tattooing with shared instruments and unprotected promiscuous sex. The HIV epidemic in prison is predominantly driven by IDU but it would be a mistake to neglect sexual transmission in prison. X Such risk behaviours continue, resume or start in prison, often under more risky conditions than in the community, so transmissions and even epidemics have occurred and continue to occur.3 X Preventive and harm‑reduction measures are difcult to apply and often are not available in prison. X Access to diagnostic measures and treatments aiming to reduce the virus load of infected persons in prison is often defcient, less available than in the community or not available at all. X Released prisoners who acquired infections during detention may, often without knowing, transmit their infection to the community. The high degree of mobility between prison and community typical of convicted drug users, who mostly serve short, repetitive prison sentences, increases this risk to public health. 3.2 International documents Failure to provide prisoners with access to essential prevention measures and treatment that are equivalent to those available in the community is a violation of prisoners’ right to health and against international law such as the International Convention on Economic, Social and Cultural Rights and the European Social Charter.4 A number of recommendations, rules, declarations and resolutions by the Council of Europe and other international bodies underline the obligation of prison authorities to provide preventive health care, especially against HIV and hepatitis C epidemics in prison.5 3. Jürgens R., Nowak M. and Day M: “HIV and incarceration: prisons and detention”. Journal of the International AIDS Society 14:26 (2011); WHO/UNODC/UNAIDS: Interventions to address HIV in prisons: comprehensive review, Evidence for Action Technical Paper (Geneva 2007); WHO/UNODC/UNAIDS: Efectiveness of interventions to address HIV in prisons, Evidence for Action Technical Paper (Geneva 2007); WHO Europe: Policy guidance on HIV in prisons at www.euro.who.int/en/health‑topics/communicable‑diseases/hivaids/policy/ policy‑guidance‑for‑key‑populations‑most‑at‑risk2/hiv‑in‑prisons. 4. Article 12 of the International Convention on Economic, Social and Cultural Rights; Article 11 of the European Social Charter. 5. WHO Europe: Policy guidance on HIV in prisons at www.euro.who.int/en/health‑top‑ ics/communicable‑diseases/hivaids/policy/policy‑guidance‑for‑key‑popula‑ tions‑most‑at‑risk2/hiv‑in‑prisons; CM: Prison and criminological aspects of the con‑ trol of transmissible diseases including AIDS and related health problems in prison. Recommendation R (1993) 6; CM: The ethical and organisational aspects of health care Prison health care and medical ethics Page 52