1. Training Criminal Justice Professionals in Harm Reduction Services for Vulnerable Groups funded by the European Commissions Directorate General for Health and Consumers Prison staff and harm reduction Core module session 2

2. 2 Session 2 Risk behaviour and drug related harm

3. 3 HIV / AIDS Around 33 million people around the world currently live with HIV 2,7 million new infections in 2007 2 million AIDS related deaths in 2007 HIV occurrence is higher in prison than in the community

4. 4 Activity How does HIV spread in prison?

5. 5 Lecture Drug related harm

6. 6 HIV / AIDS An infection with HIV leads after a certain time to the immunodeficiency disease AIDS HIV is transmittable via blood, sexual contacts and from mother to child AIDS is treatable but not curable Injecting drug use contributes to the spread of HIV/ AIDS

7. 7 Hepatitis C Highly prevalent among injecting drug users Transmittable via blood e.g. by sharing of injection equipment In most European countries, over 40% of injecting drug users are infected with hepatitis C (EMCDDA, 2008)

8. 8 Hepatitis B Over 40% of injecting drug users have a history of hepatitis B Transmission via sexual contacts, blood and other body fluids (saliva, breast milk) There exists a vaccination against hepatitis B

9. 9 Other health problems Bacterial infections due to Poor hygiene when injecting drugs Injection of contaminated drugs Using contaminated injecting equipment Local infections like abscesses are common among injecting drug users

10. 10 Overdose Minimum estimate of 7.000 to 8.000 drug-induced deaths per year in Europe Opioids are most often associated with drug related deaths Newly released prisoners especially are at high and acute risk of drug related death

11. 11 Drug related deaths in newly released prisoners Ten times higher than normal All female and 95 % of male deaths during the first fortnight outside prison were drug-related (overdose) Of 49.000 released prisoners 442 died within a period of 3-5 years (59% of the deaths drug related) Opioids were involved in 95% of the drug related deaths

12. 12 Other drug related harm Mental health problems Economic problems Social problems Family break-down Neglect of children Open drug scenes (i.e. public places where drug user congregate) Drug related crime Imprisonment