Delegates in Toronto have heard how HIV transmission has been overlooked by the world’s authorities and media according to activists at AIDS 2006.

The 16th annual conference has heard a number of encouraging lectures on improving responses and drug treatments, but has also heard of the continuing problem of infection for prisoners globally.

“More than 20 years into the pandemic, the response in prisons is still undecided,” said researcher Alick Nyirenda, as quoted by Agence France Presse. “Demand for services outstrips their availability.”

Between the use of infected instruments, such as needles or tattoo equipment, and homosexual encounters prisons across the globe are said to have become ‘incubators’ for HIV. Annie De Groot, of Brown University in the United States, said inmates were rarely mentioned in discussion about AIDS today.

“There must be a change in attitudes” she added.

Gay sex is not held responsible for the increase in rates, though the failure for countries who consider homosexuality illegal to deal with the problem fully in the prison system is obvious cause for concern. This is despite a proven increase in rates of homosexual activity by inmates, by choice or through sexual attack.

Some prisons provide free condoms, though a fear of being outed is blamed for them not being used.

Increased drug use has received some of the blame for continued infection in Europe. According to UNAIDS there are 600,000 injecting drug users in the former Soviet states.

In Ukraine the jump has been blamed on rocketing drug use by prisoners. This may help to explain the high rate of infection among the Ukrainian prison population.

This conclusion is supported by studies like HIV Transmission and Prevention in Prisons (2006) by Dr Elizabeth Kantor that highlights the main causes of infection for prison inmates. The study also exhibits the difference between the number of people with HIV in the general population and those in prison. The difference fluctuates, but in some the difference is as high as over 20 times.

At the conference the nature of incarceration in which inmates are placed was also blamed, with poor malnutrition and high re-offending rates blamed.

Programmes to provide free needles, such as those first piloted in Switzerland, have proven a success lowering both infection rates and the number of habitual users in jails. The program has now been introduced in 8 countries.