Mass imprisonment of drug users worldwide, as well as a scarcity of harm reduction programs, contributes to the spread of HIV, hepatitis B and C viruses (HBV, HCV) and tuberculosis (TB), according to a series of research projects.

Researchers estimate that up to half of all HIV transmissions in Eastern Europe during the next 15 years will stem from prisoners who inject drugs. They further project that cutting the population of incarcerated injection drug users (IDUs) by a quarter would reduce HIV transmissions by 7 to 15 percent among IDUs over a five-year period. Scaling up opioid replacement treatment, such as methadone, to prisoners who need it as well as to those coming out of prison could prevent 28 percent of new HIV cases among IDUs during the same period.

“Zero-tolerance drug policies and the mass incarceration of people who use drugs were implemented in the name of protecting the well-being of the public,” says the lead author of the series of studies, Chris Beyrer, MD, an epidemiologist at Johns Hopkins Bloomberg School of Public Health. “But the evidence is clear that they have failed to reduce substance use and undermined the health of the very communities they were meant to protect and have increased HIV, viral hepatitis and TB spread.”