Prison Needle Exchange: Lessons from a Comprehensive Review ...

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Methodology The evidence for this report was gathered over an 18-month period beginning in October 2002. A review of the existing international literature was undertaken. This included extensive research on prisons and • HIV • HCV • injection drug use • harm-reduction measures • needle exchange programs Sources referenced include Canadian and international published reports, journal articles, conference presentations, government publications, and prison-service reports. These materials include previous work and research on these topics published by the authors of this report. In addition, original research was conducted during site visits to prison needle exchange programs in the four countries operating such initiatives in October 2002. Site visits were made to the following prisons: • Moldova: Prison Colony 18 (Branesti), 11-18 November 2002 • Switzerland: Hindelbank (Berne), Saxerriet (Salez), Obershöngrün (Berne), 1-5 June 2003 • Germany: Lichtenberg (Berlin), Vechta (Lower Saxony), 11-14 June 2003 • Spain: Soto de Real (Madrid), 25-28 May 2003 During these site visits, the needle exchange programs were observed and unstructured interviews were held with prison medical staff, prison management, external professionals working in drug policy and/or harm reduction, and prisoners. In some cases government officials and/or representatives of non-governmental organizations were also interviewed. During the course of the research, prison needle exchange programs were initiated in two Methodology 3
other countries – Kyrgyzstan and Belarus. Since these programs were not in operation at the time the research plan was developed in October 2002, site visits to prisons in these countries were not possible. Therefore, research was conducted via • personal communications with the staff involved in coordinating the needle exchange programs • personal communications with the organizations funding the programs • written documentation provided to the authors by the above sources, including funding proposals, project reports, conference presentations, and other documents Because site visits were not possible in these cases, the information provided in the Kyrgyzstan and Belarus sections of the report is less detailed than that for the other countries. Finally, in March 2004, while the report was being drafted, the authors followed up with contacts in a number of the countries to verify and clarify information previously obtained and/or to obtain updates on the situation in a particular country’s prison system. 4 Prison Needle Exchange: Lessons from a Comprehensive Review of International Evidence and Experience
Page 2 and 3: Prison Needle Exchange: Lessons fro
Page 4: In memory of Andréa Riesch Toepell
Page 7 and 8: Spain 29 Summary 29 HIV/AIDS, HCV,
Page 10 and 11: Prison Needle Exchange: 2006 update
Page 12 and 13: Sample Evaluations of Prison Needle
Page 14 and 15: initiatives occurring in local comm
Page 16 and 17: ings on the feasibility and efficac
Page 18 and 19: Executive Summary This report exami
Page 20 and 21: • do not endanger staff or prison
Page 22 and 23: Prisoner Health Is a Public Health
Page 26 and 27: HIV and HCV Epidemics in Prison Pre
Page 28 and 29: injection drug practices and unprot
Page 30 and 31: Many prisoners, whether in pretrial
Page 32 and 33: while in holding cells before incar
Page 34 and 35: While harm-reduction policies do no
Page 36 and 37: • Additional Protocol to the Amer
Page 38 and 39: fit from medical treatment under th
Page 40 and 41: Review of International Evidence of
Page 42 and 43: History of the response to HIV/AIDS
Page 44 and 45: in drug consumption, and there were
Page 46 and 47: lence rate of approximately 0.1% in
Page 48 and 49: ic acid, filters, plaster, and sodi
Page 50 and 51: harm-reduction measures and declare
Page 52 and 53: injection drug use, HCV infection r
Page 54 and 55: the jurisdiction of the government
Page 56 and 57: punished by prison staff for access
Page 58 and 59: changed to a peer model, which has
Page 60 and 61: the prisoners who were injecting, a
Page 62 and 63: Kyrgyzstan 218 Summary Kyrgyzstan i
Page 64 and 65: of 20% to 40%. However, these treat
Page 66 and 67: working place, it is interesting to
Page 68 and 69: These findings demonstrate that the
Page 70 and 71: grams strongly reduced syringe shar
Page 72 and 73: proven effective in barracks-style
Page 74 and 75:
• Prison has opportunity to maint
Page 76 and 77:
staff, is also an indication of the
Page 78 and 79:
Needle Exchange Programs Should Be
Page 80 and 81:
professor of Aboriginal ancestry; a
Page 82 and 83:
contained and standards presented i
Page 84 and 85:
sophically supportive of the use of
Page 86 and 87:
• do not increase drug consumptio
Page 88 and 89:
the case in countries, including Ca
Page 90 and 91:
15 Central and Eastern Europe Harm
Page 92 and 93:
67 R Keppler, F Nolte, H Stöver.Tr
Page 94 and 95:
121 Australian National Council on
Page 96 and 97:
180 Delegación del Gobierno para e
Page 98 and 99:
245 Ibid at 14. 246 This analysis i
Page 100 and 101:
Bibliography International instrume
Page 102 and 103:
Byrne A, K Dolan. Methadone treatme
Page 104 and 105:
2000). Elementos Clave para la Impl
Page 106 and 107:
Landry S et al. Étude de prévalen
Page 108 and 109:
Shapshak P, RK Fujimura, JB Page, D
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