Prevention would be better than care

EDITOR—Edwards et al point out that the main cause of HIV in prisoners is injecting drug use.1 Work done in Scottish prisons indicates that 4% of the male prison population have continued their previous community injecting practices and 8% of male prisoners start injecting in prison. 2 3

Measures for reducing viral transmission in the community, such as needle exchange, are not available in British prisons. It is possible, therefore, that many of the prisoners referred internally had contracted HIV by sharing injecting equipment while incarcerated. The recommendation by Edwards et al that HIV status should be confirmed in all prisoners should therefore be qualified with a recommended frequency. …