Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. E11440)
Starnini G, Brunetti B, Babudieri S, Giuliani E, Armignacco O Starnini, Viterbo, Italy
There are different ways to approach the problems of seropositive people in prison, from the social research to the clinical and epidemiological diagnosis. Anyway, it is essential to analyse the phenomenon in its entirety, as it consists of aspects that are all equally important. Up to today, in Italy, none of these aspects has been completely and definitively resolved. According to recent statistics, the epidemic has fallen: from 2.489 seropositive prisoners in 1990 (out of 25.573 prisoners) to 1.454 in June 2001 (out of 55.216 prisoners), but the (optional) test has never reached the 50% of the prisoners. The lack of homogeneity on the national territory - with regions where the seropositive prisoners are more than 100, such as Lombardy (411), Latium (160) and Piedmont (137), and other regions where the problem of seropositivity in prison is irrelevant - makes necessary to carry out different projects, suitable to the different regional realities. On the grounds of these data, that the Department of Prison began to gather in 1990, even if the first researches on this subject began in 1984, the Department itself and the Ministry of Justice had to consider problems of great technical, juridical and social relevance. The strategy of intervention tended immediately towards a twofold aim, the same pursued today: to consider all the possibilities for seropositive prisoners to go out of prison; to better health care inside prisons. Other researches carried out in 1999, that proved that many prisoners did not take the prescribed antiretroviral therapy, raised doubts on the efficacy of the legislative and the sanitary measures that had been adopted. Anyway, the Law 12/7/99 n. 231 took an important step forward, providing: similar benefits for any serious pathology (not only AIDS); the possibility of alternative measures to detention in the presence of one of the following parameters: Karnofsky's index ≤ 60, CD4 > 200 mm3 in two subsequent measurements.
Keywords: AEGIS, Prisoners, Prisons, Delivery of Health Care, Italy, Acquired Immunodeficiency Syndrome, Social Justice, Disease Outbreaks, ethics
