Needle Exchange Needed To Curb Rising HIV Rate In Cdn Prisons: Advocacy Groups

Rates of HIV among inmates in federal prisons appear to be rising dramatically, prompting advocacy groups to call for sweeping changes to prevent further spread of the disease, both inside the institutions and in the community at large.

A newly released report from Correctional Service Canada revealed that 4.6 per cent of prisoners reported having HIV-AIDS in 2007, more than double the 1.6 per cent rate cited in previous reports. The 2007 survey data are the most recent available.

“When we found the HIV prevalence rate, we were astounded at the number of 4.6 per cent,” said Sandra Ka Hon Chu, a senior policy analyst with the Canadian HIV-AIDS Legal Network in Toronto, who noted that prevalence rate is 15 times higher than that found in general population.

“So this is the new reality we’re working with,” she said Wednesday, deeming the HIV infection rate “comparable to many countries in the region of sub-Saharan Africa.”

The report also found the estimated rate of hepatitis C among federal prisoners was 31 per cent – 39 times greater than that found in the community.

Incarcerated women, and especially Aboriginal women, were found to be disproportionately infected with HIV and hepatitis C.

The survey, which involved questionnaires filled out by 3,370 prisoners, showed 34 per cent of men and 25 per cent of women used non-injection drugs, while 17 per cent of men and 14 per cent of women were injection-drug users.

Advocacy groups want Ottawa to implement needle-exchange programs to stop the spread of HIV and hepatitis C through injection-drug use.

The Canadian HIV-AIDS Legal Network, which was not involved in writing the report, says about half of prisoners surveyed reported sharing used needles or syringes to inject drugs. Those are typically opiates like heroin and cocaine which are smuggled into prisons by visitors and occasionally even by staff, said Ka Hon Chu.

She said drug-using prisoners have reported stealing syringes from medical services within their institutions or fashioning makeshift needles.

“And that’s the scariest part – things being made from rubber tubing or pens that create large scars or wounds in the arm,” she said. “So anything they can imagine using they will get their hands on, they will create a needle with it.”

With no clean-needle program in place in any federal or provincial prison or jail in Canada, it is not unusual for “filthy” needles to be shared among 30 or 40 inmates, said HIV specialist Dr. Peter Ford.

The retired Queen’s University professor, who has worked with prisoner populations for years, said he sees nothing new in the report other than more realistic prevalence figures.

“None of this is news to them,” he said of Corrections Canada. “People have been telling them for the last 15 to 20 years that they have to do something about it. They have not done anything about it, so clearly they have to take a very serious look at syringe-exchange in prison.”

But Ford doesn’t see that happening any time soon.

“Trying to sell needle exchange in prisons to the current Conservative government would be … like selling condoms to the Catholic Church.”

Ka Hon Chu said in countries around the world that have adopted in-prison needle-exchange programs, the results have been mostly positive.

“I think it’s just we don’t want to feel like we’re failing by providing these implements to people to inject drugs or enable them,” she said of Canada’s prison system.

“But the studies have shown that where the programs exist … there’s no increase in the use of drugs or injection drugs. There is actually a decrease in (the use of) syringes and needles and increasing referrals to drug addiction treatment programs.”

Yet crime bills recently proposed by the Harper government have included minimum mandatory-sentencing policies, which prisoner advocacy groups say would increase the number of people incarcerated and potentially lead to even higher rates of HIV and hepatitis C.

On Wednesday, a Corrections Canada spokeswoman said prison-based needle-exchange programs are not being considered.

“The government has a zero-tolerance policy for drugs in our institutions,” Christelle Chartrand said by email. “Providing needles for illicit drug use runs counter to that policy. Illicit drugs in federal prisons compromise the safety and security of correctional staff as well as our communities.”

Chartrand said CSC has a comprehensive anti-drug strategy combined with a number of health-promotion practices and harm-reduction measures to prevent the spread of infectious diseases.

DiCenso said the average Canadian may wonder why they should care about needle-exchange and other programs to prevent infections in people who are illicit drug users and have been incarcerated because they have broken the law.

For one thing, she said, it’s far more expensive for society to treat cases of HIV or hepatitis C than to prevent the diseases in the first place. And secondly, those infections won’t be contained within prison walls.

“The vast majority of people in prison are going to get out and they’re going to come back to our communities, where they’re bringing HIV and hep C with them,” DiCenso said.

“So we need to think how that relates to us because they are part of our community. They’re not separate from our community.”