[Transmission of infectious diseases during imprisonment--results of a study and introduction of a model project for infection prevention in Lower Saxony].

The increasing imprisonment rate of drug users is linked to a spread of infectious diseases in prisons (HIV and Hepatitis B and C). Several studies indicate a close correlation of imprisonment and transmission of infectious diseases. An analysis of international studies showed that worldwide in several cases transmissions of HIV-infection during imprisonment have been discovered. The cross-sectional examination presented here is describing the situation in the women's prison of Vechta (Lower-Saxony). Empirical data on the prevalence of infections with HIV, HBV, HCV and Lues of the years 1992 to 1994 were recorded. Moreover the scientific interest also included on the diagnosis of seroconversions. Discovered seroconversions were examinated on a possible transmission in custody. The spread of infectious diseases in prisons led to the demand for an alignment of internal drug aid services with external, tried and tested prophylaxis models. The availability of sterile syringes is included. The basic comparability of health care inside and outside prison (principle of equivalence) is not only demanded and recommended by the prison law [4] but also by international organisations [27]. As the first provencial government, the state of Lower Saxony in Germany has started to develop infection prophylaxis offers in two prisons (in the women's prison in Vechta since April 15th 1996 and in the men's prison of Lingen I, department Gross Hesepe since July 15th 1996) in 1996. These offers include the provision of sterile injection equipment to intravenous drug addicts (ivDA). Modalities of the practice and first experiences documented by the schientific evaluation are presented.