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Commentary on Larney (2010): a call to action-opioid substitution therapy as a conduit to routine care and primary prevention of HIV transmission among opioid-dependent prisoners.

Larney [1] should be commended for delineating clearly the serious deficits not only in the paucity of available opioid substitution treatment (OST) in prisons, but also on the limited critical evaluation of such programs within the literature to date. The few available studies without significant methodological flaws confirm OST conferring positive public health outcomes by reducing intra-prison injection drug use (IDU) and IDU-related human immunodeficiency virus (HIV) risk behavior. While this review focused specifically on OST's impact on HIV risk behaviors, the benefit of providing this medically indicated and evidence-based treatment goes well beyond this narrowly defined outcome.