J Int AIDS Soc. 2011 May 19;14:26. doi: 10.1186/1758-2652-14-26.
The high prevalence of HIV infection among prisoners and pre-trial detainees, combined with overcrowding and sub-standard living conditions sometimes amounting to inhuman or degrading treatment in violation of international law, make prisons and other detention centres a high risk environment for the transmission of HIV. Ultimately, this contributes to HIV epidemics in the communities to which prisoners return upon their release. We reviewed the evidence regarding HIV prevalence, risk behaviours and transmission in prisons. We also reviewed evidence of the effectiveness of interventions and approaches to reduce the risk behaviours and, consequently, HIV transmission in prisons. A large number of studies report high levels of risk behaviour in prisons, and HIV transmission has been documented. There is a large body of evidence from countries around the world of what prison systems can do to prevent HIV transmission. In particular, condom distribution programmes, accompanied by measures to prevent the occurrence of rape and other forms of non-consensual sex, needle and syringe programmes and opioid substitution therapies, have proven effective at reducing HIV risk behaviours in a wide range of prison environments without resulting in negative consequences for the health of prison staff or prisoners.The introduction of these programmes in prisons is therefore warranted as part of comprehensive programmes to address HIV in prisons, including HIV education, voluntary HIV testing and counselling, and provision of antiretroviral treatment for HIV-positive prisoners. In addition, however, action to reduce overcrowding and improve conditions in detention is urgently needed.
囚犯和审前拘留人员中艾滋病毒感染率居高不下，加上过度拥挤和生活条件不达标，有时构成违反国际法的不人道或有辱人格的待遇，使监狱和其他拘留中心成为艾滋病毒传播的高风险环境。最终，这导致囚犯获释后返回的社区艾滋病毒流行。我们审查了关于监狱中艾滋病毒流行率、风险行为和传播的证据。我们还审查了减少风险行为、从而减少监狱中艾滋病毒传播的干预措施和方法的有效性证据。大量研究报告显示，监狱中存在大量高危行为，并且已经有艾滋病毒传播的记录。来自世界各地的大量证据表明，监狱系统可以采取哪些措施来预防艾滋病毒传播。特别是， condom distribution programmes （ condom 译为安全套），伴以防止强奸和其他形式的非自愿性行为、针具和注射器方案以及阿片类药物替代疗法的措施，已被证明在广泛的监狱环境中有效减少艾滋病毒风险行为，而不会对监狱工作人员或囚犯的健康造成负面影响。因此，这些方案的引入是合理的，应作为全面解决监狱中艾滋病毒问题的方案的一部分，包括艾滋病毒教育、自愿艾滋病毒检测和咨询，以及为艾滋病毒阳性囚犯提供抗逆转录病毒治疗。然而，除此之外，还迫切需要采取行动减少过度拥挤和改善拘留条件。
