Episode 10 - AIDS & Hepatitis

Levels of HIV and hepatitis infection in prisons reflect the fact that a high proportion of prisoners have injected drugs and that some have worked in the sex industry to fund their drug use.

When HIV first hit the headlines in the UK in the late 1980s prisoners known to have the virus or suspected of belonging to a high risk group for HIV were separated from other prisoners. Such was the level of fear that even staff would avoid physical contact with them, to the point where they would wear protective clothing (like space suits) when working on the landings where those known or suspected of having the virus were held.

Since then a great deal has changed. Prison staff and prisoners are better informed and know that normal day to day contact is not a risk. Prisoners are generally less worried about others knowing that they are HIV positive. Spike's concern that Buki and Crystal might tell others is probably because she is on the mother and baby unit where new mothers are likely to be particularly protective of their babies.

Spike and Baxter were on medication, and prisoners with HIV in prison have access to the same treatment and drugs as people in the community.

Hepatitis is in many ways more of a concern in prisons than HIV. All prisoners can request vaccination against hepatitis B, an infection which is quite common in drug users and more easily spread than HIV. There is no vaccination against hepatitis C and the infection rate in prisons seems to have been rising. Hepatitis C is spread through blood to blood contact like HIV.

One of the main routes of infection with HIV and hepatitis is through sharing equipment to inject drugs. Although most injecting drug users stop injecting when they arrive in prison, research has shown that more than half of those who continue to inject share needles and syringes. No method of cleaning injecting equipment is 100%, but in prison there is usually no access to sterilization tablets, which are more effective than nothing. Even more worryingly a proportion of prisoners start injecting in prison in order to make the most of the limited amounts of drugs available.