NEEDLE EXCHANGE PROGRAMS SOUGHT FOR FEDERAL PRISONS

National HIV/AIDS groups are calling for needle exchanges to be
piloted in Canada's prison system.

This comes even as the provincial government has ordered an extensive
review of Saskatchewan's needle exchange programs.

"We disproportionately incarcerate people who use drugs," said
Richard Elliott, executive director of the Canadian HIV/AIDS Legal
Network, a Toronto-based organization that advocates on behalf of
those infected with the virus.

"Drugs are getting into prisons notwithstanding everything we do to
keep them out ... People are shooting up in prisons and they aren't
doing it with the proper equipment."

Prison populations are about 10 times more likely than the public to
be infected with the HIV virus and 20 times more likely to be
infected with hepatitis C, Elliott said.

A report by the Canadian Centre on Substance Abuse indicates that
estimates of HIV prevalence among male prisoners range from one to
four per cent, and one to 10 per cent among female prisoners. They
also write that estimates for hepatitis C infection among prisoners
are 28 to 40 per cent.

Elliott believes that needle exchanges - where one clean needle is
handed out for every used or "dirty" needle that's handed in - would
lower these high rates of infection considerably.

"(Federal prisons) need it because it makes public health sense,
human rights sense and fiscal sense, too," Elliott said.

It costs about $30,000 a year to treat an HIV-positive
prisoner.

Prisoner health is part of public health, Elliot said. Most prisoners
do eventually go back to their communities and whatever diseases they
acquired while incarcerated go home with them.

"It seems to me this is not public policy-making based on evidence,
here," he said.

Jeff Campbell, regional director for Correctional Service Canada,
refused to comment on the issue except to say that no prisons in his
jurisdiction have needle exchange programs.

However, the Public Health Agency of Canada has written that: "The
availability of sterile injection equipment has been shown to
substantially reduce the transmission of blood-borne pathogens in
areas where needle exchange programs (NEPs) are used ... in selected
prison settings."

In the same report, opposition to needle exchanges by Correctional
Service Canada was attributed to general safety concerns and the
belief that needle exchanges would send a contradictory message about
drug use within the prison system.

The political side of the issue is "dead in the water," according to
Elliot. The federal government was testing out a "safe tattoo"
program in 2005 and 2006 but it was axed by Public Safety Minister
Stockwell Day. No moves have been made to implement needle exchanges.

"I think we can have this debate," said Trevor Gray, youth and
outreach education co-ordinator at the Prisoners HIV/AIDS Support
Action Network. "People are not going to stop taking drugs, but can
we at least allow them to have the tools they need?"

The federal government is responsible for the medical care of inmates
in its penitentiaries. Prisoners should have access to the same
health care as other Canadians, Gray said. Needle exchanges have been
in place in Canada for 20 years, he pointed out, sometimes funded by
the government itself.

Federal prisons already make condoms available to prisoners as well
as bleach to clean inmates' homemade injection rigs. But it takes a
lot of work to clean one of these rigs and prisoners who are
injecting drugs are often doing it as quickly and secretly as
possible in order to avoid getting caught, according to Elliott.

He said the rigs, which are often made by attaching a sharp end and
plunger to a ballpoint pen barrel, are more likely to create larger
wounds with more blood smeared and a higher chance for infection.