Spinal litigation remains a source of significant cost to the NHS. The complexity of resolving these cases is reflected in the associated legal costs.

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of the genital tract significantly increases the rate of transmission of HIV.4 Genitourinary medicine services have a pivotal role in preventing HIV infection by education, counselling, and the management of other sexually transmissible infections. It is thus of particular concern that many prisons in Scotland have no specific genitourinary medicine services, and the few existing services may be under threat. Policies to reduce harm need to address all aspects of potential transmission of HIV and not to concentrate on injecting drug use to the exclusion of others. Furthermore, the provision of entirely confidential, high quality open access genitourinary medicine services to this group of people should be an important component of such policies.