UNODC launches toolkit for HIV assessment in prisons
23 July 2010 - UNODC has released a publication entitled "Toolkit for HIV Situation and Needs Assessment in Prisons" at the 2010 International AIDS Conference being held between 18 and 23 July in Vienna, Austria.
The Toolkit, which provides information and guidance on conducting situation and needs assessments for the prevention and treatment of HIV infection and tuberculosis (TB) in prisons, has been compiled to help Governments set more specific targets for achieving the universal access of prisoners to evidence-based HIV prevention, treatment, care and support interventions.
The Toolkit takes into account that many countries lack mechanisms to address such issues. With more than 30 million men, women and children worldwide spending time in detention each year, the barriers to fair and decent services must be removed. The Toolkit therefore proposes comprehensive HIV care which should be made available to all prisoners in the form of prevention, voluntary counselling and testing, antiretroviral treatment, prevention and treatment of opportunistic infections, as well as support. In many countries prisoners are excluded from AIDS response strategies, including from national HIV surveillance systems. Information on the HIV situation in prisons is often lacking or incomplete.
By using the Toolkit, Governments may set more specific targets tailored to the needs of prisoners and prison staff. It is based on the premise that the incidence of HIV and other infectious diseases is not only higher among prisoners, but also easily spread to the population at large due to prisoners moving to and coming from the community. The Toolkit states that good prisoner health means good public health and that this is essential for effective custodial management and non-discriminatory health care.
The launch of the Toolkit supports the aim of the AIDS 2010 conference calling for "Rights Here, Right Now" since the rights of prisoners are often overlooked by public health authorities.
Some of the core issues and findings to come out of the Toolkit are:
- From the limited data available, it is evident that HIV, hepatitis C and TB rates in prisons are particularly high, and always higher than in the community at large. In Mauritius for instance the rate is up to 50 times higher. In the absence of appropriate measures, outbreaks can occur - for example in Australia, Lithuania, Russia, Scotland and Thailand;
- Women in prisons are at higher risk than men in prisons. In the US state of Connecticut in the year 2006 for example, HIV prevalence for women prisoners was at 16 per cent compared to 5 per cent among male prisoners;
- Annually 30 million men, women and children spend time in prisons and are therefore at risk for HIV, hepatitis C and TB and may continue their spread after they leave prison;
- Effective policies to prevent HIV and hepatitis inside prisons and other correctional institutions are often hampered because of the denial of the existence of factors contributing to the spread of HIV such as men having sex with men, drug use or tattooing;
- The people at greatest risk of contracting HIV are also those who are at greater risk of committing crime and facing incarceration, such as drug dependent people or the mentally ill ;
- Effective action to address HIV and AIDS must be undertaken in substandard or antiquated prison conditions. Overcrowding, violence, corruption, inadequate natural lighting and ventilation, violence and malnutrition, are common in many prisons across the world and undermine the implementation of effective responses to HIV and AIDS ;
- All HIV prevention, treatment and care interventions, including harm reduction interventions, available in prisons, must be available both to prisoners and prison staff. There is evidence that all HIV prevention and treatment interventions are effective in prisons. Health care in prisons should be at least equivalent to that in the community.
- Detained persons living with HIV are often stigmatized and at increased risk of isolation, violence, and human rights abuses from both prisoners and prison staff.