Thus, inmates retain their rights to access to medical, nursing, and pharmaceutical care of the same standard and accessibility as is available in the community at large. In addition, no medical procedure may be undertaken without the prisoner's informed consent. Finally, prisoners should receive all the advice and health education available to the general community relating to health promotion and the control of infectious disease, as well as additional information related to factors in the prison environment. The prevalence of infection with HIV is far lower in England and Wales than in the United States and mainland Europe. All prisoners receive health screening on entry. HIV antibody testing has been available on demand by prisoner patients on the same conditions as it has been available to the general community and from the same date. Counseling is also provided before and after testing. In addition, a clear policy statement covers confidentiality, activities of HIV-positive persons, and treatment. Extensive education and training are also provided. Condoms remain contraband, however, and the prison service does not intend to supply sterile needles to intravenous drug abusers.