Available data show geographical and temporal variation in seroprevalence among inmates along with infrequent intraprison transmission of HIV-1. Still, HIV-1 infection remains a major prison health problem. Large numbers of persons either at risk for infection or already infected continue to enter correctional facilities. Prudent policies are needed to continue monitoring, treating, and intervening with this population so as to prevent and control HIV-1 infection. Responses to HIV-1 infection in the correctional setting have included inmate risk education; screening for antibody to HIV-1 infection; segregation of seropositive inmates; and, to a lesser extent, treatment for drug abuse. Cost-effective planning for AIDs education programs should recognize that fundamental concepts of HIV-1 transmission and prevention are likely already to have been disseminated to inmates. A current focus for such programs should include clarification of unlikely transmission sources, with the objective of minimizing unnecessary fears and concerns. The use of serological screening of inmates in costly, but two factors may offset the cost: voluntary rather than mandatory screening and screening to identify and target subgroups most likely to benefit from intervention. This would include intravenous drug users. The latter should also receive drug treatment in an effort not only to reduce their risk for HIV-1 infection, but to improve their chances for rehabilitation. 39 references and 1 table
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