Objectives: To determine a frame work for significant prison environment and health systems factors influencing transmission of HIV/STI/TB and Drug Abuse in prisons. Methods: Data base: Medline, CINAHL, Cochrane Library and WHO Journals, Reports/Policy. Documents that review the progress of prison health care were identified. The sources for the study were chronologically examined under historical development of prison health care trends since 1900. The documents were reviewed and organized around Knowledge, Attitude and Practice, Legal &, Prison Systems, Prisons Health Care, Interventional areas and Practice Topics or Issues, not the chronology of the research. Results: Prison health frame work on HIV/STI/TB environmental factors was extensively studied and was found suitable for the 21st century prison health care in accordance with the WHO guidelines. The construct was analyzed to provide the needed knowledge, attitude and practice. The problems for implementing prison health are: lack of committed leadership, lack of strategic planning and a locative efficiency by the Ministry concerned, coupled with no or lack of resources and amnesty decisions on patients. Conclusion: Better understanding of the three infectious diseases must produce effective prisoners and prison staff in reducing HIV/STI/TB transmission. Knowledge, Attitude and Practice facilitate early diagnosis of the disease. Inmates lack understanding of the transmission of these diseases. Overcrowding, poor nutrition, inadequate and lack of ventilation and light must be prevented or controlled. Prisons lack of clear policies on how to reduce transmission, modified attitude towards human rights and to strategically promote good prison health and also provide a basis for promoting equity of access to health care and quality systems, performance monitoring and evaluation of prison health care, practices and quality activities.
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