Rates of HIV among inmates in federal prisons appear to be rising dramatically, suggests a report, prompting advocacy groups to call for sweeping changes to prevent further spread of the disease, both inside the institutions and in the community at large.
The 2007 survey by Correctional Service Canada found an estimated 4.6 per cent of prisoners reported having HIV-AIDS, more than double the 1.6 per cent rate cited in an earlier report.
"When we found the HIV prevalence rate, we were astounded at the number of 4.6 per cent," said Sandra Ka Hon Chu, a senior policy analyst with the Canadian HIV-AIDS Legal Network in Toronto. That prevalence rate is 15 times higher than that found among the population as a whole.
"So this is the new reality we're working with," she said Wednesday, deeming the HIV infection rate "comparable to many countries in the region of sub-Saharan Africa."
The report also found the estimated rate of hepatitis C among federal prisoners was 31 per cent -39 times greater than that found in the community. Incarcerated women, and especially aboriginal women, are also disproportionately infected with HIV and hepatitis C, it showed.
Advocacy groups want Ottawa to implement needle-exchange programs for injection drug-using prisoners to try to stop the spread of HIV and hepatitis C, which can be passed through infected blood when syringes are shared.
The Canadian HIV-AIDS Legal Network says about half of prisoners surveyed reported sharing used needles or syringes to inject drugs - typically opiates like heroin and cocaine - which are smuggled into prisons by visitors and occasionally even by staff, said Ka Hon Chu.
She said drug-using prisoners have reported stealing syringes from medical services within their institutions and fashioning makeshift needles.
"And that's the scariest part - things being made from rubber tubing or pens that create large scars or wounds in the arm," she said. "So anything they can imagine using they will get their hands on, they will create a needle with it."
With no clean needle program in place in any federal or provincial prison or jail in Canada, it is not unusual for "filthy" needles to be shared among 30 or 40 inmates, said HIV specialist Dr. Peter Ford, a former professor at Queen's University.
Yet Ka Hon Chu said in countries around the world which have adopted in-prison needle-exchange programs, the results have been mostly positive.
"I think it's just we don't want to feel like we're failing by providing these implements to people to inject drugs or enable them," she said of Canada. "But the studies have shown that where the programs exist ... there's no increase in the use of drugs or injection drugs. There is actually a decrease in syringes and needles (use) and increasing referrals to drug addiction treatment programs."
However, crime bills recently proposed by the Harper government have included mandatory-sentencing policies, which prisoner advocacy groups say would lead to even higher rates of HIV and hepatitis C, aggravating the already existing public health crisis in federal prisons.
A CSC spokeswoman said the federal department "is not considering the introduction of prison-based needle-exchange programs."
"The government has a zero-tolerance policy for drugs in our institutions," Christelle Chartrand said by e-mail. "Providing needles for illicit drug use runs counter to that policy. Illicit drugs in federal prisons compromise the safety and security of correctional staff as well as our communities."
"CSC has a comprehensive anti-drug strategy combined with a number of health promotion practices and harm reduction measures to mitigate the spread of infectious diseases.
The anti-drug strategy includes prevention, intervention/treatment and enforcement."
Advocacy groups reacting to the CSC report Wednesday also called on Ottawa to institute programs that will ensure prisoners receive proper health care.
In the CSC report, about 60 per cent of prisoners surveyed said they had experienced "interruptions" that prevented them receiving their medications at certain times.