HIV and hepatitis in prisons: addressing prisoners’ healthcare needs

Prison Reform Trust/ National AIDS Trust - London 2005


Prison Reform Trust | National AIDS Trust

# HIV and hepatitis in UK prisons: addressing prisoners’ healthcare needs
http://www.nat.org.uk/ 2005

In the UK, the two main groups affected by HIV are men who have sex with men and black Africans. IDUs are only a small proportion of those living with HIV in the UK. Only 6.5 per cent of all HIV diagnoses reported in the UK to the end of 2003 had probably been acquired through injecting drug use.10 HIV prevalence amongst IDUs attending specialist services is 0.5 per cent in England,Wales and Northern Ireland, and 0.4 per cent in Scotland, but 2.9 per cent in London. These rates are, however, significantly above general population HIV prevalence rates and have important implications for prisons given the large proportion of those imprisoned who have been IDUs. Recent significant increases in the black African prison population could also have increased HIV prevalence in prison. There are 16,200 black African men and women living with HIV in the UK, 31 per cent of the total number of those living with HIV and the largest group affected by HIV through heterosexual sex. In 2000, the population of white prisoners represented 188 per 100,000 in the general population. In the same year, the rate for black prisoners was 1,615 and black Africans in particular were incarcerated at a rate of 1,704 per 100,000.


Human Rights Watch
# Inhumane Prison Conditions Still Threaten Life, Health of Alabama Inmates Living with HIV/AIDS, According to Court Filings
www.hrw.org/ February 27, 2005
We are deeply concerned about recent reports that Limestone inmates living with HIV/AIDS continue to endure inhumane conditions, in clear violation of the terms of the settlement agreement. We urge you to take immediate action to ensure compliance with the settlement agreement, and to stop any abuses of the rights to life and health that plague Limestone’s HIV-positive inmates.


Kate A Dolan, Murdo Bijl and Bethany White

# HIV education in a Siberian prison colony for drug dependent males
International Journal for Equity in Health 2004, 3:7

Among the general population, the number of new HIV infections in Russia has increased dramatically in the past decade. National statistics show an explosive rise from 24 new HIV cases in 1987 to 88,494 in 2001. Among all registered HIV cases with known risk factors, 94% were attributed to injecting drug use. During this same period, Russia's prison population has experienced epidemics in both tuberculosis and HIV. During  the first half of 2002 alone, 17 percent of registered HIV cases in Russia were among prison inmates. In 2002, there were 34,000 HIV positive prisoners in Russia, 95 percent of whom were injecting drug users. Russia has the second highest rate of imprisonment in the world at 665 per 100,000 [6]. Nationwide there are hundreds of penal facilities and close to one million prisoners. The prevalence of HIV and other infectious diseases are typically higher among prison populations than the surrounding communities, and numerous studies have demonstrated high levels of HIV risk behaviours in prison such as injecting drug use, tattooing and sexual activity. Research has found that inmates worry about contracting HIV while in prison and that prison can be an ideal setting for HIV education.


Grace E. Macalino, David Vlahov, Stephanie Sanford-Colby, Sarju Patel, Keith Sabin, Christopher Salas, Josiah D. Rich
# Prevalence and Incidence of HIV, Hepatitis B Virus, and Hepatitis C Virus Infections Among Males in Rhode Island Prisons
Am J Public Health 2004; 94:1218–1223
High infection prevalence among inmates represents a significant community health issue. General disease prevention efforts must include prevention within correctional facilities. The high observed intraprison incidence of HBV underscores the need to vaccinate prison populations.


Ann N. Burchell, Liviana M. Calzavara, Ted Myers, Julia Schlossberg, Margaret Millson, Michael Escobar, Evelyn Wallace, Carol Major
# Voluntary HIV testing among inmates: Sociodemographic, behavioral risk, and attitudinal correlates
JAIDS Journal of Acquired Immune Deficiency Syndromes 32:534–541 2003
e sought to determine the prevalence and correlates of self-reported HIV testing among inmates in correctional centers in Ontario, Canada. A cross-sectional survey was conducted with a stratified random sample of 597 male and female adult inmates. The participation rate was 89%. Descriptive statistics and multiple logistic regression were used to analyze HIV testing. Fifty-eight percent had ever been tested, and 21% had voluntarily tested while incarcerated in the past year. Having ever been tested was more common among those at risk for HIV through injection drug use (IDU) or sexual behavior...The predominant motivations for testing while incarcerated were IDU or fears of infection inside, possibly through contact with blood, during fights, or even by casual contact. Voluntary HIV testing in prison should be encouraged, and inmates should receive appropriate counseling and information to allow realistic assessment of risk...


S. Ardita - B. Brunetti - G. Starnini - S. Babudieri

# Incompatibilità con lo stato di detenzione dei pazienti con infezione da HIV
Rassegna Penitenziaria e Criminologica, Numero 3 - 2003

# Norme su HIV - AIDS e incompatibilità con la detenzione


National Minority AIDS Council

# Women and HIV/AIDS in Prisons and Jails

Washington 2003

Women prisoners are a minority of the United States prison population, but they are very highly affected by HIV/AIDS. Incarcerated women are 36 times as likely as non-incarcerated women to be living with HIV/AIDS.


Paola Comucci
# Considerazioni sulla normativa regolante i rapporti fra detenzione e infezioni da HIV
Rassegna Penitenziaria e Criminologica, Numero 3 - 2002


Rachel Maddow - National Minority AIDS Council
#  Pushing for Progress:HIV/AIDS in prisons
National Minority AIDS Council. Buildin Healthier Communities -Washington 2002


Morag MacDonald, Daniele Berto
# Harm Reduction in Italian and UK Prisons: The Gap Between Policy and Implementation for HIV and Drugs.
The 13th International Conference on the Reduction of Drug Related Harm, Ljubljana, Slovenia, 3-7 March 2002
Even when there are effective harm-reduction measures in the community it is often difficult to apply them to the prison environment. One of the aims of the Department of Health Care in the UK, since its inception in 1993, was to place more emphasis on the promotion of heath to move prison medicine away from the treatment model to the health-promotion model. This reflected the national trend in health care. The Health Advisory Committee for the Prison Service supported the idea of health promotion and considered the prison setting to be a site where WHO guidelines should apply. Despite the emphasis on health promotion, the development of HIV prevention in prison has been quite different to how it developed in the wider community.


Beena Varghese, Thomas A. Peterman
# Cost-Effectiveness of HIV Counseling and Testing in US Prisons
Journal of Urban Health: Bulletin of the New York Academy of Medicine Vol. 78,No. 2,June 2001
Our baseline model shows that, compared to no CT, offering CT (counseling and testing) to 10,000 inmates detects 50 new or previously undiagnosed infections and averts 4 future cases of HIV at a cost of $125,000 to prison systems. However, this will save society over $550,000. Increase in HIV prevalence, risk of transmission, or effectiveness of counseling increased societal savings. As prevalence increases, focusing on HIV- infected inmates prevents additional future infections; however, when HIV prevalence is less than 5%, testing and counseling of both infected and uninfected inmates are important for HIV prevention...


F. Cannizzaro, A. Mazzari
# AIDS e carcere nell'evoluzione legislativa
Temi Romana, 2000, p. 487

Paradossalmente l'attuale stato dell'arte della ricerca scientifica che, pur mancando l'obiettivo salvifico del ''vaccino'', ha individuato adeguati ed efficaci sistemi di terapia, ancorché costosi e particolarmente stressanti per la compliance dei pazienti (fino a 18 farmaci giornalieri, ancorché intervallati da brevi periodi di sospensione della somministrazione) che comportano un recupero della capacità immunitaria e dell'attitudine al reinserimento nella vita sociale e lavorativa, aggrava enormemente il problema AIDS, che non ammette l'indifferenza istituzionale.


United Nations Programme on HIV/AIDS (UNAIDS)
# WHO guidelines on HIV infection and AIDS in prisons
Geneva 1993/1999

Compulsory testing of prisoners for HIV is unethical and ineffective, and should be prohibited. Voluntary testing for HIV infection should be available in prisons when available in the community, together with adequate pre- and post-test counselling. Voluntary testing should only be carried out with the informed consent of the prisoner. Support should be available when prisoners are notified of test results and in the period following.


Dorothy Jolofani and Joseph DeGabriele (Penal Reform International)

# HIV / AIDS in Malawi Prisons. A study of HIV transmission and the care of prisoners with HIV / AIDS in Zomba, Blantyre and Lilongwe Prisons

Penal Reform International, Paris 1999

HIV transmission and the care of prisoners with HIV / AIDS in African Prisons is of serious concern. However as the Dakar Conference pointed out, "our level of understanding is superficial". The report goes on to say that "the underlying causes of this deficiency are the absence of tools needed for an accurate assessment of the epidemic, the impenetrable nature of the prison environment, legal constraints, and the insulation of those actors who could make a difference"...

Although many prisoners come into custody already infected with HIV, there is evidence that HIV transmission in prison is a problem, especially at ZCP. Only a very few prisoners said that their main concern was that HIV was transmitted through shared razor blades and toothbrushes. Most prisoners and POs acknowledged that homosexual activity was common and that this was the main method of transmitting HIV within prison. Furthermore although some prisoners felt uncomfortable in discussing issues pertaining to homosexual activity, most were very open about it. We are also sure that there was no misunderstanding involved: homosexual activity involves anal sex. In order to reduce the transmission of HIV it is necessary to understand some of the patterns of homosexual activity in prisons, who is involved and why.


Massimo Montisci
# Aids e carcere, in "HIV/AIDS: Diritti e responsabilità"
N N D Network Nazionale sulle Dipendenze 1998
Sintetizzando l’ampio dibattito scientifico in materia, è da ritenere sostanzialmente inutile lo screening universale, come anche quello selettivo, obbligatorio. Questo sia per le così dette categorie a rischio, sia per altri particolari gruppi, quale appunto quello della popolazione carceraria.  Detta convinzione si fonda su numerose e varie considerazioni dettagliatamente esposte da diversi autori6 e sulle quali non ci si sofferma. Vale per tutti, a prescindere da difficoltà organizzative, la semplice convinzione dell’importanza della collaborazione e della fiducia nel rapporto con il sieropositivo e con il malato di AIDS, tanto più se detenuto. L’imposizione di norme coercitive non farebbe altro che spingere queste persone a comportamenti autodistruttivi aggressivi nei confronti della società. In tal senso quindi risulta importante l’adozione di una strategia fondata sull’offerta consapevole ed informata del test.


Rossella Snenghi

# Aids e tossicodipendenza, in "HIV/AIDS: Diritti e responsabilità"
N N D Network Nazionale sulle Dipendenze 1998

In Italia i dati sulle attività dei SERT, relativamente alla diffusione del virus HIV tra i soggetti trattati, dimostrano complessivamente la decrescita dei casi di sieropositività (periodo 1991-1996). La proporzione dei soggetti infetti è comunque più bassa nei nuovi ingressi di sesso maschile e più elevata nei vecchi utenti di sesso femminile. La minore prevalenza dell’infezione tra i nuovi utenti si può spiegare con la minore età di questi soggetti rispetto a quelli in carico, e quindi desumibilmente con una storia di droga più breve e di minore esposizione al rischio di infezione. D’altronde posto che l’età media dei nuovi utenti sta aumentando, mentre si riduce nel tempo la prevalenza dell’infezione, si potrebbe ammettere che i vari interventi di informazione-educazione sulle modalità di contagio abbiano modificato i comportamenti dei nuovi adepti al consumo di stupefacenti...


Matt Gaughwin

# Behind Bars - Risk Behaviours For HIV Transmission In Prisons. A Review
National Centre for Epidemiology and Population Health - Australian National University Canberra, ACT - 1991

Prisons have responsibilities and power to make a substantial contribution to stemming HIV transmission. To accept such responsibility will require courage and the insight that they do not exist in a world which is apart from the communities in which they are located and that they need to address with their communities the welfare of prisoners both while they are in prison and while they are outside.


Teresa Abate

#  AIDS e penitenziario: una visione europea sulle problematiche gestionali
Rassegna Penitenziaria e Criminologica, Numero 1,3 - 1989


il raggio della questione



Tetyana I. Vasylyeva, Samuel R. Friedman, Jose Lourenco, Sunetra Gupta, Angelos Hatzakis, Oliver G. Pybusa, Aris Katzourakis, Pavlo Smyrnov, Timokratis Karamitros, Dimitrios Paraskevis, Gkikas Magiorkinis
# Reducing HIV infection in people who inject drugs is impossible without targeting recently-infected subjects
http://journals.lww.com/ 28 november 2016

As a large proportion of transmissions among PWID (people who inject drugs) occur within 1 month after infection, reducing and delaying transmissions through scale-up of harm reduction programmes should always form the backbone of HIV control strategies in PWID. Growing PWID populations in the developing world, where primary prevention is scarce, constitutes a public health time bomb.


# Global AIDS Update
www.who.int/ 2016
# UNAIDS, 17 million people with access to antiretroviral therapy, www.who.int/ 31 May 2016

The new UNAIDS report highlights both the enormous gains already made and what can be achieved in the coming years through a fast-track approach. In just the last two years the number of people living with HIV on antiretroviral therapy has increased by about a third, reaching 17.0 million people—2 million more than the 15 million by 2015 target set by the United Nations General Assembly in 2011. This accounts to 46% of all people who need ART, with additional 2 million people starting treatment during last year.


Giacomo Galeazzi, Ilario Lombardo
# Hiv: in Italia il virus silenzioso contagia 11 persone al giorno
La Stampa, 6 marzo 2016
Quattro sieropositivi su dieci lo nascondono ai familiari, il 5% al partner. Quasi uno su tre è immigrato. E adesso arriva il primo piano nazionale anti-Aids. Le risorse per comunicazione su Aids e sesso sicuro sono crollate: il ministero della Salute nell'ultimo anno ha stanziato solo 80 mila euro. Ogni giorno, in Italia, 11 persone scoprono di essere sieropositive. Secondo l'Istituto Superiore di Sanità le nuove diagnosi di infezione da Hiv sono 4 mila l'anno. Siamo il secondo Paese in Europa per incidenza di Aids, dopo il Portogallo.



# Fact Sheet 2015 - Global Statistics

www.unaids.org/ 2015

15.8 million people accessing antiretroviral therapy (June 2015) | 36.9 million [34.3 million–41.4 million] people globally were living with HIV (end 2014) | 2 million [1.9 million–2.2 million] people became newly infected with HIV (end 2014) | 1.2 million [980 000–1.6 million] people died from AIDS-related illnesses (end 2014) |  As of June 2015, 15.8 million people living with HIV were accessing antiretroviral therapy, up from 13.6 million in June 2014...


# On the Fast-Track to end AIDS by 2030. Focus on location and population
Prisons have higher prevalence of HIV infection, hepatitis B and C and TB, as well as elevated risks for contracting such diseases and reduced access to health services. The HIV prevalence in prisons and other closed settings is 2–10 times, and in rare cases up to 50 times, higher than in the general population. TB incidence rates are an average 23 times higher than in the general population, and TB drug resistance rates and TB-related death rates are higher. The prevalence of hepatitis C is far higher among people held in prison, especially among those with a history of injecting drug use.


Liz Highleyman
# Successful hepatitis C treatment lowers risk of death for people with HIV and HCV co-infection
www.aidsmap.com/ 28 October 2015
Lars Peters of Rigshospitalet in Copenhagen, Denmark, and fellow investigators with the COHERE Hepatitis Subgroup looked at the long-term risk of all-cause, liver-related and non-liver-related death among people with HIV and HCV co-infection, and its relation to hepatitis C treatment response, in a large multi-cohort study. Prior research has shown that sustained response to hepatitis C treatment is associated with reduced mortality among HIV-negative people with HCV, Peters noted as background. The survival benefit of treatment for people with co-infection could be greater due to their accelerated fibrosis progression, or less because they are more likely to die of other ‘competing’ causes.


EACS European AIDS Clinical Society
# Guidelines. Version 8.0
www.eacsociety.org/ October 2015
The appropriate management of co-morbidities, which include cardiovascular, pulmonary, hepatic, metabolic, neoplastic, renal, bone, central nervous system disorders as well as sexual dysfunction, has increasingly become an integral part of the overall management of individuals living with HIV. Potential contributors to co-morbidity pathogenesis include a higher prevalence of recognised risk factors, ART-exposure and toxicity, HIV itself as well as immune dysfunction/dysregulation and chronic immune activation/inflammation, associated with HIV or other co-infections (e.g. CMV, HCV)

# EACS European AIDS Clinical Society, Guidelines 7.1, November 2014


Gus Cairns
# The majority of migrants living with HIV in Europe may have acquired HIV in their new country
www.aidsmap.com/ 23 October 2015
A study presented at the 15th European AIDS Conference yesterday found evidence that the majority of migrants living with HIV in Europe, and who were diagnosed less than five years ago, probably acquired the virus in their host country rather than the one in which they were born. The aMASE (Advancing Migrant Access to Health Services in Europe) study found that the proportion of people with a documented or probable date of HIV infection later than their move to, or within, Europe was higher than those with a documented or probable pre-migration infection date, and that this applied to all risk groups, all areas of origin, and both sexes.


Ibidun Fakoya, Débora Álvarez-del Arco, Melvina Woode-Owusu, Susana Monge, Yaiza Rivero-Montesdeoca, Valerie Delpech, Brian Rice, Teymur Noori, Anastasia Pharris, Andrew J. Amato-Gauci, Julia del Amo, Fiona M. Burns
# A systematic review of post-migration acquisition of HIV among migrants from countries with generalised HIV epidemics living in Europe: mplications for effectively managing HIV prevention programmes and policy
www.biomedcentral.com/ BMC Public Health (2015) 15:561
Migrant populations from countries with generalised HIV epidemics make up a significant proportion of all HIV/AIDS cases in many European Union and European Economic Area (EU/EEA) countries, with heterosexual transmission the predominant mode of HIV acquisition. While most of these infections are diagnosed for the first time in Europe, acquisition is believed to have predominantly occurred in the home country. A proportion of HIV transmission is believed to be occurring post-migration, and many countries may underestimate the degree to which this is occurring. Our objectives were to review the literature estimating the proportion of migrants believed to have acquired their HIV post-migration and examine which EU member states are able to provide estimates of probable country of HIV acquisition through current surveillance systems.


Kpandja Djawe, Kate Buchacz, Ling Hsu, Miao-Jung Chen, Richard M. Selik, Charles Rose, Tiffany Williams, John T. Brooks, Sandra Schwarcz
# Mortality Risk After AIDS-Defining Opportunistic Illness Among HIV-Infected Persons—San Francisco, 1981–2012
Journal of Infectious Diseases, 2015
Survival after first AIDS-OI diagnosis has improved markedly since 1981. Some AIDS-OIs remain associated with substantially higher mortality risk than others, even after adjustment for known confounders. Better prevention and treatment strategies are still needed for AIDS-OIs occurring in the current HIV treatment era.

# Thirty years of AIDS data highlight survival gains, room for improvement
medicalxpress.com/ 2015, June 4


USAID | PEPFAR | LINKAGES Across the Continuum of HIV Services for Key Populations
# Quarterly Research Digest on HIV and Key Populations
www.fhi360.org/ March 2015
The LINKAGES Project is pleased to provide this quarterly compilation of article abstracts from the peer- eviewed literature related to HIV and key populations in Africa, Asia and Pacific, Eastern Europe, Latin America, the Caribbean, and the Middle East. Abstracts are grouped by type of key population. This quarterly digest includes articles published between December 1, 2014 and March 1, 2015. For open access articles, we include the link to the full text.


Maruthappu, Mahiben, Charlie Da Zhou, Callum Williams, Thomas Zeltner, Rifat Atun
# Unemployment, public–sector health care expenditure and HIV mortality: An analysis of 74 countries, 1981–2009
Journal of Global Health 5(1) 2015
Recent economic turmoil has resulted in increased unemployment and decreased PSEH (public–sector expenditure on health care) in countries around the world, raising the question of how economic changes, both within and outside crises, impact population health. Our study has shown that unemployment rises, and falls in PSEH, between 1981 and 2009, have been significantly associated with prolonged worsened HIV mortality. Policy interventions and austerity measures which negatively influence employment and PSEH may present additional barriers to HIV management.


Jennifer A Smith, Monisha Sharma, Carol Levin, Jared M Baeten, Heidi van Rooyen, Connie Celum, Timothy B Hallett, Ruanne V Barnabas

# Cost-eff ectiveness of community-based strategies to strengthen the continuum of HIV care in rural South Africa: a health economic modelling analysis
Lancet HIV, February 24, 2015
Expansion of the use of antiretroviral therapy is a major component of approaches to control the HIV epidemic, particularly vital in sub-Saharan Africa, where about 1·5 million new HIV infections occur each year. However, despite the high burden of disease, only a third of adults in sub-Saharan Africa have been tested for HIV in the past year, and less than a third of those testing positive receive antiretroviral therapy.


# Statistics: worldwide...


European Centre for Disease Prevention and Control ECDC | World Health Organization WHO
# HIV/AIDS surveillance in Europe 2013
www.ecdc.europa.eu/ Scientific Publication - Nov 2014
# Valeria Pini, Hiv, la sfida perdente dell'Europa: mai così tanti casi. Oltre 136mila nel 2013, www.repubblica.it  1 dicembre 2014


Ecdc European Centre for Disease Prevention and Control
# From Dublin to Rome: ten years of responding to HIV in Europe and Central Asia
Stockholm, November 2014

During the last ten years, there has been a 36% decrease in newly reported cases of HIV among people who inject drugs in the EU/EEA (although there was a slight increase in 2011 and 2012 due to localised outbreaks in Greece and Romania). In 2013, transmission due to injecting drug use in the EU/EEA accounted for only 5% of new reported HIV diagnoses. This reflects the significant efforts made by many countries to implement effective harm reduction programmes at scale. In countries where people who inject drugs account for a significant proportion of prisoners, HIV prevalence among prisoners has also declined.


Lila - Dipartimento di Psicologia dell’Università di Bologna
# Question aid. Indagine su conoscenze e comportamenti in materia di HIV/AIDS
www.cesdop.it/ 26 novembre 2014

... Il campione valido è di 11.588 questionari. Il 64% ha riferito di aver effettuato almeno una volta il test HIV, di questi, il 49% lo ha effettuato negli ultimi 12 mesi. Il risultato dell’ultimo test HIV effettuato è stato positivo per il 12% dei casi mentre le persone con HIV risultano essere il 7% dell’intero campione. Quattro persone su dieci conoscono il termine di tre mesi necessario per considerare l’esito di un test HIV definitivo....


# Global Report. UNAIDS report on the global AIDS epidemic 2013
Joint United Nations Programme on HIV/AIDS (UNAIDS) 2013

The world is within reach of providing antiretroviral therapy to 15 million people by 2015. In 2012, 9.7 million people in low- and middle-income countries received antiretroviral therapy, representing 61% of all who were eligible under the 2010 World Health Organization (WHO) HIV treatment guidelines. However, under the 2013 WHO guidelines, the HIV treatment coverage in low- and middle-income countries represented only 34% (32-37%) of the 28.3 million people eligible in 2013. Antiretroviral therapy not only prevents AIDS-related illness and death: it also has the potential to significantly reduce the risk of HIV transmission and the spread of tuberculosis...


HIV Cooperation Program for Indonesia HCPI
# Methadone Maintenance Treatment in Indonesian Prisons
www.grminternational.com/ 2014


UNAIDS | unicef | World Health Organization
# Global AIDS response progress reporting 2013: Construction of core indicators for monitoring the 2011 UN Political Declaration on HIV/AIDS
Joint United Nations Programme on HIV/AIDS (UNAIDS) 2013

The goal in the response to HIV is to reduce HIV infection. HIV prevalence at any given age is the difference between the cumulative numbers of people that have become infected with HIV up to this age minus the number who have died, expressed as a percentage of the total number alive at this age. At older ages, changes in HIV prevalence are slow to reflect changes in the rate of new infections (HIV incidence) because the average duration of infection is long. Furthermore, declines in HIV prevalence can reflect saturation of infection among those individuals who are most vulnerable and rising mortality rather than behaviour change. At young ages, trends in HIV prevalence are a better indication of recent trends in HIV incidence and risk behaviour. Thus, reductions in HIV incidence associated with genuine behaviour change should first become detectable in trends in HIV prevalence figures for 15–24 years olds (or even earlier in 15-19-year-olds if this age breakdown is available). Where available, parallel behavioural surveillance survey data should be used to aid interpretation of trends in HIV prevalence.


WHO World Health Organization
# HIV operational plan 2012-2013: WHO’s support to implement the Global health sector strategy on HIV/AIDS.
World Health Organization 2012 - Printed in France

Goal: All countries with low-prevalence or concentrated HIV epidemics have halted or reversed HIV prevalence among populations at higher risk of HIV infection (people who inject drugs and their sexual partners, sex workers, men who have sex with men and transgender people, prisoners and migrants) by 2015.

Guidance on integrating HIV, TB and drug dependence services will be developed in collaboration with partners, with technical assistance and support provided to support implementation at the country level. Guidance and technical support will be developed for integrating HIV services with TB and drug dependence services, and on comanagement of HIV/TB services for specific populations and settings, including harm reduction and prison health programmes.


Michel Sidibé, Peter Piot, Mark Dybul [UNAIDS, 1211 Geneva, Switzerland (MS); London School of
Hygiene and Tropical Medicine, London, UK (PP); and The Global Fund to Fight AIDS, TB and Malaria, Geneva, Switzerland (MD)]

# AIDS is not over

www.thelancet.com Vol 380 December 15/22/29, 2012

The estimates from the Global Burden of Disease Study 2010 confi rm that HIV/AIDS remained a leading cause of disease burden and death in 2010.3 It was ranked 33rd in 1990, but its burden had moved up to fi fth by 20044 and remained there in 2010...
Worldwide AIDS-related deaths increased dramatically during the late 1980s and peaked in 2005–06, followed by a steep decline to 2010–11. Yet, despite substantial reductions in AIDS mortality rates in many countries, AIDS remains the leading cause of death in southern and eastern Africa, and ranks number three in eastern Europe. Furthermore, AIDS continues to aff ect young people disproportionately. In 2010, AIDS was the leading cause of death in women aged 15–49 years (14·4%) and the second most common cause of death for men aged 15–49 years (10·7%). UNAIDS  estimated that 34 (range 31·4–35·9) million people lived with HIV in 2011...



# Death due to AIDS (HIV-disease), by sex

Publish Date : 03-JAN-2013 -- http://epp.eurostat.ec.europa.eu/

Death rate of a population adjusted to a standard age distribution. As most causes of death vary significantly with people's age and sex, the use of standardised death rates improves comparability over time and between countries, as they aim at measuring death rates independently of different age structures of populations. The standardised death rates used here are calculated on the basis of a standard European population (defined by the World Health Organization).


WHO World Health Organization - Europe

#  HIV/AIDS country profile 2011: Italy
© World Health Organization 2012

Prendendo in considerazione le infezioni non diagnosticate, il Programma delle Nazioni Unite sull'HIV / AIDS (UNAIDS) e l'OMS stimano che 140 000 persone vivevano con l'HIV in Italia nel 2009 e che meno di 1000 persone sono morte per cause AIDS correlate nel corso del 2009 ... Nel 2008, circa 95 000 persone in Italia sono state sottoposte a terapia antiretrovirale.


Istituto Superiore di Sanità - Centro Operativo AIDS || ISS -- COA

#  Aggiornamento delle nuove diagnosi di infezione da HIV e dei casi di AIDS in Italia al 31 dicembre 2011

Notiziario dell'Istituto Superiore di Sanità - Supplemento 1 - 2012

Dal 2010 i dati sulla sorveglianza delle nuove diagnosi di infezione da HIV sono disponibili per tutte le regioni italiane. Nel periodo 1985-2011, sono state riportate 52.629 nuove diagnosi di infezione da HIV. L’incidenza delle nuove diagnosi ha visto un picco di segnalazioni nel 1987, per poi diminuire fino al 1998 e stabilizzarsi successivamente. Nel 2011 l’incidenza era pari a 5,8 nuovi casi per 100.000 residenti. Negli anni si osserva un aumento dell’età mediana alla diagnosi, nonché un cambiamento delle modalità di trasmissione: diminuisce la proporzione di tossicodipendenti ma aumentano i casi attribuibili a trasmissione sessuale. Nel 2011 sono stati segnalati al COA 774 casi di AIDS diagnosticati nel 2011, e 486 casi diagnosticati negli anni precedenti.



Prevenzione Trattamento


Fan Yang, Xiuye Shi, Weihua He, Songjie Wu, Jiaojiao Wang, Kai Zhao, Hongfang Yuan, Kuete Martin, Huiping Zhang
# Factors of the HIV Transmission in Men Who Have Sex with Men in Suizhou City from 2009 to 2013
Sex Med 2015;3:24–31
Results of our study highlight sexual orientation of the young male Chinese population despite their educational level and official heterosexual status. Even though, sexual behavior changes occurred after interventions among MSM living in Suizhou City, additionally, high condom use was reported during sexual intercourse with female partner. Further efforts are needed to improve on the field of the government’s responses to the epidemic in the midst of MSM.


Ministero della Salute
# Linee Guida Italiane sull’utilizzo dei farmaci antiretrovirali e sulla gestione diagnostico-clinica delle persone con infezione da HIV-1
www.salute.gov.it/ 18 dicembre 2014
L’inizio della terapia antiretrovirale di combinazione (cART) è un momento cruciale nella gestione del programma di cura dell’HIV/AIDS, il cui successo, che in gran parte dipende dall’aderenza al percorso di trattamento richiede accettazione, comprensione e condivisione da parte del paziente. Una buona relazione medico-paziente è determinante al fine di garantire il successo dell’esordio di terapia e deve essere caratterizzata da: Un rapporto di reciproca fiducia; Una qualità della comunicazione condivisa... 


Élise Marsicano, Rosemary Dray-Spira, France Lert, Christine Hamelin
# Les personnes vivant avec le VIH face au discriminations en France métropolitaine
www.ined.fr/ Population & Sociétés Novembre 2014
En France, les personnes vivant avec le VIH, c’est-à-dire séropositives, ont accès à des traitements antirétroviraux qui contrôlent l’infection et devraient leur assurer une vie normale. Ce n’est malheureusement pas le cas. Utilisant une enquête nationale représentative menée en 2011, Élise Marsicano, Rosemary Dray-Spira, France Lert et Christine Hamelin décrivent les discriminations auxquelles ces personnes font face, que ce soit au travail, chez le médecin ou à l’hôpital, en famille, et distinguent celles liées à leur séropositivité de celles liées à d’autres motifs.


Xuefeng Li, Hongyan Lu, Catherine Cox, Yuejuan Zhao, Dongyan Xia, Yanming Sun, Xiong He, Yan Xiao, Yuhua Ruan, Yujiang Jia, and Yiming Shao
# Changing the Landscape of the HIV Epidemic among MSM in China: Results from Three Consecutive Respondent-Driven Sampling Surveys from 2009 to 2011
BioMed Research International, 2014

Historically, the HIV epidemic in China has been confined to certain high-risk populations such as injection drug users (IDUs) and former blood and plasma donors in geographically disparate rural areas. In recent years, the synthesized data suggested that HIV transmission has begun to shift from IDUs to populations at risk through unprotected sex, either through heterosexual contacts or male homosexual sex, accounting for nearly half of all new infections in 2007...


Gang Zeng, Liangui Feng, Lin Ouyang, Rongrong Lu, Peng Xu, Guohui Wu, Fan Lu
# The Dynamic Trends of HIV Prevalence, Risks, and Prevention among Men Who Have Sex with Men in Chongqing, China
BioMed Research International, 2014
According to the national estimations of the HIV/AIDS epidemic in China, the proportion of HIV/AIDS cases infected via homosexual contact increased from 7.3% in 2005 to 13.0% in 2011. It was estimated that 29.4% of new HIV infections in 2011 were transmitted via homosexual contact...


Rui Cai
# Risk Factors and Interventions for HIV Control in China
Erasmus University Rotterdam
The HIV epidemic in China continues to expand and by the end of 2011 the cumulative number of HIV/AIDS cases was estimated at 780,000. Historically, injection drug users (IDUs) and former plasma donors (FPDs) were the two major groups affected by China’s HIV epidemic. However, HIV prevalence has lately increased rapidly among men who have sex with men (MSM). Nationally, the prevalence of HIV among MSM increased from 1.5% in 2005 to 5.0% in 2009...


Mauss − Berg − Rockstroh − Sarrazin − Wedemeyer (eds)
# Short Guide to Hepatitis C
www.HepatologyTextbook.com/ 2014 Edition
Of the 35 million HIV-infected persons worldwide in 2012 it is estimated that at least 5 million of them had hepatitis C virus infection. Whereas both viruses are transmitted with high efficacy via blood-to-blood contact, HCV is less easily transmitted sexually. Thus, the prevalence of hepatitis C coinfection within different countries, regions and populations is closely related to the prevalence of blood-borne transmission (mainly intravenous drug use) of HIV


Mohamed A. Daw, Amira Shabash, Abdallah El-Bouzedi, Aghnya A. Dau
# Seroprevalence of HBV, HCV & HIV Co-Infection and Risk Factors Analysis in Tripoli-Libya
www.plosone.org/ vol.9, 1 June 2014
This study gives clear insights into the epidemiology of these three viruses among Libyans, particularly the epidemiological status of HIV and co-infection, which has hardly been explored in previous studies. Our study highlights the risks that Libyans may face and provides data that would be useful for designing measures to limit HBV, HCV and HIV infections and coinfections.


# Vivere “al meglio” con HIV
ReAd files anno 15, n.2, giugno 2014


Giovanni Maga
# AIDS: la verità negata. Come l'HIV causa l’AIDS e perché dall'AIDS si potrà guarire
www.pensiero.it/ 2014

Negare l’AIDS non è semplicemente esprimere un’opinione controcorrente, per quanto assurda possa sembrare alla prova dei fatti. Negare l’AIDS significa indurre pazienti a rinunciare a terapie in grado di salvare loro la vita. Significa anche suscitare nelle nuove generazioni la falsa idea che l’AIDS e l’HIV non esistano, con il risultato di allargare ancora di più la pandemia e condannare quelle medesime generazioni e i loro figli allo stesso tragico destino occorso a milioni di persone negli ultimi trent’anni.


Steven G Deeks, Sharon R Lewin, Diane V Havlir
# The end of AIDS: HIV infection as a chronic disease
the Lancet, October 21, 2013
The idea of HIV as a chronic disease has emerged as a result of advances in treatment in the past three decades. Combination antiretroviral therapy (ART) improves health, prolongs life, and substantially reduces the risk of HIV transmission. In both high-income and low-income countries, the life expectancy of patients infected with HIV who have access to ART is now measured in decades...


Unaids | Unicef | Who
# 2013 progress report on the global plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive
Unaids Joint United Nations Programme on Hiv/aids June 2013

The Global Plan towards the elimination of new HIV infections among children by 2015 and keeping their mothers alive (Global Plan) was launched in July 2011 at the United Nations General Assembly High Level Meeting on AIDS. This report presents the interim progress made by 20 countries in sub-Saharan Africa and some of the challenges they face in meeting the agreed targets for 2015. Of the 22 Global Plan priority countries, data from India were not available at the time this report was written. Only provisional data were available from Uganda at the time of  publication. The preliminary results for Uganda are included in the aggregated values, but no country-specific data are presented here.


World Health Organization (in partnership with UNICEF and UNAIDS)
# Global update on HIV treatment 2013: results, impact and opportunities
WHO June 2013
Improving epidemiological surveillance has demonstrated that the HIV epidemic disproportionately affects certain populations, especially sex workers, men who have sex with men, transgender people and people who inject drugs. In some regions and countries, prison populations, refugee populations, migrants and mobile workers are also at higher risk of HIV infection. However, data detailing the access to ART of these populations remain extremely limited. One reason is that classifying people receiving ART as members of key populations can have serious human rights and legal complications in countries in which the behaviour associated with a key population is stigmatized and/or criminalized.


Sharon R Lewin | The Lancet
# A cure for HIV: where we’ve been, and where we’re headed
www.thelancet.com Vol 381 June 15, 2013
2013 marks the 30th anniversary of the discovery of HIV. 30 Years of HIV Science: Imagine the Future, a meeting at the Pasteur Institute in Paris, France, in May, 2013, sought to celebrate successes in countering the HIV/AIDS epidemic and to map out the challenges ahead. The successes have been spectacular. Antiretroviral therapy (ART) has transformed what was once a death sentence into a chronic manageable disease.


Institut Pasteur, Paris - France
# 30 years of HIV science: Imagine the future
www.30yearshiv.org/ May 21 - 23, 2013

May 2013 will mark the 30th year since the publication in Science reporting for the first time the identification of a retrovirus associated with AIDS-related syndromes, now referred to as human immunodeficiency virus. To celebrate this anniversary, the Institut Pasteur in collaboration with the U.S. National Institutes of Health, ANRS and Sidaction is organizing an international symposium. The objective of this symposium is not to trace the history of the discovery of the virus, but to focus on the critical challenges and the future priorities that remain in HIV science as a result of 30 years of fantastic achievements. Distinguished international speakers will share their findings and their vision of the priorities of HIV research in the coming years. The symposium will gather a broad array of participants: senior scientists, young investigators, students and clinical researchers working in HIV and related areas from developed as well as resource-limited countries.


Regina McEnery
# Mon Dieu! 30 Years of HIV Science. Leading researchers praise the field’s many successes—but remind us the war on AIDS is far from over
www.vaxreport.org/ VAX May 2013
Now in its fourth decade, the HIV pandemic already ranks among the most devastating in recorded history. And the scientific response has, in some ways, been historic as well. Scientists now know far more about the canny virus that causes AIDS than they do about any other viral pathogen. Even better, their discoveries have led directly to the development of a robust arsenal of antiviral drugs that have transformed both the treatment and the prevention of HIV. So the 500 scientists gathered at the Institut Pasteur in Paris for the 30 Years of HIV Science meeting May 21-23—marking the 30th anniversary of the discovery of HIV at that storied institution—had reason to feel at least a little proud...


Michael P Manns, Markus Cornberg
# Sofosbuvir: the final nail in the coffin for hepatitis C?
www.thelancet.com/infection Vol 13 May 2013
In February this year, Gilead Sciences announced that
patients with HCV genotype-3 are more difficult to treat than previously thought.16 However, these data give hope for patients with chronic HCV infection, and, barring any unforeseen surprises, sofosbuvir should be approved by early 2014.


H Guimarães Nebenzahl, Â Lopes, R Castro, F Pereira
# Prevalence of human immunodeficiency virus, hepatitis C virus, hepatitis B virus and syphilis among individuals attending anonymous testing for HIV in Luanda, Angola
South African Medical Journal, Vol 103, No 3 (2013)
Nearly a quarter (23.6%) of this clinic population had reactive antibodies/antigens to at least one of the infections studied. Among the 6% who had more than one reactive test, the most frequent co-infection was HIV and HBV. In conclusion, a high prevalence of the sexually transmitted infections studied was found in this clinic population. These results indicate a need to improve screening and treatment of HIV and STIs in Angola, and for health promotion campaigns aimed at reducing the morbidity and mortality associated with these diseases, and prevention of their transmission.


Ira M. Jacobson et. al.
# Sofosbuvir for Hepatitis C Genotype 2 or 3 in Patients without Treatment Options
The New England Journal of Medicine 2013

Patients chronically infected with hepatitis C virus (HCV) genotype 2 or 3 for whom treatment with peginterferon is not an option, or who have not had a response to prior interferon treatment, currently have no approved treatment options. In phase 2 trials, regimens including the oral nucleotide polymerase inhibitor sofosbuvir have shown efficacy in patients with HCV genotype 2 or 3 infection.


g. d. b.

# Epatite C - Farmaco orale, rapido, salvavita | avanza la ricerca ma costi più alti
la Repubblica 7 maggio 2013

Epatite C: killer silente, la patologia (nel 90% dei casi) decorre senza sintomi per anni, e nel 20/30% dei casi progredisce in cirrosi epatica. Alcol e concomitante infezione da HIV aggravano e accelerano i danni al fegato... La speranza arriva da un nuovo farmaco, il sofosbuvir...


CDC - Department of Health & Human Services - USA

# HIV and Tuberculosis

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB prevention
Division of HIV/AIDS Prevention - March 2013

In 2009, 1.1 million people in the United States were living with HIV, 18% of whom did not know they were infected. | The rate of new TB disease diagnoses in 2011 was 3.4 per 100,000 population (10,528 cases), the lowest since reporting began in 1953. | In 2011, 82% of patients with TB disease knew their HIV status. | Among 8,683 people with TB disease who had a documented HIV test result in 2011, 6% were coinfected with HIV.


Asier Saez-Cirio, Charline Bacchus, Laurent Hocqueloux, Veronique Avettand-Fenoel, Isabelle Girault, Camille Lecuroux, Valerie Potard, Pierre Versmisse, Adeline Melard, Thierry Prazuck, Benjamin Descours, Julien Guergnon, Jean-Paul Viard, Faroudy Boufassa, ANRS VISCONTI Study Group (Viro-Immunological Sustained CONtrol after Treatment Interruption)

# Post-Treatment HIV-1 Controllers with a Long-Term Virological Remission after the Interruption of Early Initiated Antiretroviral Therapy

www.plospathogens.org | PLOS Pathogens | 1 March 2013

The HIV controllers (HICs) were patients from the ANRS CO15 and CO18 cohorts who had been infected for more than 5 years, were naı¨ve of antiretroviral treatment and whose last 4 consecutive plasma HIV RNA values were less than 400 copies/ ml. Viremic (VIR) patients were defined as patients who were HIV-1-infected for more than 6 months, were not receiving antiretroviral therapy and had HIV-1 plasma viral loads greater than 7500 RNA copies/ml. cART-treated individuals (ARTs) were HIV-1-infected patients whose viral load had been less than 50 RNA copies/ml of plasma for at least 6 months on cART initiated either on PHI or CHI.


Zosia Kmietowicz
# Early HIV treatment led to “functional cure” in 14 patients, report researchers
BMJ 2013;346

French researchers have reported a group of 14 patients who achieved a “functional cure” of HIV after stopping antiretroviral treatment, some of whom have maintained an undetectable viral load for nearly 10 years.


Nicolas Foureur, Sandrine Fournier,  Marie Jauffret-Roustide, Vincent Labrouve, Xavier Pascal, Guillemette Quatremère, Daniela Rojas Castro - Association AIDES
# SLAM. Première enquête qualitative en France
AIDES - 2013
Slam. Mot anglais qui signifie « claquer ». Il désigne l'injection de produits divers de type psychostimulant (principalement des cathinones), dans un contexte sexuel. Le terme est utilisé par des hommes gays... L’utilisation de préservatifs ne parait pas être au centre des préoccupations des slameurs. Tout cela expose une fois de plus à un risque infectieux : IST bactériennes et virales, hépatites B et C et VIH. Enfin, les usagers n’étant pas habitués à ces pratiques d’injection ou ne se reconnaissant pas comme « toxicomanes », les prises de risques de contamination par le sang paraissent souvent sous-estimées... La création de nouveaux centres de santé sexuelle, répondant aux recommandations du Programme national de lutte contre le sida 2010-2014, devrait être envisagée : ces espaces semblent particulièrement adéquats pour accueillir les slameurs.


CDC - U.S. Centers for Disease Control and Prevention

# Epidemiology of HIV Infection through 2011

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB prevention
Division of HIV/AIDS Prevention - February 28, 2013


Patricia Gray
Strategies for Electronic Exchange of Sensitive Information: HIV, AIDS, and STDs
www.hietexas.org/ February 2013
The Privacy Rule does not specifically address HIV or AIDS, but it does authorize disclosure of protected health information (PHI) without the patient’s specific authorization for purposes related to public health, law enforcement, emergency management, and with limitations, research.


CDC - U.S. Centers for Disease Control and Prevention

HIV Among African Americans

National Center for HIV/AIDS, Viral Hepatitis, STD, and TB prevention - Division of HIV/AIDS Prevention - February 2013

African Americans accounted for an estimated 44% of all new HIV infections among adults and adolescents (aged 13 years or older) in in 2010, despite representing only 12% to14% of the US population. In 2010, black men accounted for 70% (14,700) of the estimated 20,900 new HIV infections among all adult and adolescent blacks. The estimated rate of new HIV infection for black men (103.6/100,000 population) was seven times as high as that of white men, twice as high as that of Latino men, and nearly three times as high as among black  women. In 2010, black gay, bisexual, and other men who have sex with men (MSM) represented an estimated 72% (10,600) of new infections among all black men and 36% of an estimated 29,800 new HIV infections among all MSM. More new HIV infections (4,800) occurred among young black MSM (aged 13-24) than any other age or racial group of MSM.


The SPARTAC Trial Investigators

# Short-Course Antiretroviral Therapy in Primary HIV Infection
The New England Journal of Medicine 368;3 January 17, 2013

In summary, we found that a 48-week course of ART during primary HIV infection delayed a decline in the CD4+ count to less than 350 cells per cubic millimeter or the initiation of longterm ART, but this delay was not significantly longer than the 48-week treatment period. However, our finding that, with the use of a realistic, clinically relevant definition of primary HIV infection, 48 weeks of ART altered the course of the two main markers of HIV disease progression — namely, the CD4+ count and the HIV RNA level — beyond the treatment period is an intriguing observation that requires further evaluation. For maximal individual benefit, future studies that examine longer courses of therapy, therapy initiated earlier in primary HIV infection, or both may be required.


# Short Pulse Anti Retroviral Therapy at HIV Seroconversion (SPARTAC)


Istituto Superiore di Sanità

# La normativa italiana in materia di HIV, AIDS e Infezioni Sessualmente Trasmesse (IST)
A cura di Anna Maria Luzi, Anna Colucci e Barbara Suligoi -- Dipartimento Malattie Infettive, Parassitarie ed Immunomediate

2012, vi, 80 p. Rapporti ISTISAN 12/8

La finalità prioritaria di questo lavoro è stata quella di realizzare una Guida comprendente le principali disposizioni legislative, regolamentari e amministrative per una più facile e rapida consultazione da parte di coloro i quali siano direttamente o indirettamente coinvolti nelle problematiche legate all’infezione da HIV e alle Infezioni Sessualmente Trasmesse (IST). Tale compendio di norme, quadri giurisprudenziali, indicazioni del Garante per la protezione dei dati personali e aspetti deontologici è articolato in due parti: la prima riguarda la legislazione in materia di infezione da HIV e AIDS, la seconda parte affronta il complesso quadro legislativo concernente le IST. Ognuna delle due parti si apre con una descrizione dello scenario epidemiologico, al quale segue una trattazione dettagliata, se pur non esaustiva, degli elementi normativi, giurisprudenziali, deontologici concernenti, rispettivamente, l’infezione da HIV e le Infezioni Sessualmente Trasmesse.


Melanie A. Thompson et al.
# Antiretroviral Treatment of Adult HIV Infection. 2012 Recommendations of the International Antiviral Society–USA Panel
©2012 American Medical Association - JAMA, July 25, 2012—Vol 308, No. 4         

New recommendations for HIV patient care include offering ART [antiretroviral therapy] to all patients regardless of CD4 cell count, changes in therapeutic options, and modifications in the timing and choice of ART in the setting of opportunistic illnesses such as cryptococcal disease and tuberculosis.


Panel on Antiretroviral Guidelines for Adults and Adolescents
# Guidelines for the Use of Antiretroviral Agents in HIV-1-Infected Adults and Adolescents
Developed by the HHS Panel on Antiretroviral Guidelines for Adults and Adolescents – A Working Group of the Office of AIDS Research Advisory Council (OARAC)
http://aidsinfo.nih.gov/guidelines - Last updated March 27, 2012


Polly Clayden, Simon Collins, Colleen Daniels, Nathan Geffen, Mark Harrington, Richard Jefferys, Coco Jervis, Karyn Kaplan, Erica Lessem, and Tracy Swan | Edited by Andrea Benzacar
#  2012 PIPELINE Report. HIV, Hepatitis C Virus (HCV), and Tuberculosis (TB) Drugs, Diagnostics, Vaccines, and Preventive Technologies in Development
i-Base/Treatment Action Group July 2012
Injection drug use is associated with many factors that place individuals at high risk for TB, including poor nutritional status, a weakened immune system, HIV and other infections, and substandard living conditions. Given the illicit nature of injection drug use in most settings, people who use injection drugs are often marginalized and have trouble accessing care. Separate silos of services for drug use, HIV, and TB make referrals to care unlikely; even worse, many drug users are imprisoned without medical services.66 Studies in both high- and low- TB burden settings—such as Denmark, Kenya, Thailand, the United States, and Vietnam—have documented that injection drug use is associated with TB infection, disease, and death.


The United Republic of Tanzania - Ministry of Health and Social Welfare Tanzania Mainland
# National AIDS Control Programme (NACP) - Fourth Edition
(April 2012) Dar es Salaam - Tanzania

Establish Intensified TB Case Finding - Intensified TB case finding involves screening for symptoms and signs of TB (Annex 9 TB screening tool) in settings where HIV-infected people are concentrated. Early identification of signs and symptoms of TB, followed by diagnosis and prompt treatment in people living with HIV/AIDS, their household contacts, groups at high risk for HIV, and those in congregate settings (e.g., prisons, police quarters, military barracks, refugee camps, mining camps, schools, and living quarters for workers, especially labour-intensive agricultural areas), increases the chances of survival, improves quality of life, and reduces transmission of TB in the community.

Incarcerated Prisoners and Those who Leave Prisons
• Promote voluntary screening for HIV, TB, STI, Hepatitis B and Hepatitis C among those incarcerated in prisons
• Provide access to care and treatment for HIV positive individuals incarcerated in prisons
• Provide access to care and treatment for HIV positive prisoners leaving prisons
• Provide TB/HIV collaborative activities within prisons...
Men who have Sex with Men (MSM)
• Promote voluntary screening for HIV, TB, STI, Hepatitis B and Hepatitis C among males who have sex with men (MSM) and their sexual partners
• Provide access to treatment for HIV positive men who have sex with men and their sexual partners (where indicated)...


African Union - Union Africaine - União Africana

# Roadmap on Shared Responsibility and Global Solidarity for AIDS, TB and Malaria Response in Africa

Developed by the African Union Commission (AUC) and the NEPAD [The New Partnership for Africa's Development] Planning and Coordinating Agency (NEPAD Agency), with support from UNAIDS

Addis Ababa, ETHIOPIA, 16 July 2012

Structured around three strategic pillars—health governance, diversified financing and access to medicines—the Roadmap offers a set of practical and African-owned solutions to enhance sustainable responses to AIDS, TB and malaria. It defines goals, expected results, roles and responsibilities to hold stakeholders accountable over a three-year time frame, through 2015...

Many African countries depend on external sources to provide life-saving medicines for their populations. In the case of AIDS, more than 80% of HIV drugs dispensed in Africa are imported. A vast majority of HIV medicines keeping Africans alive are paid for through external aid...
The Roadmap establishes a set of priority actions to accelerate access to affordable and quality-assured medicines in Africa. These include: strengthening African drug regulatory systems; ensuring that countries in Africa acquire essential health-related technologies and commodities through South-South cooperation; and removing trade barriers to allow for the emergence of pharmaceutical production hubs within Africa that can serve regional markets.


Human Rights Watch
# Sex Workers at Risk. Condoms as Evidence of Prostitution in Four US Cities
hrw.org July 2012

Police and prosecutors defended the use of condoms as evidence necessary to enforce prostitution and sex trafficking laws. However, the use of any type of evidence must be determined by weighing the potential harm that occurs from its use and the benefits provided. In legal systems everywhere, categories of potentially relevant evidence are excluded as a matter of public policy, with laws excluding testimony regarding a rape victim’s sexual history providing but one of many examples. Law enforcement efforts should not interfere with the right of anyone, including sex workers, to protect their health. The value of condoms for HIV and disease prevention far outweighs any utility in enforcement of anti-prostitution laws.


The U.S. President’s Emergency Plan for AIDS Relief
#  Eighth Annual Report to Congress on PEPFAR (2012)
U.S. Government interagency website managed by the Office of U.S. Global AIDS Coordinator
and the Bureau of Public Affairs, U.S. State Department


Public Health Agency of Canada
# Summary: Estimates of HIV Prevalence and Incidence in Canada, 2011

Centre for Communicable Diseases and Infection Control 2012

A total of 74,174 positive HIV tests have been reported to CCDIC since testing began in November 1985 through December 31, 2011. After adjusting for underreporting and duplicates, we estimated that there were a cumulative total of 77,620 persons diagnosed with HIV in Canada by the end of 2011. Of these, we further estimated that approximately 24,300 individuals have died. Thus, there were an estimated 53,320 (77,620 minus 24,300) Canadians living with HIV infection in 2011 who have been diagnosed with HIV (i.e. tested HIV-positive) and were therefore aware of their HIV status. Since there was an estimated total of 71,300 persons living with HIV in Canada in 2011, the remaining 17,980 (range of 14,500–21,500) persons, or 25% of prevalent cases, were unaware of their HIV infection (compared with an estimated 16,900 in 2008). This proportion is slightly lower than the estimate of 26% who were unaware of their HIV status in 2008.


Regione Lombardia - Direzione Generale Sanità - DECRETO n. 3546 del 23/04/2012
# Aggiornamento del documento avente ad oggetto "Percorso diagnostico terapeutico (PDT) del paziente affetto da malattia HIV/AIDS" approvato con decreto del Direttore Generale Sanità n. 7458 del 5 agosto 2011


# Together we will end AIDS

Copyright © 2012

 Getting to Zero ... Harm reduction... Nothing for us without us... A decade of antiretroviral treatment has transformed HIV from a death sentence to a manageable chronic disease. There is a real opportunity to eliminate new infections among children within the next three years, and our goal to ensure that 15 million people receive antiretroviral therapy by 2015 can be achieved. Yet every day, thousands more people are newly infected with HIV. Many are in groups at higher risk. They deserve special support and access to prevention services, such as condoms and measures to reduce harm. Others lack the information and resources they need and deserve to avoid infection. Far too many do not have the power to negotiate safer sex. Stigma against people living with HIV and those at higher risk of infection persists. This is a human rights violation that also hampers our ability to address AIDS. Stigma, discrimination, punitive laws, gender inequality and violence continue to inflame the epidemic and thwart our strongest efforts to ‘get to zero’...


Gestos - Hiv+ || World Aids Campaign WAC || UNAIDS

# Civil Society Accelerated Action to Promote The UNAIDS Agenda For Accelerated Country Action for Women, Girls, Gender Equality and HIV

Printed and bound at Gráfica Dom Bosco, Recife, 2012

The UNAIDS Agenda for Women and Girls was launched in March, 2010 and contains twenty-six strategic actions to be adapted and implemented at the country level and driven mainly through the United Nation Joint Teams on AIDS, in close collaboration with civil society, and government partners. A key objective is to ensure that national AIDS policies and programmes are responsive to the specific needs of women and girls, promoting and protecting their rights.


ECDC European Centre for Disease Prevention and Control

# Evaluating HIV treatment as prevention in the European context

This report was commissioned by the European Centre for Disease Prevention and Control (ECDC), coordinated by Mika Salminen, Anastasia Pharris and Marita van de Laar, and produced by the Research Department of Infection and Population Health, University College London Medical School, London, United Kingdom.

Stockholm, June 2012
1.1 HIV in Europe – epidemiology - Since the first cases of AIDS were identified in 1981(1), there have been dramatic increases in the number of individuals living with HIV and AIDS worldwide. The Joint United Nations Programme on HIV/AIDS (UNAIDS) estimate that more than 33 million HIV positive adults and young children were living worldwide at the end of 2009, of whom 820,000 were from Western and Central Europe, and 1.4 million were from Eastern Europe and Central Asia(2). New HIV infections occur most commonly through heterosexual sex, sex between men, transmission from mother to child and through exchange of blood products (e.g. through needle sharing in intravenous drug users and blood transfusions of infected blood). Despite concerted efforts to prevent new infections occurring, there were more than 27,000 newly diagnosed HIV infections reported in the European Union (EU) and the European Economic Area (EEA) in 2010. The reported number of people with diagnosed HIV is an underestimate of the number living with HIV due to delayed diagnosis, underreporting and reporting delay (3). Thus, further efforts to reduce the number of new infections occurring in the EU/EEA area are warranted.


Chris Beyrer, Stefan D Baral, Frits van Griensven, Steven M Goodreau, Suwat Chariyalertsak, Andrea L Wirtz, Ron Brookmeyer,

# Global epidemiology of HIV infection in men who have sex with men

The Lancet, Volume 380, Issue 9839, Pages 367 - 377, 28 July 2012

Summary -  Epidemics of HIV in men who have sex with men (MSM) continue to expand in most countries. We sought to understand the epidemiological drivers of the global epidemic in MSM and why it continues unabated. We did a comprehensive review of available data for HIV prevalence, incidence, risk factors, and the molecular epidemiology of HIV in MSM from 2007 to 2011, and modelled the dynamics of HIV transmission with an agent-based simulation. Our findings show that the high probability of transmission per act through receptive anal intercourse has a central role in explaining the disproportionate disease burden in MSM. HIV can be transmitted through large MSM networks at great speed. Molecular epidemiological data show substantial clustering of HIV infections in MSM networks, and higher rates of dual-variant and multiple-variant HIV infection in MSM than in heterosexual people in the same populations. Prevention strategies that lower biological transmission and acquisition risks, such as approaches based on antiretrovirals, offer promise for controlling the expanding epidemic in MSM, but their potential effectiveness is limited by structural factors that contribute to low health-seeking behaviours in populations of MSM in many parts of the world.
This is the first in a Series of seven papers about HIV in men who have sex with men


Patrick S Sullivan, Alex Carballo-Diéguez, Thomas Coates, Steven M Goodreau, Ian McGowan, Eduard J Sanders, Adrian Smith, Prabuddhagopal Goswami, Jorge Sanchez

#  Successes and challenges of HIV prevention in men who have sex with men

The Lancet, Volume 380, Issue 9839, Pages 388 - 399, 28 July 2012

Summary - Men who have sex with men (MSM) have been substantially affected by HIV epidemics worldwide. Epidemics in MSM are re-emerging in many high-income countries and gaining greater recognition in many low-income and middle-income countries. Better HIV prevention strategies are urgently needed. Our review of HIV prevention strategies for MSM identified several important themes. At the beginning of the epidemic, stand-alone behavioural interventions mostly aimed to reduce unprotected anal intercourse, which, although somewhat efficacious, did not reduce HIV transmission. Biomedical prevention strategies reduce the incidence of HIV infection. Delivery of barrier and biomedical interventions with coordinated behavioural and structural strategies could optimise the effectiveness of prevention. Modelling suggests that, with sufficient coverage, available interventions are sufficient to avert at least a quarter of new HIV infections in MSM in diverse countries. Scale-up of HIV prevention programmes for MSM is difficult because of homophobia and bias, suboptimum access to HIV testing and care, and financial constraints.


Millett GA, Peterson JL, Flores SA, Hart TA, Jeffries WL 4th, Wilson PA, Rourke SB, Heilig CM, Elford J, Fenton KA, Remis RS.

#  Comparisons of disparities and risks of HIV infection in black and other men who have sex with men in Canada, UK, and USA: a meta-analysis.

The Lancet, Volume 380, Issue 9839, Pages 341 - 348, 28 July 2012

HIV epidemics in black men who have sex with men (MSM; as well as other populations at risk for HIV) are inextricably linked to social and economic environments that should be considered and addressed to successful stem disparities in HIV infection.
Interventions that support early initiation of antiretroviral therapy (ART), adherence, and clinical visits for HIV-positive black MSM might have a greater effect in the reduction of HIV infection rates than do those that focus on sexual or drug use risks.
Physicians have a role in addressing racial disparities in HIV infection by providing regular HIV testing to and ART access for black MSM.
Because of intergenerational sexual mixing, providers must diagnose and suppress the viral load of as many older (≥30 years of age) MSM as possible to stem increasing rates of new infections in young (<30 years) black MSM.
In view of studies showing a relation between diagnoses of sexually transmitted infections (STI) and new HIV diagnoses within a year, repeat STI testing and treatment of STIs in black MSM should be a priority for providers in the USA and the UK.


Public Health Agency of Canada PHAC
# Population-Specific HIV/AIDS Status Report: Women
Canadian AIDS Treatment Information Exchange 2012
The proportion of HIV infection attributed to adult women has gradually increased over the last 10 years.  As of 2008, it is estimated that women  account for 17% of people living with HIV and 26% of all new HIV infections in Canada. While the annual number of positive HIV tests among women has varied over the last decade, it is not declining. Approximately three quarters of the new infections that occurred among women in 2008 can be attributed to heterosexual sex exposure, and more than one third of new infections can be attributed to exposure through injection drug use. On a positive note, the proportion of infants confirmed to be infected with HIV through perinatal transmission decreased from 9.3% in 2000 to 1.7% in 2008.


Institut National de Santé Publique due Québec
# Statistiques sur les services relatifs aux programmes de prévention du virus de l’immunodéficience humaine (VIH) et des hépatites B et C auprès des personnes utilisatrices de drogues par injection au Québec. Avril 2010 à Mars 2011
Gouvernement du Québec (2012)
Outre les mesures d’éducation relatives à l’injection à risques réduits, , l’accès à des services psychosociaux, l’utilisation du condom et le traitement de substitution aux opioïdes et l’utilisation d’approches par les pairs, l’accès au matériel d’injection stérile constitue une stratégie efficace pour diminuer le partage de matériel d’injection entre les personnes UDI...


Anthony Lyons, Marian Pitts, Jeffrey Grierson, Anthony Smith, Stephen McNally, Murray Couch

# Age at first anal sex and HIV/STI vulnerability among gay men in Australia
Sex Transm Infect 2012 88: 252-257 originally published online January 2012

Australian Research Centre in Sex, Health and Society, La Trobe University, Melbourne, Australia

Key messages
- Findings from this nationwide survey show strong links between age at first anal intercourse and gay men’s HIV/STI vulnerability.
- Gay men with a history of HIV and STIs were significantly younger on average when they first had anal intercourse than other men.
- Gay men with a recent history of higher risk sexual behaviour were also younger on average when they first had anal intercourse than other men.


Brazilian Ministry of Health - Health Surveillance Secretariat - Department of STD, AIDS and Viral Hepatitis
# Progress Progress Report on the Brazilian Response to HIV/AIDS (2010-2011)
Revised version 08 June 2012 - Brazil, 2012

In relation to AIDS, 30 years into the epidemic it is stabilized and concentrated in certain vulnerable population sub-groups. According to the most recent Epidemiological Bulletin (base year 2010), there were 608,230 cumulative AIDS cases between 1980 and June 2011, of which 397,662 (65.4%) were male cases and 210,538 (34.6%) were female cases...
The rate of HIV infection prevalence in the population aged 15 to 49 has been stable at 0.6% since 2004, being 0.4% in females and 0.8% in males. With regard to more vulnerable population groups aged over 18, studies conducted in 10 Brazilian municipalities between 2008 and 2009 estimated HIV prevalence rates of 5.9% in IDU, 10.5% in MSM and 4.9% in female sex workers.


Daniel E. Winetsky et al.
# Screening and Rapid Molecular Diagnosis of Tuberculosis in Prisons in Russia and Eastern Europe: A Cost-Effectiveness Analysis
PLOS Medicine | www.plosmedicine.org November 2012 | Volume 9 | Issue 11 |

Our study did not explicitly model HIV, given data limitations and the complexity of HIV-TB co-infections. However, it is well known that HIV affects the susceptibility for and clinical presentation of TB in ways relevant to the screening methods we have examined. In most former Soviet republics, estimates of HIV prevalence in places of incarceration range from 0% to 4.76%, but higher rates have been reported in select prisons in Ukraine and the Baltic states [35]. Our analysis is likely less accurate for these settings, though it is difficult to predict how including HIV might have affected our results, given that HIV disease can impact both the radiographic appearance and the bacillary load of sputum in individuals co-infected with TB.



# Brazil. Country programme document 2012-2016

Executive Board on 10 February 2012

According to estimates,15 approximately 630,000 Brazilians are living with the human immunodeficiency virus (HIV). Of the 593,000 cases of acquired immunodeficiency syndrome (AIDS) reported from 1980 to 2010, 32,000 were among children under 19 years old. Initiatives to fight vertical transmission have been successful, and the incidence among children under 5 decreased 41.7 per cent from 1997 to 2007. Between 1985 and 2007, there was a strong shift in the male/female ratio of AIDS cases: from 15/1 to 1.5/1. Among adolescents aged 13 to 19, this ratio has already inverted: there are 10 cases among girls for every 8 cases among boys.


Gavino Maciocco

# La sanità secondo Beppe Grillo

SaluteInternazionale.info 3 settembre 2012

In uno spettacolo del 2000 di fronte a una vasta platea di gente che ride Grillo parla di cose serie, serissime, ovvero di Africa e di Aids, sparando uno sfondone dietro l’altro (tanto la gente non sa e se la ride, chi se frega?). Forse per far colpo sulla platea lancia l’idea shock: l’AIDS non è causato dal virus HIV...


ILGA-Europe [ILGA-Europe is the European Region of the International Lesbian, Gay, Bisexual, Trans & Intersex Association] (Cailin C.E. Mackenzie, Evelyne Paradis, Silvan Agius, Juris Lavrikovs)
# Annual Review of the Human Rights Situation of Lesbian, Gay, Bisexual, Trans and Intersex People in Europe 2011
With support from the European Union and the financial support of the American Jewish World Service

May 2012

The main trends identified for 2011 include contradictory developments. On the one hand, great progress was achieved at the international and European levels in terms of recognition of the grounds of sexual orientation and gender identity particularly in the fields of asylum and protection from violence; various countries continued moving towards the extension of legal recognition and equal rights to rainbow families; and there are a number of legal proposals towards the introduction of humane laws regarding the change of legal name and gender of trans people. On the other hand, in some countries there is either no progress whatsoever, or worse, there are moves towards the adoption of legislation criminalising the ‘propaganda of homosexuality’.


Federal Democratic Republic of Ethiopia - HIV/AIDS Prevention and Control Office (HAPCO) - UNAIDS
# Country Progress Report on HIV/AIDS. Response, 2012
Addis Ababa - April 2012
The emergence of the HIV epidemic is one of the biggest public health challenges the world has ever seen in recent history. In the last three decades HIV has spread rapidly and affected all sectors of society- young people and adults, men and women, and the rich and the poor. Sub- Saharan Africa is at the epicentre of the epidemic and continues to carry the full brunt of its health and socioeconomic impact. Ethiopia is among the countries most affected by the HIV epidemic. With an estimated adult prevalence of 1.5%, it has a large number of people living with HIV (approximately 800,000); and about 1 million AIDS orphans.


Journal of the International AIDS Society
# Abstract supplement - Eleventh International Congress on Drug Therapy in HIV Infection
11–15 November 2012, Glasgow, UK
International AIDS Society - Geneva november 2012

The trend towards universal access for HIV prevention and treatment that was initiated at the beginning of the 21st century (international donor funding has been multiplied by 3 to reach 27 billion US$ in 2010) has been threatened by the 2008 9 economic crisis which currently translates in a fiscal crisis for most developed countries (including the US, France and the UK the main donors for HIV/ AIDS). Other advances such as the drastic drop in ARV drug   prices are also threatened (generic first line drugs close to marginal cost, insufficient drop in second line drug prices, etc.). The presentation will discuss the negative consequences of slowing down and delaying universal access on macro-economic growth in the most affected countries and suggest alternative sources of funding such as the financial transaction tax recently introduced by the French Parliament.


New York State Department of Health - AIDS Institute

#  Mental Health Screening. A Quick Reference Guide for HIV Primary Care Clinicians
New York State Department of Health 06/12


Raveen Parboosing, Glenn E. M. Maguire, Patrick Govender and Hendrik G. Kruger
# Nanotechnology and the Treatment of HIV Infection
Viruses 2012, 4, 488-520


WHO World Health Organization  - HIV / AIDS Programme               

# The HIV drug resistance report - 2012

© World Health Organization 2012


CDC Centers for Disease Control and Prevention

# HIV in the United States: At a Glance

March 2012

CDC estimates that MSM account for just 2% of the U.S. population, but accounted for 61% of all new HIV infections in 2009. MSM accounted for 49% of people living with HIV infection in 2008 (the most recent year national prevalence data are available). In 2009, white MSM continued to account for the largest number of new HIV infections of any group in the U.S. (11,400), followed closely by black MSM (10,800).
Young, black MSM were the only risk group in the U.S. to experience statistically significant increases in new HIV infections from 2006–2009—from 4,400 new HIV infections in 2006 to 6,500 infections in 2009.
Since the epidemic began, almost 300,000 MSM with AIDS have died, including an estimated 6,863 in 2009. Heterosexuals and Injection Drug Users also continue to be affected by HIV.
Heterosexuals accounted for 27% of estimated new HIV infections in 2009 and 28% of people living with HIV infection in 2008.
Since the epidemic began, more than 80,000 persons with AIDS, infected through heterosexual sex, have died, including an estimated 4,434 in 2009.


Sten H. Vermund and Andrew J. Leigh-Brown - CHS Perspectives Cold Spring Harbor Perspectives in Medicine
# The HIV Epidemic: High-Income Countries
Cold Spring Harb Perspect Med 2012;2:a007195

The HIV epidemic in higher-income nations is driven by receptive anal intercourse, injection drug use through needle/syringe sharing, and, less efficiently, vaginal intercourse. Alcohol and noninjecting drug use increase sexual HIV vulnerability. Appropriate diagnostic screening has nearly eliminated blood/blood product-related transmissions and, with antiretroviral therapy, has reduced mother-to-child transmission radically. Affected subgroups have changed over time (e.g., increasing numbers of Black and minority ethnic men who have sex with men)...

In Canada, Mexico, Western Europe, Australia, New Zealand, and higher-income island nations of the Caribbean, MSM continue to be the principal driver of the HIV/AIDS epidemic. This is also true of lower-income nations of Latin America and represents a growing proportion of cases in urban Asia (Baral et al. 2007; van Griensven and de Lind van Wijngaarden 2010). The epidemic spread exceedingly among MSM, reaching peaks of greater than 50% prevalence of young MSM in the high-prevalence neighborhoods of three cities where it was first recognized (Los Angeles, New York, and San Francisco) by 1984...


Centre for Research on Drugs and Health Behaviour, London School of Hygiene & Tropical Medicine - Institute of Public Health, University of Porto - Faculty of Medicine, University of Porto - World Health Organization Europe
# A rapid assessment of the accessibility and integration of HIV, TB and harm reduction services for people who inject drugs in Portugal
Final Study Report, April 2012
© World Health Organization 2012
We undertook a rapid assessment combining the following methods and data sources: a mapping of existing HIV, TB, hepatitis C virus (HCV) and drug dependency treatment services in Porto; a review of existing data on HIV, TB and drug treatment service use and integration; semi‐structured interviews with 30 PWID with experience of HIV and/or TB, and with seven providers representing HIV, TB, drug treatment, outreach and prison health services... People who inject drugs (PWID) are vulnerable to multiple, overlapping health harms, reduced access to health care and social marginalisation. The high burden of HIV and hepatitis C virus (HCV) among this population has been widely documented [3‐6] and evidence of harm reduction and HIV treatment interventions reviewed. In the absence of national or regional surveillance data, studies  in North America, Europe and Asia have documented high latent and active TB prevalence among PWID recruited in health care and community settings. PWID are at increased risk of TB for a number of reasons. Poverty, homelessness, overcrowding and imprisonment, harms to which drug users are vulnerable, are key social determinants of TB. Co infection with HIV also greatly increases the risk of progression from latent TB to active disease. TB care typically involves repeated, regular contact with health services to which PWID may have poorer access and adherence...


Government of Canada - UNGASS Country Progress Report - CANADA

Report to the Secretary General of the United Nations on the United Nations General Assembly Special Session [UNGASS] on HIV/AIDS

# Declaration of Commitment on HIV/AIDS - Canada’s UNGASS 2012 Report

At the end of 2008, 22,300 Canadians were reported to have died of AIDS and an estimated 65,000 (54,000 - 76,000) were living with HIV infection (including AIDS). Of these 65,000, an estimated 16,900 (12,800 - 21,000) were unaware of their HIV infection. Approximately 2,300 to 4,300 new infections were estimated to have occurred in 2008.


# Global AIDS Response Country Progress Report - Germany
Reporting period: January 2010–December 2011 - Submission date: March 29, 2012

The HIV epidemic in Germany can be characterized as a concentrated epidemic. The most affected population groups are
• MSM (estimated number of MSM living with HIV by the end of 2011: 46,500)
• Migrants originating from HIV high prevalence countries (estimated number of migrants living with HIV by end of 2011: 9,000)
• IDU (estimated number of IDU living with HIV by end of 2011: 6,800 [including former IDU])
Currently, the incidence is highest among MSM. It is estimated that 74 % of the HIV infections acquired in Germany are through male homosexual contact, 20% through heterosexual contact, 6% associated with injecting drug use. Less than 1% of infections are due to mother-to-child transmission.


WHO Regional Office for Europe
# European Action Plan for HIV/AIDS 2012–2015
World Health Organization 2011

HIV in Europe disproportionally affects populations that are socially marginalized and people whose behaviour is socially stigmatized (such as men who have sex with men) or illegal (such as people who use drugs). Specific key populations at higher risk of HIV exposure and infection are: people who inject drugs and their sexual partners; men who have sex with men, transgender people, sex workers, prisoners and migrants...Assessment of progress will be based on data collected through existing reporting processes. No additional data will need to be collected. WHO will continue to work with the UNAIDS secretariat, the United Nations Children’s Fund (UNICEF), the European Commission and its specialized agencies, in particular the European Centre for Disease Prevention and Control (ECDC), and other agencies to support countries in the standardized collection of core indicators, as part of harmonized joint WHO, UNAIDS and UNICEF annual reporting processes (United Nations General Assembly Special Session (UNGASS) and Health Sector Response monitoring and reporting). UNAIDS will support a full review of progress towards universal access in June 2016.


National Institute for Public Health and the Environment (RIVM)

# Sexually transmitted infections, including HIV, in the Netherlands in 2011

S.C.M. Trienekens - F.D.H. Koedijk - I.V.F. van den Broek - H.J. Vriend - E.L.M. Op de Coul - M.G. van Veen - A.I. van Sighem - I. Stirbu-Wagner - M.A.B. van der Sande

National Institute for Public Health and the Environment June 2012

In 2011, a total of 113,180 persons were tested at one of the sexually transmitted infection (STI) clinics in the Netherlands. This was 8 percent more than in 2010. STI clinics offer easily accessible diagnosis and additional curative care to high-risk populations. There were especially more consultations by men who have sex with men (MSM) in 2011, an increase of 11 percent compared with 2010. One or more STIs were found in 14 percent of the attendees (in 20 percent of MSM and in 13 percent of heterosexual attendees. These figures are comparable with previous years. 3,005 men and 11,282 women came in for a Sense consultation... The number of new HIV diagnoses, as reported in the Dutch HIV treatment centres, has fluctuated in recent years around 1,100 (in 2010: 1,090). In 2011, 812 new HIV diagnoses were reported (incomplete due to reporting delay). In 2010, in the same period, the number was 825. The number of positive HIV tests in the STI clinics was 415, an increase of 11 percent compared with 2010. However, the proportion of positive HIV tests at the STI clinics remained stable (0.4 percent). Since 2010, all STI clinic attendees have been tested for HIV, except those who explicitly refused, known as opting-out testing. In 2011, 2 percent of all STI clinic attendees not knowing their HIV status refused an HIV test. Among those MSM known to be HIV-positive, 30 percent were diagnosed with one or more STIs in 2011.... In 2011, 113,180 new consultations were registered in the national surveillance in STI centres, an increase of 8 percent compared with 2010. The increase was highest in MSM (11 percent).


CNS Conseil National du SIDA
#  Opinion on the Potential Benefits of the Concept of HIV/AIDS Pre-Exposure Prophylaxis (PREP)
Adopted by the French National AIDS Council on 12 January 2012



Philippine National AIDS Council

# Country Progress Report, Philippines: 2012 Global AIDS Response Progress Report

Manila, Philippines: PNAC, March 2012.

The Philippines tracks its AIDS epidemic through passive and active surveillance. The Philippine HIV & AIDS Registry is a passive reporting system with nationwide reach that includes newly diagnosis cases, those on ART, and mortalities. On the other hand, active surveillance among key affected populations called the Integrated HIV Behavioral and Serologic Surveillance (IHBSS) is conducted every 2 years. The country uses information from these systems when developing the Philippine Size Estimates of the Most At-Risk Population and the Philippine Estimates of People Living with HIV (PLHIV).
From 1984 to the end of 2011, there were 8,364 newly diagnosed HIV cases reported to the Philippine HIV & AIDS Registry. This reported number is only 43% of the estimated 19,335 PLHIV by 2011. Of the estimated number, 81% are males; among the reported cases, 93% are males. Majority (62%) of the reported cases in 2011 were 21-30 years.
In general, the Philippines has a low HIV prevalence, estimated at 0.036 percent in 2011 or 36 cases per 100,000 adult Filipinos. Based on the current trend, HIV prevalence will likely double but remain below one percent by 2015, or 0.063 percent, or 63 per 100,000. The latest EPP/Spectrum projection estimates between 29,370 to 53,993 PLHIV in the Philippines by 2015 with a median of 36,910 (2012 Philippine PLHIV Estimates). That is an additional 17,575 new HIV cases in four years from the 2011 estimate, or around 4,000-5,000 new cases each year


Nathalie Beltzer, Leïla Saboni, Claire Sauvage, Cécile Sommen | Observatoire régional de santé d’Ile-de-France | Groupe KABP [Knowledge, Attitudes, Beliefs and Practices)

# Connaissances, attitudes, croyances et comportements face au VIH / sida dans la population générale adulte en Ile-de-France en 2010
Décembre 2011
Au niveau épidémiologique, les données de la surveillance obligatoire du VIH montrent que l’Ile-de-France, comme la France, fait face à une épidémie qui est toujours active. Au niveau national, le nombre estimé de personnes qui découvrent leur séropositivité est en 2009 en légère augmentation par rapport à 2008, passant de 6 400 (intervalle de confiance à 95% [6 200 – 6 600]) à 6 700 [6400-6900]3, augmentation essentiellement retrouvée chez les hommes homosexuels4. Ce nombre est stable en Ile-de-France depuis 2007, et rapporté à la population totale, il est quatre fois supérieur au niveau observé hors Ile-de-France5. Les personnes qui ont découvert leur séropositivité en 2009 étaient en majorité contaminées lors de rapports hétérosexuels. Il s’agit toujours majoritairement de femmes et de personnes originaires d’Afrique subsaharienne.


Republic of Philippines - Department of Health
Philippine HIV and AIDS Registry
# Newly Diagnosed HIV Cases in the Philippines
National HIV/AIDS & STI Strategic Information and Surveillance Unit
NEC National Epidemiology Center October 2011


Yves Marie Dominique Georges
# HIV/AIDS in Haiti. An Analysis of Demographics, Lifestyle, STD Awareness, HIV Knowledge and Perception that Influence HIV Infection among Haitians
Public Health Theses. Paper 172 - May 7, 2011

Haiti has the highest prevalence of HIV infection in Latina America and the Caribbean. The country faces the worst AIDS epidemic outside Africa and bears the greatest burden of HIV in the western hemisphere... Recent epidemiologic data show that the HIV infection in Haiti is mostly concentrated among youth. Young Haitians lack of sexual education and awareness, and misconceptions are the main drivers of HIV risks. To avert the increasing epidemic of HIV/AIDS in Haiti, public health efforts must concentrate in youth education. Such education must emphasize sexual behaviors, lifestyle issues and attitudes...


HIV and AIDS Data Hub for Asia-Pacific

#  Review in Slides Thailand

#  Thailand Maps

Evidence to Action 2011


The Kirby Institute

# HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2011

The Kirby Institute | The University of New South Wales, Sydney, NSW 2011

Transmission of HIV in Australia continues to occur primarily through sexual contact between men. In 2006 – 2010, 66% of new HIV diagnoses occurred among men who have sex with men, 25% were attributed to heterosexual contact, 3% to injecting drug use and exposure was undetermined in 7%. Men who have sex with men accounted for 86% of diagnoses of newly acquired HIV infection. Exposure to HIV was attributed to heterosexual contact and injecting drug use in 10% and 1%, respectively, of diagnoses of newly acquired HIV infection.


Institut de veille sanitaire, Département maladies infectieuses, Unité VIH-IST-VHC-VHB chronique, Saint-Maurice | CNR du VIH, Inserm U966, CHU Bretonneau Tours
# Surveillance du VIH-sida en France - Données du 30 juin 2011
Institut de veille sanitaire 2011
5 millions de sérologies VIH réalisées en 2010, dont les ¾ en ville | En 2010, environ 6 300 personnes ont découvert leur séropositivité VIH, soit un taux de 97 cas par million d’habitants – ~ 2 500 hommes contaminés par rapports sexuels entre hommes, – ~ 2 000 personnes nés en Afrique subsaharienne (1 200 femmes et 800 hommes) – ~1 100 personnes nées en France contaminées par rapports hétérosexuels (500 femmes et 600 hommes) | le nombre de découvertes est stable depuis 2008 autour de 6 300 par an après avoir diminué entre 2004 (7 700) et 2007 | Des disparités régionales importantes persistent en 2010 – Les taux de découvertes de séropositivité sont supérieurs à la moyenne nationale en Guyane, Guadeloupe, Ile-de-France et en Martinique.


UNITAID Annual Report 2011

# Five Years of Innovation for Better Health

© World Health Organization (Acting as the host Organization for the Secretariat of UNITAID)


Edward M. Gardner, Margaret P. McLees, John F. Steiner, Carlos del Rio, and William J. Burman
# The Spectrum of Engagement in HIV Care and its Relevance to Test-and-Treat Strategies for Prevention of HIV Infection
Clinical Infectious Diseases 2011; 52(6):793–800

For individuals with human immunodeficiency virus (HIV) infection to fully benefit from potent combination antiretroviral therapy, they need to know that they are HIV infected, be engaged in regular HIV care, and receive and adhere to effective antiretroviral therapy. Test-and-treat strategies for HIV prevention posit that expanded testing and earlier treatment of HIV infection could markedly decrease ongoing HIV transmission, stemming the HIV epidemic. However, poor engagement in care for HIV-infected individuals will substantially limit the effectiveness of test-and-treat strategies.


Constance Meiners, Luis Sagaon-Teyssier, Lia Hasenclever, Jean-Paul Moatti

# Modeling HIV/AIDS Drug Price Determinants in Brazil: Is Generic Competition a Myth?

PLoS ONE | Published August 15, 2011 -- Copyright: 2011 Meiners et al.
Brazil became the first developing country to guarantee free and universal access to Highly Active Antiretroviral Therapy (HAART). Access to HIV/AIDS treatment was established as a legal right in 1996, but public delivery of antiretroviral drugs (ARVs) started as early as 1991. In 2009, HAART was delivered to nearly 190,000 people living with HIV and AIDS (PLWHA), covering more than 90% of estimated need according to previous 2006 World Health Organization (WHO) guidelines. Access to HIV/AIDS treatment in Brazil has been sustained through a set of strategies mixing local generic production of off-patent ARVs, centralized procurement, and the threat of issuing compulsory licenses on patent-protected drugs.


UNITAID Rapport annuel 2011

# Cinq Années d’Innovation au Service de la Santé

© Organisation mondiale de la Santé


United Nations | General Assembly | Sixty-fifth session
Resolution adopted by the General Assembly
# Political Declaration on HIV and AIDS: Intensifying Our Efforts to Eliminate HIV and AIDS

A/RES/65/277 | General 8 July 2011
60. Commit to ensure that financial resources for prevention are targeted to evidence-based prevention measures that reflect the specific nature of each country’s epidemic by focusing on geographic locations, social networks and populations vulnerable to HIV infection, according to the extent to which they account for new infections in each setting, in order to ensure that resources for HIV prevention are spent as cost-effectively as possible and to ensure that particular attention is paid to women and girls, young people, orphans and vulnerable children, migrants and people affected by humanitarian emergencies, prisoners, indigenous people and people with disabilities, depending on local circumstances...


Istituto Superiore di Sanità - Centro Operativo AIDS
# Sorveglianza delle nuove diagnosi di infezione da HIV

Giornata Mondiale dell’AIDS, 1 dicembre 2011

Nel 2010 sono stati diagnosticati 5,5 nuovi casi di Hiv positività ogni 100.000 residenti.
L'incidenza è maggiore al centro-nord rispetto al sud-isole. L'incidenza è di 4,0 nuovi casi tra italiani residenti e 20,0 nuovi casi tra stranieri residenti. Nel 2010 quasi una persona su tre diagnosticate come Hiv positive è di nazionalità straniera.
Negli ultimi 12 anni si osserva, nelle aree per le quali il dato è disponibile, una lieve diminuzione dell'incidenza delle nuove diagnosi di infezione da Hiv, da attribuire principalmente alla diminuzione di incidenza tra consumatori di sostanze per via iniettiva, mentre l'incidenza è rimasta costante sia per gli eterosessuali che per gli MSM (maschi che fanno sesso con maschi). Nel 2010 la maggioranza delle nuove infezioni è attribuibile a contatti sessuali non protetti, che costituiscono l'80,7% di tutte le segnalazioni (eterosessuali 49,8%, MSM 30,9%). Le persone che hanno scoperto di essere Hiv positive nel 2010 hanno un'età mediana di 39 anni per i maschi e di 35 anni per le femmine.
Oltre un terzo delle persone con una nuova diagnosi di Hiv viene diagnosticato in fase avanzata di malattia, e presenta una rilevante compromissione del sistema immunitario (numero di linfociti CD4 inferiore a 200 cell/μL). Queste persone che scoprono di essere Hiv positive in ritardo (linfociti CD4 inferiore a 200 cell/μL) hanno mediamente più di 40 anni di età, hanno contratto l'infezione prevalentemente attraverso contatti eterosessuali, e sono più spesso stranieri.


UNESCO United Nations Educational, Scientific and Cultural Organization
# UNESCO'S Strategy for HIV and AIDS
© UNESCO 2011 - Published by the United Nations Educational, Scientific and Cultural Organization Education Sector, Division of Education for Peace and Sustainable Development - Section of Education and HIV & AIDS

HIV epidemics are diversifying and becoming more complex, as new epidemiological patterns emerge. Sexual transmission is growing in significance in Eastern Europe and Central Asia, where the epidemic has until recently been largely concentrated among people who inject drugs. In sub-Saharan Africa, where heterosexual transmission has been predominant, there is evidence of elevated HIV risk among men who have sex with men (MSM) and people who inject drugs. Sex work remains central to epidemics in a number of countries in Asia and sub-Saharan Africa, and the overlap between sex work and injecting drug use is a major factor in HIV transmission in the worst affected countries of Eastern Europe and Central Asia...

UNESCO’s Role in the UNAIDS Division of Labour:
. Protect drug users from becoming infected with HIV and ensure access to comprehensive HIV services for people in prisons and other closed settings
. Empower MSM, sex workers and transgender people to protect themselves from HIV infection and to fully access antiretroviral therapy
. Remove punitive laws, policies, practices, stigma and discrimination that block effective responses to AIDS...


GNP The Global Network of People Living with HIV - Joint United Nations Programme on HIV/AIDS UNAIDS
#  Positive Health, Dignity and Prevention: A Policy Framework
© January 2011. The Global Network of People Living with HIV

Positive Health, Dignity and Prevention highlights the importance of placing the person living with HIV at the centre of managing their health and wellbeing. Among other things, this Framework takes us beyond the more limited concept of ’positive prevention’ which focuses only on people living with HIV ’preventing’ the transmission of HIV. In contrast, Positive Health, Dignity and Prevention stresses the importance of addressing prevention and treatment simultaneously and holistically. It also emphasises the leadership roles of people living with HIV in responding to policy and legal barriers within the socio-cultural and legal contexts in which they live, and in driving the agenda forward toward better health and dignity. In considering the ongoing challenge of HIV prevention, people living with HIV should be recognised as a part of the solution—not a part of the ‘problem’. The public health and human rights goal of preventing new HIV infections can only be achieved when the human, sexual, and reproductive rights of people living with HIV are protected and supported; when the broader health and dignity needs of people living with HIV are met; and when access to timely and uninterrupted treatment and care encourages greater uptake of confidential voluntary counselling and testing.


Giulio Maria Corbelli <giuliomcorbelli@hotmail.com>

#  Prevenzione dell’Hiv e delle infezioni sessualmente trasmesse nei maschi che fanno sesso con altri maschi (MSM)
meeting LILA 14 maggio 2011

Nei paesi dell’UE e dell’area economica europea, assimilabili con quelli occidentali, la quota maggiore del numero totale di nuovi casi di Hiv continua a essere diagnosticata negli MSM.

Gli attuali indicatori suggeriscono che meno del dieci percento degli MSM e delle persone transgender globalmente hanno accesso a servizi per la prevenzione dell’Hiv e la cura dell’Aids di cui hanno bisogno. Molti fattori contribuiscono a questa situazione, inclusi rifiuto sociale o dalla comunità, stigma e discriminazione e violazioni dei diritti umani. Moltiplicare gli interventi per gli MSM è difficile perché farlo spesso aumenta la loro stessa visibilità. Questo ha conseguenze per le relazioni interpersonali e di comunità e la sicurezza personale (specie in contesti dove il sesso tra uomini è un tabù, è criminalizzato o rifiutato). L’accesso ai servizi per l’Hiv rimane limitato per gli MSM e questo incrementa la loro vulnerabilità all’Hiv.


ECDC European Centre for Disease Prevention and Control - WHO  World Health Organization Europe

# HIV/AIDS surveillance in Europe 2010

© European Centre for Disease Prevention and Control, 2011.

In 2010, 27 116 newly diagnosed cases of HIV infection were reported by 28 countries of the European Union and European Economic Area (EU/EEA). The highest rates were reported by Estonia, Latvia, Belgium and United Kingdom.
• In the EU/EEA, the predominant mode of transmission for HIV infection is sex between men, followed by heterosexual contact. Around one third of the cases reported to be heterosexually acquired were diagnosed in individuals originating from countries with generalised HIV epidemics.
• In the WHO European Region the predominant transmission mode varies by geographical area, illustrating the wide diversity in the epidemiology of HIV in Europe. In the East, heterosexual transmission is the predominant mode of transmission, closely followed by injecting drug use, while in the Centre the predominant mode of HIV transmission is sex between men followed by heterosexual contact. In the West, the predominant transmission mode is sex between men, followed by heterosexual contact, when cases originating from countries with generalised epidemics are excluded.
• In the 50 countries that have consistently reported HIV surveillance data over the period 2004–2010, the rate of newly diagnosed cases of HIV infection reported per 100 000 population has increased by 18% from 6.6 per 100 000 in 2004 to 7.8 per 100 000 in 2010.


Ministero della Salute -- Commissione Nazionale per la lotta contro l’AIDS -- Consulta delle Associazioni per la lotta contro l’AIDS

# Linee Guida Italiane sull’utilizzo dei farmaci antiretrovirali e sulla gestione diagnostico-clinica delle persone con infezione da HIV
Ottobre 2011



COA Centro Operativo AIDS - ISS Istituto Superiore di Sanità

# Aggiornamento delle nuove diagnosi di infezione da HIV AL 31 dicembre 2009 e dei casi di AIDS in Italia al 31 dicembre 2010

Notiziario dell'Istituto Superiore di Sanità, Volume 24 - Numero 5, Supplemento 1 - 2011

Nel periodo 1985-2009 sono state riportate, nelle 17 regioni/province segnalanti, 45.707 nuove diagnosi di infezione da HIV. L’incidenza delle nuove diagnosi ha visto un picco di segnalazioni nel 1987, per poi diminuire fino al 1998 e stabilizzarsi successivamente. Nel 2009 sono state segnalate 2.588 nuove diagnosi, pari a un’incidenza di 6,0 per 100.000 residenti. Negli anni si osserva un aumento dell’età mediana alla diagnosi, nonché un cambiamento delle categorie di trasmissione: diminuisce la proporzione di tossicodipendenti, ma aumentano i casi attribuibili a trasmissione sessuale (omosessuale ed eterosessuale). Sono anche riportati i dati dei nuovi casi di AIDS e un’Appendice con dati dettagliati sulle segnalazioni delle nuove diagnosi di infezione da HIV e dei casi di AIDS. ...Scoperta tardiva del proprio stato di sieropositività. Ancora troppe persone in Italia scoprono di aver contratto l'HIV quando compaiono i primi sintomi dell'AIDS, fenomeno che in alcune realtà supera il 60%. E' quello che i tecnici chiamano ritardo di diagnosi. Questo fenomeno è segnale di una bassa percezione del rischio, soprattutto fra chi si infetta per via sessuale e fra gli stranieri. Si stima infatti che un quarto delle persone HIV positive, in Italia, non conosca il proprio stato di sieroposività.


Istituto Superiore di Sanità

# L’accesso al test HIV: risultati di un progetto di ricerca del Ministero della Salute svolto dall’Istituto Superiore di Sanità e dalle Associazioni della Consulta di Lotta all’AIDS

A cura di Anna Colucci, Anna Maria Luzi, Pietro Gallo, Stefania D’Amato e Maria Grazia Pompa

2011, vi, 174 p. Rapporti ISTISAN 11/41

Il presente Rapporto intende illustrare i diversi momenti del Progetto che, avvalendosi della partecipazione fattiva e integrata dei numerosi attori coinvolti – Associazioni della Consulta per la Lotta contro l’AIDS, Ministero della Salute, Centri diagnostico-clinici territoriali, Istituto Superiore di Sanità – ha fornito una panoramica della situazione relativamente alle modalità di accesso al test HIV esistenti nelle diverse regioni e province d’Italia. La realizzazione delle azioni progettuali ha, inoltre, consentito di elaborare e sperimentare in tre differenti aree urbane, Genova, Firenze e Palermo, strumenti, metodologie e percorsi utili a promuovere una concreta fruibilità del test HIV in tre diversi target (giovani, donne, migranti).


Office of National AIDS Policy - The White House
# Implementing the National HIV/AIDS Strategy: Overview of Agency Operational

February 2011

The transmission of HIV has long been concentrated in groups that have been marginalized or underserved, and we also know that some groups are far less likely to know their HIV-positive serostatus or have appropriate access to quality care consistent with the latest clinical practice standards. These inequities are manifested by people coming into care late in the course of their illness, poorer clinical outcomes, and earlier death. We know that Black Americans and Latinos are more likely to die from HIV compared to whites, and that the majority of all AIDS deaths in the U.S. have occurred among gay and bisexual men. The Strategy calls for a concerted national effort to increase engagement and service delivery capacity of whole communities to prevent HIV and support community members living with HIV.


Ministry of Health, People's Republic of China - Joint United Nations Programme on HIV/AIDS - World Health Organization
# 2011 Estimates for the HIV/AIDS Epidemic in China
Beijing, China November 2011

AIDS killed 28,000 people in China last year, and another 48,000 new infections from the HIV virus were discovered in the country, according to an official report on Saturday.
In China 780,000 people live with the HIV virus, of which 154,000 developed AIDS, a report jointly produced by China’s Ministry of Health, the Joint United Nations Programme on HIV/AIDS and the World Health Organization said. In September 2011 there were 136,000 people receiving anti-viral treatment for the disease, it said, making the treatment coverage rate 73.5 percent, an increase of 11.5 percentage points compared to 2009.


Republic of South Africa - SANAC South African National AIDS Council

# National Strategic Plan on HIV, STIs and  TB: 2012 – 2016

SANAC 2011 - www.sanac.org.za

Correctional and detention facilities: These facilities have high rates of TB and high rates of HIV. The Department of Correctional Services must ensure the provision of appropriate prevention and treatment services, including HIV, STI and TB screening, prompt treatment of all inmates and correctional services staff, ensuring a continuum of care through proper referrals, and the enforcement of laws and policies to prevent sexual violence in prison settings, including the use of newly developed screening guidelines to identify inmates who are vulnerable to sexual violence


The U.S. President’s Emergency Plan for AIDS Relief
# Guidance for the Prevention of Sexually Transmitted HIV Infections

August 2011


Paola Cinque (Department of Infectious Diseases San Raffaele Scientific Institute Milan, Italy)

# CNS Opportunistic Infections: an update
North European Workshop on HIV-infection in the CNS (HANSA Meeting) Goteborg, Sweden, 26-27 May 2011


David M. Margolis (The University of North Carolina at Chapel Hill)
# HIV Persistence and the Central Nervous System as a Sanctuary

North European Workshop on HIV-infection in the CNS (HANSA Meeting) Goteborg, Sweden, 26-27 May 2011


Ingo W. Husstedt (University Hospital Münster Germany)
#  Depression and HIV

North European Workshop on HIV-infection in the CNS (HANSA Meeting) Goteborg, Sweden, 26-27 May 2011


Peter Reiss (University of Amsterdam)
#  Ageing with HIV

North European Workshop on HIV-infection in the CNS (HANSA Meeting) Goteborg, Sweden, 26-27 May 2011


Public Health Agency of Canada - HIV and AIDS in Canada
Declaration of Commitment on HIV/AIDS

#  Populations at Risk

January 2010-December 2011

Prison inmates in correctional facilities experience higher rates of infectious diseases than the general population2. Many enter the correctional system already infected, often as a result of their history of high-risk behaviours. Those who continue to engage in high-risk behaviours, while incarcerated, put others at risk of infection, including placing themselves at risk of further infection.


Justin C. McArthur

#  Clinical Perspectives – Neuro AIDS Research Needs in the Era of HAART
Johns Hopkins Neurology 2011


CDC Centers for Disease Control and Prevention

#  Estimates of New HIV Infections in the United States, 2006–2009

August 2011


John T. Brooks

#  Changing Patters of HIV Epidemiology United States - 2011
Epidemiology Branch - Division of HIV/AIDS Prevention, CDC


Santiago Avila-Rıos et al.
#  National Prevalence and Trends of HIV Transmitted Drug Resistance in Mexico
PLoS ONE November 2011 - 6(11): e27812. doi:10.1371/journal.pone.0027812

According to data from the National Centre for AIDS Prevention and Control (CENSIDA) and UNAIDS, by the end of 2009, 220,000 adults were estimated to live with HIV in Mexico from which 27% were receiving ART, 14% were under medical follow-up without ART and 59% may have been unaware of their HIV infection status or were not under medical follow-up in any public institution [18]. Considering this scenario, the extent to which TDR has spread in Mexico after nearly five years of broad access to ART remains an important issue to be assessed.


HIV and AIDS Data Hub for Asia - Pacific | Evidence to Action

#  Vietnam at a Glance

Country Review December 2011

The HIV epidemic is predominantly drug-related, with IDUs accounting for most (53%) of  the recorded infections as of September 2009 – followed by 28% of cases attributed to heterosexual transmission, 3% to perinatal transmission and 16% to unknown modes of transmission. The epidemic affects mainly those under the age of 40, with 80% of all reported cases of HIV being among those aged 20-39.8 Seventy-three percent of cases reported in 2009 were among men.


The Republic of Uganda - Uganda Aids Commission
# National Hiv & Aids Strategic Plan 2011/12 - 2014/15
www.aidsuganda.org/ Uganda AIDS Commission decembre 2011
Recent estimates suggest that the annual number of new HIV infections increased by 11.4% from 115,775 in 2007/08 to 128,980 in 2010/11 (UAC 2011). Among adults, the annual number of new HIV infections rose by 16.4% during this period but there was a 6.2% decline in new infections among children <15 years of age, most likely because of improvements in prevention of mother to child transmission (PMTCT) uptake registered during this period.


HIV and AIDS Data Hub for Asia - Pacific | Evidence to Action

# Vietnam. Review in Slides - 2011

Basic socio-demographic indicators / HIV prevalence and epidemiological status (1990-2009) / Risk behaviors (2005-2009) / Vulnerability and HIV knowledge (2005-2009) /
HIV expenditure (2001-2009) / National response (2005-2009) / Archives


Republic of Albania Ministry of Health - Institute of Public Health Tirana
#  2012 Global AIDS Response Progress Reporting | 2012 Universal Access in the Health Sector Reporting | 2012 Dublin Declaration Reporting
Reporting period: January 2010-December 2011

World Health Organization 2010
#  The world health report: health systems financing: the path to universal coverage.
www.who.int 2010

The picture is less bleak if we take into account recent efforts by the GAVI Alliance and the Global Fund to Fight AIDS, Tuberculosis and Malaria to support health systems development and capacity-building. Nevertheless, diseases outside these headline issues continue to be neglected by donors,  as do health systems issues such as management, logistics, procurement, infrastructure and workforce development..


United Nations
#  The Millennium Development Goals Report 2010
Published by the United Nations Department of Economic and Social Affairs (DESA) — June 2010
TARGET - Have halted by 2015 and begun to reverse the spread of HIV/AIDS.
The spread of HIV appears to have stabilized in most regions, and more people are surviving longer.
The latest epidemiological data indicate that, globally, the spread of HIV appears to have peaked in 1996, when 3.5 million people were newly infected. By 2008, that number had dropped to an estimated 2.7 million. AIDS-related mortality peaked in 2004, with 2.2 million deaths. By 2008, that toll had dropped to 2 million, although HIV remains the world’s leading infectious killer. The epidemic appears to have stabilized in most regions, although prevalence continues to rise in Eastern Europe, Central Asia and other parts of Asia due to a high rate of new HIV infections. Sub-Saharan Africa remains the most heavily affected region, accounting for 72 per cent of all new HIV infections in 2008.


Journal of the International AIDS Society
#  Abstracts of the Tenth International Congress on Drug Therapy in HIV Infection

Glasgow, UK. 7-11 November 2010



Joint United Nations Programme on HIV/AIDS (UNAIDS)

#  UNAIDS Report on the Global AIDS Epidemic | 2010

More than 5 million people are now receiving HIV treatment In 2009 alone, 1.2 million people received HIV antiretroviral therapy for the first time—an increase in the number of people receiving treatment of 30% in a single year. Overall, the number of people receiving therapy has grown 13-fold, more than fi ve million people in low- and middle-income countries, since 2004. Expanding access to treatment has contributed to a 19% decline in deaths among people living with HIV between 2004 and 2009. Th is is just the beginning: 10 million people living with  HIV who are eligible for treatment under the new WHO guidelines are still in need.


WHO World Health Organization

HIV / AIDS Programme. Strengthening health services to fight HIV/AIDS

#  Antiretroviral Therapy for HIV Infections in Adults and Adolescents: Recommendations for a public health approach
World Health Organization Department of HIV/AIDS - 2010 revision

Since the publication in 2006 of Antiretroviral therapy for HIV infection in adults and adolescents: Recommendations for a public health approach, new evidence has emerged on when to initiate ART, optimal ART regimens, the management of HIV coinfection with tuberculosis and chronic viral hepatitis and the management of ART failure. This evidence formed the basis for the recommendations contained in the 2010 update, which outlines a public health approach to the delivery of ART for adults and adolescents in settings with limited health systems capacity and resources. The recommendations were based on the preparation GRADE evidence profiles, systematic and targeted reviews, risk-benefit analyses, consultations with PLHIV, technical reports, and assessments of impact, feasibility and cost.... The guidelines identify the most potent, effective and feasible first-line, second-line and subsequent treatment regimens, applicable to the majority of populations, the optimal timing of ART initiation and improved criteria for ART switching, and introduce the concept of third-line antiretroviral regimens...


Istituto Superiore di Sanità - Centro Operativo AIDS
#  Sorveglianza delle nuove diagnosi di infezione da HIV

Giornata Mondiale dell’AIDS 2010

Nel 2009 sono stati diagnosticati 4,5 nuovi casi di HIV positività ogni 100.000 residenti italiani e 22,2 nuovi casi di HIV positività ogni 100.000 stranieri residenti. Nel 2009 quasi una persona su tre diagnosticate come HIV positive è di nazionalità straniera. L’incidenza è maggiore al centro-nord rispetto al sud-isole... Dall’inizio dell’epidemia nel 1982 ad oggi sono stati segnalati circa 63.000 casi di AIDS, di cui quasi 40.000 deceduti.


Istituto Superiore di Sanità - Laura Camoni, Vincenza Regine, Stefano Boros, Maria Cristina Salfa, Mariangela Raimondo, Barbara Suligoi
e i Referenti Regionali del Sistema di Sorveglianza delle nuove diagnosi di infezione da HIV - Centro Operativo AIDS, Dipartimento di Malattie Infettive, Parassitarie ed Immunomediate, ISS

#  L’epidemia da HIV/AIDS nei giovani e nelle donne in Italia

Notiziario dell'Istituto Superiore di Sanità, Volume 23 - Numero 12 Dicembre 2010

Dal 1982 al 2009 sono stati notificati al Registro Nazionale AIDS 61.537 casi di AIDS; di questi, 2.666 (4,3%) sono diagnosi in giovani tra i 15 e i 24 anni. La proporzione dei giovani diminuisce dall'11,1% alla fine degli anni '80 al 2,2% nel biennio 2008-09.In particolare, nel 2009 sono stati segnalati 19 casi (0,7%) di AIDS nei giovani...
Le diagnosi legate all'uso iniettivo di droghe sono diminuite di 27 volte (dal 92,3% nel biennio 1984-85 al 3,4% nel biennio 2008-09), mentre le diagnosi legate ai rapporti sessuali (eterosessuali e omosessuali) sono aumentate dal 3% nel biennio 1984-85 al 69,5% nel biennio 2008-09).
Il 22,7% (n. 13.959) delle 61.537 notifiche pervenute al Registro Nazionale AIDS dal 1982 al 2009, sono diagnosi in persone di genere femminile. Il rapporto maschi/femmine è diminuito: alla fine degli anni '80 era di 4 a 1 mentre nel 2009 è di 2,5 a 1. Nel tempo si evidenza un aumento dell’età mediana alla diagnosi nella popolazione femminile, che è passata da 25 anni negli anni '80 a 40 anni nel 2009. Le donne straniere costituiscono l’11,7% del campione. Il 47,1% delle donne con AIDS ha acquisito l’infezione attraverso l’uso iniettivo di droghe e il 39,1% attraverso rapporti eterosessuali.


Kevin Stoloff, John Joska
# Mental Health in HIV – Manual for Primary Healthcare Workers
www.anovahealth.co.za/ First published 2010
Mental illness (problems or disorders) are more common in PLWHA (People living with HIV/AIDS). These may be caused by stress (such as money, relationship problems or stigma), the direct effect of HIV on the brain, or medications that are taken for HIV or TB.People with mental illness (with or without HIV) are more likely to engage in risky sex and the abuse of substances.


Ministero della Salute -- Commissione Nazionale per la lotta contro l’AIDS -- Consulta delle Associazioni per la lotta contro l’AIDS

# Linee Guida Italiane sull’utilizzo dei farmaci antiretrovirali e sulla gestione diagnostico-clinica delle persone con infezione da HIV
Luglio 2010


Melanie A. Thompson et al.

#  Antiretroviral Treatment of Adult HIV Infection. 2010 Recommendations of the International AIDS Society–USA Panel,
©2010 American Medical Association. All rights reserved. (Reprinted) JAMA, July 21, 2010—Vol 304, No. 3


Susan Sharp et al.

#  A Review of Psychosocial Factors that Facilitate HIV Infection Among Women Living in Canada & the United States: Implications for Public Health Policy

UTSC Printing Services, University of Toronto Scarborough
Citation: Women's Health and Urban Life, Vol 9 (2), pg. 63-79. December 2010

In Canada and the U.S., HIV infection among women has been associated with mental health symptoms, injection drug use, past trauma history, sexual partner characteristics, gender power inequalities, poverty, racial segregation and health care disparities. The psychosocial needs of women living with HIV often go unmet, facilitating HIV transmission, poor psychiatric outcomes and faster disease progression. Therefore, it is important to understand the complex biological, psychological, social and behavioral factors affecting women living with HIV. This article discusses urban women’s health from a biopsychosocial and behavioral perspective as well as the implications for health care policy and practice that are specific to HIV prevention and intervention


Ashish Swarup Verma, Udai Pratap Singh, Premendra Dhar Dwivedi,1 and Anchal Singh

#  Contribution of CNS cells in NeuroAIDS

Journal of Pharmacy And Bioallied Sciences 2010 Oct-Dec; 2(4): 300–306.


New York State Department of Health AIDS Institute
#  Depression and Mania in Patient with HIV/AIDS
www.hivguidelines.org - Updated October 2010


Mark Tomlinson
#  Family-centred HIV interventions: lessons from the field of parental depression
Journal of the International AIDS Society 2010, 13(Suppl 2):S9


#  UNITAID Annual Report 2010

#  UNITAID Annual Report 2009

#  UNITAID Annual Report 2008

#  UNITAID Annual Report 2007


#  Leading Through Civilian Power. The First Quadrennial Diplomacy and Development Review 2010

Department of State USA - United States Agency International Development - Quadrennial Diplomacy and Development Review



Médecins Sans Frontières
#  No time to quit: HIV/AIDS treatment gap widening in Africa
Médecins Sans Frontières analysis of the widening funding gap for HIV/AIDS treatment in sub-Saharan Africa - May 2010 - Published by Médecins Sans Frontières Brussels operational centre

Msf mostra come la maggior parte delle istituzioni internazionali che erogano fondi come Pepfar, Banca Mondiale, Unitaid e i paesi che finanziano il Fondo globale, abbiano deciso di tagliare, ridurre o interrompere i loro finanziamenti per le cure e i farmaci antiretrovirali. Il Piano di emergenza per l’Aids della presidenza degli Stati Uniti (Pepfar) ha ridotto il suo budget per l’acquisto di farmaci antiretrovirali nel 2009 e 2010 e ha bloccato il budget complessivo. Altri donatori, come Unitaid e la Banca Mondiale, hanno annunciato riduzioni negli investimenti dei prossimi anni in Malawi, Zimbabwe, Mozambico, Uganda e Repubblica Democratica del Congo. Anche il Fondo globale per l’Hiv, Tubercolosi e Malaria sta fronteggiando un calo dei finanziamenti. Tra il 2009 e il 2010, gli stanziamenti già approvati si sono ridotti dell'8-12%. I tagli generalizzati si sono tradotti nella riduzione del numero di persone in grado di iniziare un trattamento antiretrovirale in Sudafrica, Uganda e Repubblica Democratica del Congo: il numero di nuovi pazienti è diminuito di ben sei volte. A Khayelitsha, baraccopoli alla periferia di Città del Capo con circa 1 milione di abitanti, quasi un adulto su tre è sieropositivo. In tutto il Sudafrica, epicentro dell'epidemia nell'Africa australe, circa 5,7 milioni di persone sono affetti da Hiv (su 50 milioni di abitanti). Nell'Africa sub-sahariana 6 milioni di persone hanno bisogno del trattamento antiretrovirale, ma solo il 30% di loro ha accesso ai farmaci salva-vita, perché troppo costosi o non disponibili.


NACO - Department of AIDS Control - National AIDS Control Organisation - Ministry of Health & Family Welfare Government of India
#  Develop State Regional Resources for Streenghtening of State Folk Art Based Communication on HIV & AIDS

Annual Report 2010-2011 - http:\\nacoonline.org
The recent HIV estimations highlight an overall reduction in adult HIV prevalence as well as new infections (HIV incidence) in the country, although variations exist across the states. The analysis of epidemic projections has revealed that the number of annual new HIV infections has declined by more than 50 percent during the last decade.


Australian Government Department of Health and Ageing

#  Sixth National HIV Strategy 2010–2013

© Commonwealth of Australia 2010

The high turnover of inmates, the frequency of risk practices such as unsafe injecting drug use, unsafe tattooing, unprotected sex (including through sexual assault), and an over-representation of priority populations (including Aboriginal and Torres Strait Islander peoples and people who inject drugs) heighten the risk of exposure to HIV during incarceration.


Kingdom of Cambodia - National Religion King
#  Cambodia Country Progress Report. Monitoring the Progress towards the Implementation of the Declaration of Commitment on HIV and AIDS
Reporting period: January 2008 December 2009
Prepared and Submitted by: The National AIDS Authority - March 2010


IOM International Organization for Migration, Thailand - Joint United Nations Programme on HIV/AIDS (UNAIDS) - Thailand Country Office - Canada South East Asia Regional HIV/

#  Migration and HIV/AIDS in Thailand: Triangulation of biological, behavioural and programmatic response data in selected provinces

© 2010 International Organization for Migration, Bangkok, Thailand

The actual magnitude of HIV infection among the migrant population is unknown as research studies to observe the epidemic of HIV in this population group has been sporadic despite the policy awareness on migrants’ vulnerabilities to HIV/AIDS and the subsequent impacts to host communities. There is no national policy requiring local authorities to conduct sentinel surveillance in the migrant population. As a result, some of the provinces studied (i.e., Chiang Rai, Phang Nga, Mukdahan and Nong Khai) have no survey and Sa Kaeo Province begun to implement theirs in 2006.


Louisa Degenhardt, Bradley Mathers, Mauro Guarinieri, Samiran Panda, Benjamin Phillips, Steffanie A. Strathdee, Mark Tyndall, Lucas Wiessing, Alex Wodak, John Howard
# Meth/amphetamine use and associated HIV: Implications for global policy and public health
International Journal of Drug Policy 21, 2010

Amphetamine type stimulants (ATS) have become the focus of increasing attention worldwide. There are understandable concerns over potential harms including the transmission of HIV.  A  comprehensive search of the international peer-reviewed and grey literature was undertaken. Multiple electronic databases were searched and documents and datasets were provided by UN agencies and key experts from around the world in response to requests for information on the epidemiology of use. Amphetamine or methamphetamine (meth/amphetamine, M/A) use was documented in 110 countries, and injection in 60 of those...


United Nations General Assembly Special Session on HIV/AIDS (UNGASS)

# UNGASS Country Progress Report:Thailand. Reporting Period January 2008- December 2009

National AIDS Prevention and Alleviation Committee Thailand (2010)

In Thailand, the HIV epidemic among MSM can be considered severe. Many MSM continue to have high-risk behavior. Starting from the serosurvey of MSM in Bangkok in 2003 which found a prevalence rate of 17.3%, HIV continued to make inroads in this population. In Chiang Mai in 2005 and 2007 the level of HIV was 15.3% and 16.9% respectively. In Phuket, HIV was at a level of 5.5% in 2005 and increased to 20.0% two years later. The estimation of new HIV cases from the Asian Epidemic Model computer program forecast that the epidemic of HIV in MSM will be a driver of the national epidemic in the future. If the current trends continue, then MSM will comprise half of all new HIV infections by the year 2025. It is estimated that 5% to 10% of males between 15-49 years will have sex with other men during 2010 or, approximately 1.3 to 2.5 million persons. The results of the latest round of sentinel surveillance found that HIV declined in Bangkok from 30.7% in 2007 to 24.7% in 2009 (Figure 28), and prevalence in the population age 15-22 years declined from 22.3% in 2007 to 12.5% in 2009. In Bangkok during 2003 to 2009, it was found that reports of consistent condom use in the previous three months showed no signs of increase. In provinces not considered to be popular tourist sites, it was found that HIV prevalence in the MSM population is also high, despite being lower than in the primary tourist locations. For example, surveys in Patalung and Udorn in 2008 found levels of HIV among MSM as high as 5.5% and 4.7% respectively.

Thailand has 142 prisons and other detention facilities with 209,427 inmates (as of December 2009). Of these, 85.9% are male and 14.1% are female. Drug-related offenses account for 57.1% with methamphetamines (meth) being the most common illegal drug involved (87%), followed by heroin (8%), opium (4%), and thinner (1%). Fully 18% were drug users while 82% were dealers/possessors of the drugs. Currently, there is no formal surveillance of HIV among the prisoner population. The DoC has the policy to not conduct compulsory HIV testing. Voluntary testing is allowed as a guide to treatment. In June 2009, a total of 1,768 prisoners were known to have HIV(76.5% male). Fully 63.2% reported sexual behavior as the route of transmission, and 36.8% by injection drug use. A total of 1,172 were receiving ART and 723 had been treated for OIs.


Christopher Power, Lysa Boissé, Sean Rourke, M. John Gill

#  NeuroAIDS: An Evolving Epidemic
The Canadian Journal of Neurological Sciences, 2009; 36: 285-295


Istituto Superiore di Sanità - Centro Operativo AIDS
#  Sorveglianza delle nuove diagnosi di infezione da HIV

Giornata Mondiale dell’AIDS, 2009

Nel 2008 sono state diagnosticate circa 4.000 nuove infezioni, vale a dire 6,7 nuovi casi di positività all’HIV ogni 100.000 residenti, posizionando l’Italia fra i Paesi dell’Europa occidentale con un’incidenza di HIV medio-alta. L’incidenza HIV è maggiore al centro-nord rispetto al sud-isole. A fronte di un notevole decremento dell’incidenza HIV negli anni ’90, negli ultimi 10 anni si osserva invece una stabilizzazione delle segnalazioni. Le persone che scoprono di essere HIV positive hanno oggi un’età media di 38 anni per i maschi e 34 anni per le femmine. Aumentano i casi attribuibili a contatti eterosessuali ed omosessuali, che nel 2008 costituiscono complessivamente il 74% di tutte le segnalazioni. Su tre persone che vengono diagnosticate come HIV positive, una è di nazionalità straniera. La sorveglianza delle nuove diagnosi di infezione da HIV, che riporta i dati relativi alle persone che risultano positive al test HIV per la prima volta, è stata attivata fino ad oggi in 11 regioni/province italiane: sono purtroppo assenti i dati relativi ad alcune grandi regioni e a buona parte delle regioni del centro-sud... 1988 Principale modalità di trasmissione: uso iniettivo di droghe (71%) || 2008 Principale modalità di trasmissione: contatti etero/omosessuali (74%)


Centers for Disease Control and Prevention (CDC) - Morbidity and Mortality Weekly Report (MMWR)
#  Guidelines for the Prevention and Treatment of Opportunistic Infections Among HIV-Exposed and HIV-Infected Children
Recommendations from CDC, the National Institutes of Health, the HIV Medicine Association of the Infectious Diseases Society of America, the Pediatric Infectious Diseases Society,
and the American Academy of Pediatrics
MMWR Recommendations and Reports September 4, 2009 / Vol. 58 / No. RR-11


World Health Organization WHO

#  Special theme: strengthening linkages between sexual and reproductive health and HIV

Vol. 87, number11, November 2009

After the conference,
...the Senegalese government arrested nine members of AIDES Senegal, a nongovernmental organization that works on HIV prevention and support for people living with HIV. In January 2009, all nine were convicted as homosexuals and received the full  years’ imprisonment allowable by law for that charge plus an additional 3 years for “criminal association”.1 Following significant international pressure, the convictions were ultimately overturned on appeal, after the men had spent almost 3 months in jail. When countries sign declarations of rights – human, health, workplace – there are no exemption clauses stating: “These rights apply to everyone except men who have sex with men (MSM) and people living with HIV”. However, in practice, HIV-positive MSM are not able to access their full rights, either due to repressive laws or discrimination practices..


Guillaume Le Loup, Andreia de Assis, Maria-Helena Costa-Couto, Jean-Claude Thoenig, Sonia Fleury, Kenneth de Camargo, Bernard Larouze´,

#  A Public Policy Approach to Local Models of HIV/AIDS Control in Brazil
American Journal of Public Health | June 2009, Vol 99, No. 6

In Brazil, the HIV seroprevalence among young adults is estimated at 0.65%, and AIDS mortality has decreased significantly since 1997, when highly active antiretroviral therapy became available for free.6 The Brazilian federal and local (state and municipal) AIDS programs are considered to be a model for lowand middle-income countries because they have developed a close cooperation between government, health services, and nongovernmental organization (NGO) actors (persons or groups involved in the formulation and implementation of policies and programs). The Ministry of Health defined ambitious prevention policies and provided free access to antiretroviral treatment.


Senate National Assembly Cambodian Parliament
#  Parliamentary Handbook on HIV and AIDS
UNAIDS - National AIDS Authority - UNDP Cambodia - PRASIT - APLF Asia Pacific Leadership Forum on HIV&AIDS

Phnom Penh, 11th November 2009


World Health Organization -- United Nations Office on Drugs and Crime -- UNAIDS

#  Policy guidelines for collaborative TB and HIV services for injecting and other drug users: an integrated approach.

© World Health Organization 2008


David B. Goldstein
#  Genomics and biology come together to fight HIV
PLoS Biol 6(3) - 2008


WHO World Health Organization Executive Board
#  HIV/AIDS and mental health. Report by the Secretariat
Executive Board 124th Session - 20 November 2008


#  Epidemiological Fact Sheet on HIV and AIDS- Core data on epidemiology and response - Argentina
2008 Update



#  Eastern Europe and Central Asia AIDS epidemic update - Regional Summary

© Joint United Nations Programme on HIV/AIDS (UNAIDS) and World Health Organization (WHO) 2008.


Joint United Nations Programme on HIV/AIDS (UNAIDS)

#  UNAIDS, Report on the global AIDS epidemic

Joint United Nations Programme on HIV/AIDS (UNAIDS) 2008


Judyth Twigg - Center for Strategic and International Studies (CSIS)
#  HIV/AIDS in Russia. Commitment, Resources, Momentum. A Report of the Task Force on HIV/AIDS Center for Strategic and International Studies Challenges
© 2007 by the Center for Strategic and International Studies - Washington


Goliusov A.T.,Dementyeva L.А., Ladnaya N.N., Briko N.I., Tumanova M.S., Korzhayeva N.A., Nitzsche-Bell А., Kobzeva V.B.,

#  Country Progress Report of the Russian Federation on the Implementation of the Declaration of Commitment on HIV/AIDS, Adopted аt the 26th United Nations General Assembly Special Session, June 2001
Reporting period: January 2006 – December 2007

Ministry of Health and Social Development of the Russian Federation -  The Federal Service for Surveillance of Consumer - Rights Protection and Human Well-Being of the Russian Federation - Moscow 2008

In 2006–2007, the HIV epidemic in the Russian Federation continued to be profiled as a concentrated epidemic. During the reporting period, the most affected groups of the population were drug users, sex workers and prisoners. Among IDUs in 2006–2007, HIV infection prevalence ranged from 8 to 64 percent in different regions of the country. Based on data received through research done in 2007, 6 percent of sex workers have been infected. Among prisoners tested in 2007, HIV infection prevalence was 5 percent. The total number of people registered with HIV by 31 December 2007 was 416,113. At the end of 2007, PLHIV made up 0.3 percent4 of the population. Over the last five years, the infection is more frequently spread through sexual contact from vulnerable groups into the general population. ..



#  Syphilis

Division of STD Prevention (DSTDP) - Centers for Disease Control and Prevention - December 2007

In the United States, health officials reported over 36,000 cases of syphilis in 2006, including 9,756 cases of primary and secondary (P&S) syphilis. In 2006, half of all P&S syphilis cases were reported from 20 counties and 2 cities; and most P&S syphilis cases occurred in persons 20 to 39  years of age. The incidence of P&S syphilis was highest in women 20 to 24 years of age and in men 35 to 39 years of age... Genital sores (chancres) caused by syphilis make it easier to transmit and acquire HIV infection sexually. There is an estimated 2- to 5-fold increased risk of acquiring HIV if exposed to that infection when syphilis is present.


Joseph T. F. Lau and H. Y. Tsui
#  Comparing the magnitude of discriminatory attitudes toward people living with HIV/AIDS and toward people with mental illness in the Hong Kong general population


IPPF International Planned Parenthood Federation - The Global Coalition on Women and AIDS

# HIV Prevention for Girls and Young Women

Thailand Report Card 2007


Proceedings of the Fourth Biennial National Conference on Health Issues in the Arab American Community | Dearborn, Michigan - May 11–12, 2006
# HIV/AIDS in the Arab American Community: Breaking the Silence!
in Procedings from the Fourth Biennal National Conference on Health Issues in the Arab America Community | Ethnicity & Disease, Volume 17, Summer 2007
New diagnoses in Michigan have been statistically level since 1998, with approximately 900 new cases diagnosed annually. Risk behaviors for new HIV diagnoses in 2004 were categorized as: men who have sex with men (MSM)a - 57%; heterosexuals -25%; injecting drug users (IDU)-12%; no identified risk -10%; MSM/IDU-4%; and other, -1%. New treatments for HIV disease have meant dramatic decreases in AIDS-related deaths since 1995. This fact combined with level rates of new diagnoses means that the overall number of people living with HIV continues to rise...


Inpes Institut National de Prévention et d'Education pour la Santé
# Les populations affricaines d’Ille- de-France face au VIH/sida: connaissances,attitudes, croyances et comportements
Dossier de presse Juin 2007
64,9 % des personnes originaires d’Afrique subsaharienne vivant en Île-de-France ont déjà fait un test de dépistage du VIH au cours de la vie. Ce pourcentage est supérieur à celui de la population interrogée en métropole (53,9 %) et aux Antilles/Guyane (61,5 %). Ce résultat va à l’encontre de l’hypothèse souvent avancée selon laquelle les populations d’Afrique subsaharienne recourraient moins souvent au dépistage du VIH que les autres. Dans environ 60 % des cas, le dernier test a été réalisé soit à l’initiative du médecin à l’occasion d’un bilan de santé ou à cause de symptômes soit dans le cadre d’un protocole de dépistage (examen prénatal, certificat nuptial, don de sang). Ceci rappelle la place centrale des professionnels de santé sur cette question. Par ailleurs, les populations originaires d’Afrique subsaharienne vivant en Île-de-France ont une bonne connaissance des consultations de dépistage anonyme et gratuit (CDAG) sans qu’elles ne les utilisent plus que la population générale de métropole (6 à 7 % des derniers tests). L’hôpital joue un rôle central dans l’accès au dépistage de cette population puisque 30,4 % des derniers tests ont eu lieu en milieu hospitalier.


PLoS Medicine | www.plosmedicine.org

# Disease Mongering

April 2006 | Volume 3 | Issue 4 | e191

While the term “disease mongering” is now commonly used as shorthand to  describe campaigns that inappropriately widen the boundaries of treatable illness, there is uncertainty about how to operationally defi ne the concept. With most disorders or conditions, there will be a number of individuals who suffer severe forms of the problem, who will benefi t greatly from treatment and may be helped enormously by the publicity and marketing given to both the treatment and the disorder. For example, industry-funded awareness raising about the treatment and prevention of HIV/AIDS has surely been valuable. But in other cases, the same marketing/awareness-raising campaign will be viewed very differently depending on the perspective of the observer: what an industry-linked professional group may consider to be legitimate public education about an underdiagnosed disease, an activist group free from industry sponsorship may regard as a crude attempt to build markets for potentially dangerous drugs.


NASTAD National Alliance of State and Territorial AIDS Directors - HIV and Mental Health: The Challenges of Dual Diagnosis
John Anderson (APA - American Psychological Association Office on AIDS)

#  HIV and Mental Health: The Challenges of Dual Diagnosis
NASTAD - APA July 2005


S Dougan, J Elford, B Rice, A E Brown, K Sinka, B G Evans, O N Gill, K A Fenton

# Epidemiology of HIV among black and minority ethnic men who have sex with men in England and Wales

Sex Transm Infect 2005; 81:345–350.

Ethics - Reports of new diagnoses and of those diagnosed and living with HIV are voluntary and confidential. To maintain patient confidentiality no names are held on the database, soundex codes are used instead. The reporting system has approval under the section 60 regulations of the Health and Social Care Act (Statutory Instrument 1438 — June 2002). The ethical and legal basis for UAPMP has been described elsewhere. In short, best practice guidance states that for purposes of public health surveillance, and where samples are anonymised, specific patient consent is not required, on condition that ‘‘active local arrangements’’ allow patients the opportunity to be aware of what may happen to their samples and mechanisms are in place for respecting spontaneous objections. The programme complies with guidelines published by the Medical Research Council, and Department of Health interim guidelines on the use of human organs and tissue. All data are stored on restricted and secure databases at CDSC, with strict adherence to the Data Protection Act and Caldicott Guidelines.


Luis C. Millana Cuevas et al.
#  Aspectos neuropsicológicos y psicosociales de la infección por el virus de la inmunodeficiencia humana
Ministerio del Interior - Revista de Estudios Penitenciarios N.º 251- Madrid 2005


Ministère de l’emploi, de la cohésion sociale et du logement | Ministère des affaires étrangères
38 ème session de la Commission de la population et du développement de l’ONU New York 4 au 8 avril 2005
# Sida et pauvreté
Contribution détaillée de la France. Situation nationale
CPD 38/France/4 au 8 avril 2005
- France Lert : Synthèse : Sida et pauvreté en France - Nicole Solier : La politique française de lutte contre le VIH/sida - Florence Lot : Surveillance du VIH/sida et pauvreté - Isabelle Grémy, Sandrine Halfen, Nathalie Beltzer : Les facteurs de vulnérabilités, notamment sociales, dans la population générale, associés à une moindre perception du risque de transmission du VIH et à une moindre adoption des comportements de prévention - Marcel Calvez, Caroline Semaille, François Fierro, Anne Laporte : Pauvreté, précarité et accès tardif au système de soins - Marie Jauffret-Roustide, France Lert : L’exclusion, argument de l’émergence de la réduction des risques envers les usagers de drogues en France - Didier Fassin : Santé et immigration, un objet politique à reconstruire - France Lert, Rémi Sitta, Rosemary Dray-Spira, Yolande Obadia et le groupe VESPA : Les conditions de vie des personnes vivant avec le VIH en France métropolitaine - Résultats de l’enquête ANRS-EN12-VESPA - Patrice  Pinell : Mobilisation associative et pauvreté


ISS Istituto Superiore di Sanità,

# La ricerca psicologica, neuropsichiatrica e sociale nell’infezione da HIV e nell’AIDS
Convegno, Roma 15-16 novembre 2004 - Atti a cura di Anna Colucci, Anna Maria Luzi , Pietro Gallo, Fabrizio Starace, Loredana Cafaro e Giovanni Rezza

Rapporti ISTISAN 06/20


James Putzel (London School of Economic)
#  Institutionalising an Emergency Response: HIV/AIDS and Governance in Uganda and Senegal
A report submitted to the Department for International Development May 2003



#  HIV/AIDS Prevention and Care in Mozambique. A Socio-Cultural Approach

Maputo June 2002


UNAIDS/WHO | Working Group on Global HIV/AIDS/STI Surveillance
# Initiating second generation HIV surveillance systems: practical guidelines
In concentrated epidemics where HIV is over 5% in any subpopulation at higher risk of infection (such as drug injectors, sex workers, men who have sex with men), surveillance systems should monitor infection and behaviour in those groups, paying particular attention to behavioural links between members of those groups and the general population. Groups linking subpopulations at higher risk of infection with the general population are called ‘bridging populations’.


Julia H. Arnsten, Penelope A. Demas, Homayoon Farzadegan, Richard W. Grant, Marc N. Gourevitch, Chee-Jen Chang, Donna Buono, Haftan Eckholdt, Andrea A. Howard, Ellie E. Schoenbaum

# Antiretroviral Therapy Adherence and Viral Suppression in HIV-Infected Drug Users: Comparison of Self-Report and Electronic Monitoring
CID Clinical Infectious Diseases 2001; 33:1417–23
In this observational study of HIV-infected drug users, adherence was stable over time and across medications. Self-reported adherence was higher than MEMS (electronically monitored: Medication Event Monitoring Systems) adherence, but a strong relationship was observed between both measures and HIV load. MEMS, however, was found to be a more sensitive measure of clinically significant nonadherence.


Sandhya Ramrakha, Avshalom Caspi, Nigel Dickson, Terrie E Moffitt, Charlotte Paul

# Psychiatric disorders and risky sexual behaviour in young adulthood: cross sectional study in birth cohort
BMJ British Medical Journal VOLUME 321 29 JULY 2000

Dal Rapporto 2001 dell'Organizzazione mondiale della sanità sulla salute mentale Mental Health: New Understanding, New Hope: I giovani con disturbi psichiatrici, ad esempio depressione o dipendenza da sostanze, paragonati a quelli che non soffrono di tali disturbi, sono più facilmente inclini ad assumere comportamenti sessuali ad alto rischio. Ciò li espone a una serie di malattie sessualmente trasmesse, incluso l'AIDS [Ranrakha et al., 2001]


Massimo GIULIANI (Centro Operativo AIDS, Istituto Superiore di Sanità, Roma),

# La legislazione in Europa e in Italia per il controllo delle malattie sessualmente trasmesse
Ann. Ist. Super. Sanità, vol. 36, n. 4 (2000), pp. 409-415


# The Durban Declaration
HIV causes AIDS. Curbing the spread of this virus must remain the first step
towards eliminating this devastating disease

NATURE|VOL 406 | 6 JULY 2000 | www.nature.com


Morbidity and Mortality Weekly Report MMWR
# Pneumocystis Pneumonia --- Los Angeles
June 5, 1981 / 30(21);1-3























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