A/HRC/10/44 page 20 61. Whereas these figures reflect the situation in society at large, they are normally exacerbated when it comes to persons deprived of their liberty since places of detention create high-risk settings from the point of view of HIV, because of higher rates of HIV, high prevalence of risky-behaviour, including injecting drug use and sharing of injecting equipment, and sexual activity.50 The criminalization of drug use and of syringes may contribute to this heightened risk. At the same time, although there is strong evidence that needle and syringe programmes play a crucial role in the prevention of HIV infection, only in eight countries do prisoners have access to such programmes.51 62. The Special Rapporteur would like to stress that the Standard Minimum Rules for the Treatment of Prisoners, approved by the Economic and Social Council in its resolutions 663 C (XXIV) and 2076 (LXII), fully apply to drug users, in particular rule 22 (2), which requires that detainees have access to specialist treatment. He also refers to a 2006 case, Khudobin v. Russia, where the European Court of Human Rights found that the absence of medical assistance of a HIV-positive prisoner, in the given context, amounted to degrading treatment.52 3. Forcible testing for HIV or hepatitis C 63. Since drug users carry a higher risk of contracting blood-borne viruses, often owing to the unavailability of sterile injecting equipment, in many countries they are also disproportionately subjected to forcible testing, in particular with regard to HIV and hepatitis C. In the Special Rapporteur’s view, in general, testing must be voluntary and based on informed consent. In particular cases and circumstances, however, forcible testing may be necessary, such as for the purpose of obtaining evidence in court proceedings, but only if the necessary safeguards are in place.53 50 See for example www.who.int/hiv/topics/idu/prisons/en/index.html. 51 International Harm Reduction Association (2008), “Global state of harm reduction 2008: mapping the response to drug-related HIV and hepatitis C epidemics”, p. 17. 52 “[T]he applicant was HIV-positive and suffered from a serious mental disorder. This increased the risks associated with any illness he suffered during his detention and intensified his fears on that account. In these circumstances the absence of qualified and timely medical assistance, added to the authorities’ refusal to allow an independent medical examination of his state of health, created such a strong feeling of insecurity that, combined with his physical sufferings, it amounted to degrading treatment within the meaning of Article 3”, 26 October 2006, para. 96. 53 Saunders v. the UK, judgement of the European Court for Human Rights, 17 December 1996, paras. 69-74.