Prison settings and HIV
Each year over 30 million men and women go through "prisons", of whom over one third are pretrial detainees. Many of them are incarcerated for minor offences and will return to the community after few weeks or months. AIDS and tuberculosis (TB) are the first causes of deaths in prisons in many countries.
The prevalence of HIV, hepatitis and tuberculosis in prisons is 2 to 10 times and in exceptional cases up to 50 times as high as in the general population. Many people entering prisons are coming from groups of populations who are already at higher risks for HIV such as people who inject drugs or sex workers or men who have sex with men or transgender people.
In addition, evidences show that all HIV transmissions risks, starting from unprotected sexual intercourse to sharing of drug injecting or body piercing equipment to lack of standard precautions for infection control in health and dental care services to mother-to-child, do occur in prisons. But access to HIV, hepatitis and TB prevention, treatment and care services for both inmates and staff is often lacking. For example, when people enter prisons, or when transferred within the prison system, or upon release, treatment are often interrupted or even discontinued, which can contribute to the development of resistance to treatment.
In addition to the HIV transmission risks mentioned above, other factors related to prison management, prison infrastructure and criminal justice also contribute to the HIV vulnerability in prisons.These include overcrowding, violence, stigma, denial, poor training of staff, poor health services, isolation of prison health services from public health services and lack of alternatives to imprisonment.
To address the situation, a comprehensive evidence based and gender sensitive strategy should be implemented based on Human Rights International Instruments such as the UN Standard Minimum Rules for the treatment of prisoners, the Basic principles for the treatment of prisoners and UN Rules for the Treatment of Women Prisoners.
UNODC provides support to countries to achieve universal access to the full spectrum of the recommended HIV interventions through:
- Development of normative guidance on HIV in prisons (see relevant UNODC publications here)
- Targeted advocacy to reduce stigmatization and discrimination and to promote human rights-based, gender responsive and public health centered approaches to criminal justice and treatment of prisoners;
- Support to review, adapt, develop and implement effective legislation and policies, including on alternative to imprisonment;
- Supporting the development and implementation of comprehensive, evidence-based HIV strategies and programmes;
- Building the capacities of national partners - including government agencies, civil society and community-based organizations - to ensure that people in prisons receive the quality HIV services that are tailored to their needs.
UNODC also supports regional HIV and prison networks in Africa and in Latin America:
- The African HIV in Prison Partnership Network ( AHPPN) and
- The Monitoring Centre for HIV and Prisons in Latin America and the Caribbean
Additionally, in Europe, UNODC contributes to the WHO-EURO Health in Prisons Project ( HIPP).
Read more - Visit the prison and HIV publications page