So high HIV rates inside penal institutions can also have serious implications for the community outside. It is not just HIV which is a cause for concern. With some quarter of a million adult cases estimated last year in the general population of Eastern Europe, TB has become a significant health problem for people both outside and within penal institutions. Because the disease is airborne, overcrowded prisons provide ideal conditions for transmission between prisoners, staff and visitors. People with HIV are much more likely to develop TB because HIV suppresses the immune system.
Inaction threatens the health of prisoners, prison staff and the general population.
Experience has shown that much can be done to stop the spread of HIV, but for that to happen those responsible for penal institutions must first recognize certain risk factors and forms of behaviour in jails. In many countries the relevant authorities may deny the existence in prison of high-risk behaviour such as drug injecting and unprotected sex between men. They also often refuse to provide the means to prevent HIV infection for fear of increasing that behaviour. However, experience is proving that such fears are unfounded. While it is understandable that authorities are reluctant to be seen to be supporting activities that may be illegal in society as a whole, the fact is that there is not a prison in the world where drugs have been kept out.