HIV infection is a major public health problem in prisons and jails. In several correctional systems, AIDS has become the leading cause of death. Seroprevalence estimates for different systems in the United States and Europe range form 0 percent to 18 percent among inmates entering prison, indicating geographic variation. Reported HIV rates are higher among females compared to males, among inmates over 25 years, and among racial/ethnic minorities. The major established risk behavior for HIV infection among prison inmates is a history of pre-incarceration intravenous drug use. The prison and jail setting provides an opportunity to educate, counsel, test, and treat individuals at risk for HIV infection who otherwise might have a very limited access to care. Services to this population must be voluntary and confidential.
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