Littlehay Prison, Cambridgeshire, is one example of good practice. It has had an HIV policy committee for two years, with local clinical nurse specialist and communicable diseases specialist representatives. Chair is Stuart Copping, a senior healthcare officer at the prison. It has drawn up a protocol to ensure that any HIV-positive prisoner is treated at Hinchingbrooke Hospital in Huntingdon.

Mr Copping says prisoners have adequate supplies of combination therapy drugs and the prison makes it easy for them to stick to their regime. 'We do not segregate the HIV-positive prisoners, but if they are having any difficulties on the wing they can come into the healthcare centre at any time.'

Two of the 655 prisoners have HIV. Their home health authorities pay for their treatment while they are in Littlehay, but there is no guarantee they will get the same treatment once they transfer. Mr Copping explains: 'Because there is no national policy it is up to the individual prison.'