The advent of increasingly stringent drug laws, which have mandated incarceration of millions of drug abusers, has added substantially to the prison population and compromised the ability to meet their mental and physical health needs while incarcerated, which results in repeat incarcerations and recidivism (Butterfield, 1998). This population places a heavy financial burden on the Public Health system. HIV, Hepatitis B and C transmission frequently result from intravenous and intranasal drug use (IDU). The prostitute or IDU who finds him or herself imprisoned may either already have HIV, and/or hepatitis, or acquire it while incarcerated. The vast majority of HIV infected persons enter the system already infected (Vlahov & Putnam, 2006).
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Inmates in jails and prisons engage in risky behaviors. Sexual activity, drug use, and crowded conditions all contribute to the rate of infection. Tuberculosis, bacterial infections, sexually transmitted diseases, HIV, HBV and HCV are among the many illnesses that are spread from inmate to inmate. Clear evidence exists that sexual activity between heterosexuals and homosexuals occurs regularly in the prison setting. devices have been produced for sexual activity using latex gloves, and plastic (Mahon, 1996). Drug paraphernalia continues to be brought in, despite correctional efforts to stop contraband. The introduction of paraphernalia promotes the spread of disease Inmates in jails and prisons engage in risky behaviors. Sexual activity, drug use, and crowded conditions all contribute to the rate of infection. Tuberculosis, bacterial infections, sexually transmitted diseases, HIV, HBV and HCV are among the many illnesses that are spread from inmate to inmate. Clear evidence exists that sexual activity between heterosexuals and homosexuals occurs regularly in the prison setting. Makeshift transmission (Carvell & Hart, 1990). Rape and other forms of sexual violence have been reported by countries all over the world and some prisons continue to deny such a problem, as noted by WHO et al, (2007). Those afflicted suffer emotional trauma and increased risk of infection from HIV, hepatitis C and other diseases and as noted, condoms are usually considered as contraband in the correctional setting. Those persons afflicted would benefit from PEP (post exposure prophylaxis) and counseling and testing. Protocols are needed for the prevention and treatment of these persons at risk for sexual violence.
Prisons and jails nationwide have become holding facilities for the mentally ill. There are an estimated 350,000 men and women in prisons and jails with serious mental disorders. Approximately 4 times as many mentally ill people are in prisons than in mental health hospitals. Prisoners are 2 to 4 times more likely than the general population to be schizophrenic, depressed, bipolar, or suffering from post-traumatic stress disorder. Approximately 73 percent of mentally ill inmates suffer from a substance abuse disorder (Senator Jim Webb's S-714 web page).
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