HIV is more common among prisoners than among the general population of Thailandóone study, for example, in Klong Prem Central Prison, Bangkok, found that 25% of prisoners who agreed to be tested were HIV positive compared with a general prevalence of 1.5% in the national population.
But Thailand's prisons, say Ford and colleagues, suffer from a lack of health staff and severe budgetary constraints that impede the effective delivery of HIV care and prevention programs.
In this week's PLoS Medicine, Nathan Ford and colleagues from the humanitarian agency (MSF; Doctors Without Borders) describe their experience of providing HIV prevention and treatment in two prisons in Thailand.
In June 2003, at the invitation of the prison health services, MSF began providing clinical support in two prisons in BangkokóMinburi, a remand prison, and Bangkwang, a maximum-security prison.
In their PLoS Medicine paper, Ford and colleagues describe running workshops in these prisons on HIV prevention, offering HIV tests to prisoners, and treating prisoners with HIV infection with anti-retroviral and other drug therapies. The authors present data that suggest that the clinical outcomes of patients with HIV treated in these prisons is comparable with treatment programmes in other settings.
'The attitude of the prison health care staff towards the rights of prisoners to access antiretroviral therapy is very positive,' say the authors. 'The fact that none have questioned that three prisoners facing the death sentence receive antiretroviral treatment is a clear indication of the staff's commitment to treatment as a basic human right.'