Effective prevention for inmates requires collaboration between inmates, corrections staff, public health and community-based service organizations. This requires hard work, as these institutions often harbor distrust of each other and may have different missions. Involving inmates or former inmates as peer educators is essential for education and advocacy. Educational, social, psychological and medical services need to collaborate as well, because many inmates are triply diagnosed with infectious diseases, substance abuse and mental illness. Prevention efforts need to begin the minute inmates enter the facility and continue post release.
Discharge planning can help ensure better care for inmates once they have rejoined the community.
Also, ongoing training and education for prison staff is key for ensuring that programs are consistent and sustainable within institutions. Laws that prevent inmates' access to condoms and clean needles must also be challenged. Voluntary screening and testing for HIV, STDs, TB and hepatitis should be available, and all inmates who test positive, including IDUs, must have access to comprehensive treatment for HIV, HCV and other infections. Journal of Community Health Nursing. The state of correctional health care at the end of the millenium.