§ The first recorded case of HIV transmission within the English Prison Service has been reported and confirmed. The transmission was by sexual contact. Cases of transmission reported from Glenochil Young Offender Centre in Scotland last year were caused by injecting with contaminated needles.
§ I draw this case to your attention to remind you of the need to continue to give high priority to HIV/AIDS awareness, and to have in place a strategy for the management of HIV/AIDS in your prison. All prisons should have HIV multi-disciplinary teams as outlined in Circular Instruction 30/1991. Following the completion of the 1993 Training Programme prisons should also have trained HIV counsellors and trained HIV care and support officers who are available to develop education programmes and offer advice to staff and prisoners. The multi-disciplinary teams need to consider contingency plans for HIV emergencies including outbreaks of HIV, hepatitis B or other infectious diseases related to HIV. The medical officers, trained counsellors and care and support officers must be able to provide support and advice if such an incident occurs in each prison.
§ Doctors have particular responsibility to communicate relavant medical information promptly to their medical colleagues both inside and outside of the Service. Where transmission of HIV occurring within the prison context is documented, it is important that this information is provided to the health care adviser and the Directorate of Health Care. The names of the infected individuals need not be divulged.
§ It is important that liaison between the doctor in the prison, the health care adviser and the Directorate is achieved in order that the most appropriate action is taken, and that any relevant questions which may be raised in the media or in Parliament can be dealt with appropriately.
§ Doctors have a responsibility to ensure that any person known to have HIV infection has access to regular medical monitoring (both clinical and laboratory). This is outlined in the Circular Instruction. Regular medical monitoring must include counselling on safer sexual behaviour and safer drugs use to minimise the risk of spread of HIV infection.
§ Doctors have the clinical freedom to prescribe pharmaceutically or otherwise to protect the health of individual prisoners. Legal advice is that doctors who so prescribe for their patients with appropriate advice, in the exercise of their clinical judgment, could expect protection in law for doing so.
§ Any queries about this DDL should be addressed to Dr. Robin Ilbert or Mr. L. Curran.