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Logo of bmjThis ArticleThe BMJ
BMJ. 2007 November 17; 335(7628): 1008.
PMCID: PMC2078672
Resistance to HIV drugs

Detainees are affected

Edward Costar, foundation year 1 doctor1 and Jillian Pritchard, consultant in genitourinary medicine2

The problem of discontinuous antiretroviral therapy in the prison healthcare system leading to increased viral resistance applies also to detainees held by the immigration authorities. Many such detainees are held for a long time after the initial decision to deport, pending the resolution of legal challenges.1 Detainees are often moved between detention centres and immigration removal centres as their cases are considered, and their antiretroviral drugs often do not follow them. It may be weeks before the local genitourinary clinic is made aware that a transfer has taken place, which causes a large gap in treatment.

Consequently, when these patients are eventually deported, they have developed a resistance pattern that requires second or third line antiretrovirals, which are not available in the countries to which they are deported, even if those countries have some provision of antiretrovirals. It is a serious failure of the healthcare systems provided by the Border and Immigration Agency that the treatment of HIV positive detainees is undermined by repeated transfers and inadequate notice being given to ensure continuity of care.


Competing interests: None declared.


1. Laurent C. Prisoners are developing resistance to HIV drugs because their care is fractured. BMJ 2007;335:583 (22 September.) doi: 10.1136/bmj.39343.387315.DB [PMC free article] [PubMed]

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