2 Lack of outreach and program information to prison staff may have contributed to limited implementation. Screening for STDs or hepatitis in jail or prison systems in the US is spotty, even though inmates are disproportionately affected by these diseases. 8 Prisons and jails may be reluctant to offer voluntary HIV testing because they know that if a prisoner tests positive, he or she must have access to costly medications. Laws governing prison conduct can be barriers to disease prevention. The vast majority of correctional facilities prohibit condom possession or distribution.
All facilities prohibit possession of needles and syringes.
Therefore, inmates who engage in risky sexual and drug use activities have no means to protect themselves from disease. Prisoners often want to celebrate their release by engaging in activities that were not allowed while incarcerated. Often these activities pose high risk for infectious diseases. At the only prison facility in the state of Rhode Island, a comprehensive program addresses prisoners' needs while incarcerated as well as after their release. The program involves routine HIV testing for all entering inmates.