During recent country visits, the CPT has identifed severe defciencies in preventive measures against spread of HIV/Aids and hepatitis C.6 Preventive measures against the spread of HIV/Aids and hepatitis B/C in prison can be summarised in four steps: improvement of attitudes and knowledge, reduction of drug supply and demand, harm reduction and medical measures. 3.3 Improvement of attitudes and knowledge Acceptance of taboo realities Prison authorities and politicians all over the world hesitate to acknowledge and admit the fact that there are drugs, drug use and sexual activity in prison, for fear that the public will make them responsible and accounta‑ ble for the fact. However, as long as these realities are taboo, it will remain difcult, if not impossible, to implement appropriate measures against the transmission of viruses in prison. Politicians and the public need to learn that preventing the spread of HIV and hepatitis C and other infections in prison is important not only for the health of prisoners, a matter usually not of high political priority, but also for the sake of general public health. The Moldovan model of a needle/syringe‑exchange programme in prison, an impressive and exceptional example of good practice in preventing the spread of these infections, became possible only when the authorities, and later the public, accepted these realities. This was a good example of efective policy necessary to introduce new strategies.7 Alternatives to imprisonment Exhausting all available alternatives before incarcerating drug‑dependent ofenders is probably the most efective strategy in preventing the spread in prison. Recommendation R (1998) 7; The CPT Standards 2002 (rev. 2011); UNAIDS/ UNODC/WHO: HIV/AIDS Prevention, care, treatment and support in prison settings: a framework for an effective national response (New York 2006); WHO Europe: WHO guidelines on HIV infection and AIDS in prisons (Geneva 1993); Møller L. et al: Health in prisons: a WHO guide to the essentials in prison health (Geneva 2007); Penal Reform International: Dublin Declaration on HIV/AIDS in prisons in Europe and Central Asia (Dublin 2004); World Medical Association: Declaration of Edinburgh on prison conditions and the spread of tuberculosis and other communicable diseases (Edinburgh 2000, rev. Montevideo 2011); UNODC: HIV prevention and care in prisons and other closed settings: a comprehensive package of interventions, Policy Brief (Vienna 2012). 6. CPT/Inf (2009)1; (2009)35; (2010)33; (2011)20; (2011)29; (2012)4; (2012)32. 7. Prison Needle Exchange: Lessons from a comprehensive review of international evidence and experience, 2nd edn (2006), Canadian HIV/AIDS Legal Network. Preventing the spread of HIV/Aids and hepatitis B/C in prisons Page 53