A survey of prisoners in Ireland showed that hepatitis was a much greater health problem than HIV/AIDS, a conference was told yesterday.
This disease was prevalent among intravenous drug-users, and of the prison inmates surveyed in 1999, 41 per cent had injected drugs. Twenty-one per cent had started injecting in prison, according to Dr Jean Long of the Health Research Board.
She told the conference, organised by the Irish Penal Reform Trust and Merchants Quay Ireland, that two groups were surveyed: existing inmates and entrants to prison.
Those entering prison were less likely to be infected than long-stay inmates. Only 7 per cent of those entering prison for the first time admitted injecting drugs, but this rose to 40 per cent of those who had been in prison before. Of those, 18.5 per cent started injecting in prison.
Of the inmates who injected, 37 per cent had hepatitis C, 9 per cent had hepatitis B and 2 per cent had HIV/Aids.
Among entrants to prison, 22 per cent had hepatitis C, 6 per cent hepatitis B and the same proportion, 2 per cent, had HIV/AIDS. Dr Long said people engaged in higher risk behaviour in prison than outside, sharing needles with people they did not know and not cleaning needles properly. The low availability of heroin in prison also changed drug-taking behaviour, with inmates injecting rather than smoking the drug. They also rented needles in exchange for drugs.
Dr Heino Stoever of the University of Bremen said an EU study of drug use in prisons showed that the prevalence of hepatitis C among IV drug-users in prison ranged from 50 to 90 per cent, with HIV infection ranging from 0 to 19 per cent.
He criticised abstinence-oriented drug-prevention policies as ineffective. In Berlin prison, for example, prisoners were given leaflets saying: "Stop injecting drugs, stop anal intercourse, stop tattooing," which had little effect on prisoners' behaviour.
"Nowhere is the expertise of the prisoners integrated into the programmes, or is there realistic drug counselling," he said. "You rarely find peer-driven intervention."
Best practice involved the use of methadone both in detox programmes and in maintenance, he said.
A policy requiring a drug-free prison was a denial of the drug problem and a misunderstanding of the nature of addiction. "For some drug-users it is not possible to have drug-free intervals."