ABSTRACT
HIV-1 and AIDS are major public health concerns for prisons. The problem has been fuelled mainly by two phenomena: the rapidly increasing numbers of prisoners in many countries, for example a 300 per cent increase in the number of prisoners in the USA over the last 15 years (Dolan, Wodak and Penny, 1995), and the increasing proportion of inmates who are injecting drug users. Prisons are ‘selectively enriched’ (Bird and Gore, 1994) with injecting drug users (IDUs): in Italy, for instance, IDUs accounted for 19 per cent of the total prison population in 1986, increasing to 31 per cent in 1992 (and over 50 per cent in some metropolitan areas) (Presidenza del Consiglio dei Ministri, 1993). AIDS became the leading cause of death among inmates in New York prisons in 1985 (Vlahov et al., 1989) and in Maryland (USA) prisons in 1987 (Salive, Smith and Dolan, 1990).
