Prevention of Drug Use and HIV in Prisons
Nature and Scope
It is estimated that there are more than 10 million people imprisoned worldwide. The levels of HIV infection among prison populations tend to be much higher than among the general population. Preventing HIV in prisons is an integral part of reducing the spread of infection in the broader society, as most people who contract HIV while incarcerated will, at some point, be released.
Effective policies to prevent HIV infection inside prisons and the root causes that lead to infection are hampered by the denial of the problem.
Many factors (including drug use, unsafe sexual practices, overcrowding, inadequate nutrition, poor health services, violence, corruption and poor prison management) make prisons a high-risk environment for the transmission of HIV, tuberculosis and other communicable diseases. The lack of education among prisoners about the risks of contracting and transmitting HIV increases the risk of infection. All prisoners have the right to receive health care, including information about how to prevent contracting and spreading viruses, equivalent to that available in the community. No prisoner should be denied such information on the basis of discrimination, in particular with respect to their legal status or nationality.
UNODC's response to drug use and HIV in prisons in South Asia
UNODC is the guardian of the United Nations Standard Minimum Rules for the Treatment of Prisoners and assists countries in implementing international standards and United Nations resolutions that ensure all inmates have the right to receive health care, including HIV prevention and care, without discrimination and equivalent to those available in the community.
In 2005, UNODC, in partnership with the Governments of South Asia, initiated prison-based interventions and capacity-building programmes. Over the past few years, it has built a strong presence in prisons in South Asia. Through 27 prison interventions on drugs and HIV prevention and the training of more than 440 people in prison settings, the ground for expanding prison programming in the region is well established. UNODC provides technical assistance through various capacity-building initiatives like:
• Training prison managers and other staff, prison welfare officers, medical professionals and civil society partners on the comprehensive package of services for HIV prevention
• Training inmates in the basics of drug use and HIV, risky behaviour and prevention using a peer-led approach
• Facilitating exposure visits for government partners in the region to enable sharing of best practices on HIV prevention. Toolkits like the prison peer guide and module on HIV prevention among incarcerated substance users have also been developed and widely disseminated
|sp||The biggest breakthrough was the launch, in November 2008, of the oral substitution treatment programme for drug dependents in Tihar prisons India. This was a collaborative effort of the All India Institute of Medical Sciences (AIIMS), the Tihar administration and UNODC. It was the first oral substitution treatment programme to be launched for drug dependents in any prison in South Asia. Through the programme, systematic data is being collected to study the feasibility and effectiveness of buprenorphine as medication for treating opioid dependence in prison settings.|
To this end, a protocol for implementing an oral substitution treatment programme (with buprenorphine) in prison settings is being developed in collaboration with AIIMS. This intervention ensures that drug dependent prisoners have access to services after they are released into the community.
In Nepal, UNODC with the Government of Nepal and prison authorities provides technical assistance for prevention of HIV among drug users. This country specific project provides gender responsive comprehensive services which address women's specific needs with respect to injecting drug use, prisons and HIV and AIDS.