HIV/AIDS in Prison Settings Dr. Monica Beg HIV/AIDS Unit,
United Nations Office on Drugs and Crime, Krakow, Poland September
27, 2004
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Outline of presentation Global HIV/AIDS situation HIV/AIDS in
Eastern Europe Global injecting drug use (IDU) HIV among IDUs in
Eastern Europe HIV/AIDS in prison settings WHO/UNAIDS guidelines
relative to HIV/AIDS in prisons UN resolution specific to HIV/AIDS
in prison settings Addressing HIV/AIDS in overall prison
context
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13,158,345 IDUs Worldwide 10,292,220 of them (78%) in
developing countries 130 countries and territories Estimates on the
size of the IDU populations available in 130 countries and
territories (1998/2003) Countries with estimates on the size of IDU
S. & S-E Asia: 3.3m E. Europe & C. Asia: 3.2m E. Asia &
Pacific 2.3m MENA:0.4m S. Saharan- Africa 0.009m L. America: 1m
Caribbean: 0.02m N. America 1.4m W. Europe: 1.2m Australia & N.
Zealand: 0.2m
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In some states of Eastern Europe and Central Asia in particular
Russia, Ukraine, Lithuania, Latvia and Estonia, reports indicate
that the rates of HIV- infection among prison inmates are higher
than in the general population. Why? Prisons - a breeding ground
for HIV
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General prison conditions... Overcrowding Violence, self harm
Higher prevalence of drug use, HIV, hepatitis B and C, TB, mental
illnesses than in society outside Vulnerable groups/behaviour: -
Hierarchical homosexual relations - Other forms of sexual violence
e.g. gang rape - Tattooing - Drug use, including injecting drug use
(IDU)
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Overcrowding Prisons are overcrowded in 111 countries Prisons
in 39 countries housing 1.5 to 3 times capacity High turnover 30
million prisoners in and out of prison per year worldwide 10
million people imprisoned at any given time
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Source: Dr. Stoever, 2004
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In 1993 WHO issued guidelines on HIV infection and AIDS in
prisons All prisoners have the right to receive health care,
including preventive measures, equivalent to that available in the
community without discrimination, in particular with respect to
their legal status or nationality. The general principles adopted
by national AIDS programmes should apply equally to prisoners and
to the community.
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In 1997 UNAIDS recommended intervention components to prevent
HIV/AIDS in prisons: - Provision of syringes - Ensurance of
availability of bleach - Demand reduction for drug users including
substitution treatment - Provision of discreet and anonymous access
to condoms - Education on HIV transmission risks - Introduction of
peer education
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In 2004, the UN Economic and Social Council adopted a
resolution specific to HIV/AIDS in prison settings, recognizing
that Effective HIV/AIDS prevention, care and treatment strategies
require behavioural changes and increased availability of, and
non-discriminatory access to, HIV/AIDS prevention, care and
treatment services; Prisoners have the right to adequate health
care; Access to qualified medical personnel should be ensured for
prisoners.,
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Summary Prison settings high risk environments for HIV/AIDS
There are proven, effective interventions for prevention Issue is
governmental denial, not lack of evidence
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HIV/AIDS in prison settings warrants a comprehensive approach
Advocacy to mitigate problem of governmental denial & to create
favourable legal / policy environment HIV/AIDS prevention, care and
treatment in prison settings equivalent to outside community
Improvement of general prison conditions by - Minimizing
overcrowding (e.g. use of alternative measures and diversion
programs) - Operating secure, safe and orderly prisons - Reducing
violence
