HIV/Aids policies criticised in Europe-wide study

By Ann Cahill Europe Correspondent

Wednesday, October 14, 2009

THE country’s HIV/Aids policies, especially in prisons, have been criticised in a Europe-wide survey.

But just how many of Ireland’s 4,000 prisoners are infected is unknown and there are no common strategies to reduce risks in jails, the report found.

The country was ranked tenth out of 29 countries surveyed. The relatively good performance was because people living with HIV/Aids are fairly well cared for though it could be better, according to the Euro HIV Index.

However, programmes designed to prevent people contacting the virus are almost non-existent, especially in the country’s prisons.

According to a 2002 report by the Penal Reform Trust, infection rates were believed to be 10 times higher than among the outside population.

Expert Dr Beatriz Cebolla, who carried out the research for the index, said that harm reduction strategies in Irish prisons were non-existent.

"We found it difficult to find anybody who could tell us what has been implemented. There appears to have been some pilot projects, but they were not implemented generally," she said.

There were no standardised rules on preventing or managing HIV/Aids in Irish prisons, and each jail appeared to do their own thing, she said.

There was no clean needle exchange for intravenous drug users, no bleach made available and there are no condoms available or education about how the disease is spread, she said.

An estimated 4,500 to 5,000 people in the country have HIV/Aids at present, a doubling of the percentage over the past 12 months according to some estimates.

About a third of cases were infected through their intravenous drug use, 40% through heterosexual sex and a quarter is through men having sex with men, according to the World Health Organisation.

"We believe transmission in prisons in quite high and programmes like needle exchange would help. We have seen that in Luxembourg and Switzerland they have worked brilliantly," said Dr Cebolla.

Prisoners are offered a HIV/Aids test when being admitted to prison, but there is none offered when they are leaving.

Even though testing is voluntary a certain number would opt for it and this would give authorities a reliable estimate of how prevalent the infection was, she said.

"There is no education while they are inside. If there was, they would bring that education out into the general community when they were released, but instead they can contribute to the spread of HIV/Aids when they come out," she added.

Ireland is not the only country to have just a hazy idea of how prevalent the disease is.

Johan Hjertqvist, president of the Health Consumer Powerhouse responsible for the index said, "There is a general lack of leadership in HIV management.

"Alarmingly, no government seems to know the true number of HIV-infected inhabitants. The main conclusion of this very first HIV Index is that there is still a lot to do."

Luxembourg leads the ranking followed by Malta and Switzerland.

At the end of 2007 there were an estimated 800,000 people living with HIV in western and central Europe, an 8% increase over the previous year.

This story appeared in the printed version of the Irish Examiner Wednesday, October 14, 2009