This policy brief is anchored around two guiding principles, namely that "prison health is good public health" and that a human rights-based approach and the principle of equivalence of health in prisons are key.
The joint policy brief by UNODC, the International Labour Organization and the United Nations Development Programme proposes a comprehensive package of 15 interventions to address HIV in prisons settings:
- Information, education and communication
- HIV testing and counselling
- Treatment, care and support
- Prevention, diagnosis and treatment of tuberculosis
- Prevention of mother-to-child transmission of HIV
- Condom programmes
- Prevention and treatment of sexually transmitted infections
- Prevention of sexual violence
- Drug dependence treatment
- Needle and syringe programmes
- Vaccination, diagnosis and treatment of viral hepatitis
- Post-exposure prophylaxis
- Prevention of transmission through medical or dental services
- Prevention of transmission through tattooing, piercing and other forms of skin penetration
- Protecting staff from occupational hazards.
Recognising that the fifteen interventions proposed cannot be implemented in isolation, the authors propose an approach that is comprehensive and that takes into consideration the other factors of the response. In addition to the specific interventions recommended, good-practice recommendations support the implementation further. The absence of such conditions renders the implementation of the interventions all the more difficult and could play a role on their effectiveness. The brief advises implementers to:
- Ensure that prison settings are included in national HIV, tuberculosis and drug dependence treatment programming
- Adequately fund and reform health care in closed settings
- Ensure the availability of gender-responsive Interventions
- Address stigma and the needs of particularly vulnerable people
- Undertake broader prison and criminal justice reforms. These can include the improvement of overall conditions, the reduction of the excessive use of pretrial detention, the reduction of incarceration of people who use drugs or people with mental-health problems.
Finally, recognising that one-size does not fit all, UNODC recommends coordination at national level and greater involvement of all national stakeholders to identify the challenges, map the needs and implement the intervention in a cohesive, coordinated and tailored manner.
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