Prevention of infectious risks in prison settings in France. ANRS-PRI2DE inventory, 2009
Introduction – Prisons are at high infectious risk in France where prevention is regulated by a circular of 1996 and a methodological guide updated in 2004 issued by the Ministry of Justice and the Ministry of Health respectively. The objective of this study is to estimate the risk of infection in French prisons based on an assessment of the accessibility of preventive measures recommended in these texts.
Material-methods – A questionnaire was sent to each head of medical unit for all French prisons in November 2009 .
Results – Sixty-six percent of prisons answered, covering 74% of the prison population. A low level of accessibility to preventive measures was generally observed, especially for bleach, opioid substitution treatments, condoms, post-exposure prophylaxis for HIV and haircutting. Two score of adherence to national and international guidelines were calculated in order to evaluate the gap between recommendations and practices.
Conclusion – The French infectious risk-prevention system in prisons is quite limited statutorily compared to the system existing in the community. Moreover, it is not adequately implemented. The risk of infection is high and a new prevention and care policy in prison settings is urgently needed. Sufficient resources to expand and train health care teams as well as other stakeholders in prisons must be allocated.