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A South African sentenced to prison is at high risk of contracting HIV before he even arrives at prison for the first time. Prisoners are primarily young, black men from impoverished communities already hardest hit by HIV/AIDS. Much of their behaviour prior to incarceration is high risk for contracting HIV, and is likely to continue upon their release. Conditions in South African prisons also contribute to increased HIV prevalence due to gang violence, poor nutrition, and inadequate health care. If these issues are not addressed, the consequences will be dire, not only for the prison population, but for the broader society into which prisoners are released upon completion of their sentences. The overcrowding of prisons is one of the most important factors affecting prisoner health; reducing the size of the prison population is essential to prison reform. [ABSTRACT FROM AUTHOR]

Prisoners in South Africa face problems of overcrowding, violence and poor nutrition. Added to this burden in recent times is the increased threat from HIV. The HIV epidemic has been relatively late in coming to South Africa but infection rates are now 20% in the adult population. However, there is no data available on the level of HIV infection in the prison population. Overseas studies suggest that the characteristics of prisoners place them at much greater risk of HIV infection. Factors which contribute to increased levels of HIV infection include poor health care facilities, lack of condoms and lack of disinfectants. Current policies and practices on HIV in prison attempt to balance the constraints of limited resources with the need to preserve prisoner human rights. The outcomes include: mass testing not freely available, HIV education is limited, and early release of prisoners with advanced AIDS is not allowed. Constraints on the implementation of effective HIV prevention strategies include: bureaucratic inefficiency, lack of resources, and a reluctance by prison authorities to address the issue of HIV in prison. These problems can possibly be overcome by addressing the issue from both management and prisoner perspectives. On the management side, increased resources, increased training of prison officials, and increased political commitment to address the issue are required. Outside partnerships are probably required for an effective response. Prisoners require better nutrition, better living conditions, better health care, freely available condoms and disinfectants. [ABSTRACT FROM AUTHOR]

Within the South African prison system there are major problems like overcrowding and violence. A major problem which has received little attention is HIV/AIDS. The characteristics of the prison population makes them more highly susceptible to HIV infection than other people in South Africa. This in a society with already record-high levels of HIV infection. Government policies toward, and practices within, prisons basically ignore the HIV problem in the vain hope that it will go away. It will not go away. The dimensions of the level of HIV infection in prison is unknown and unmanaged. [ABSTRACT FROM AUTHOR]