While the precise effects of long term incarceration on the psychological well being of offenders are still unclear, it is clear that the physical health of inmates is at risk in correctional facilities. As mentioned above, the rate of HIV infection in Canadian prisons is ten times greater than in the community (Jürgens, 1996; CSC, 1998). Correctional Service Canada has implemented some measures to combat the spread of infectious diseases spread via sexual activity or needle sharing. Bleach kits have been introduced into prisons with information on the proper disinfection of syringe needles, and condoms are available. More needs to be done to make prisons safer for the health of inmates, however. Needle exchange programs would be more effective in reducing the spread of the disease since they would virtually eliminate the need for needle sharing among inmates. The CSC has stated that they cannot provide needle exchange programs because of the potential hazard that needles could present if used as weapons. But needles are readily available in correctional facilities, and the CSC has acknowledged this by introducing bleach kits for intravenous drug users. The risk of assaults with needles would not increase if a needle exchange program were introduced because only one needle would enter into the general inmate population in exchange for each needle that is returned for disposal. The CSC does not want the Canadian public to think that they are condoning intravenous drug use, so it will not allow (at least at this time) needle exchange programs in its facilities. In order to fight HIV and the hepatitis viruses, the CSC must concentrate less on appearances and more on the realities of disease transmission, and eliminate inmate needle sharing.

In sum, the protection of the community demands that we treat all inmates, but long term inmates most of all, in a humane and dignified manner. We must be vigilant in the fight against infectious diseases in prisons because inmates who contract HIV or hepatitis while incarcerated can spread these viruses when released back into the community. We must also ensure that inmates' mental health is not sacrificed for the purpose of punishment. Offenders must be taught how to live productively as law abiding citizens so that they can return to society without posing a threat to our safety. These goals can be accomplished, but to do so, policy makers must make rehabilitation paramount in sentencing over retribution and punishment.

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