UNODC toolkit for HIV situation and needs assessment in prisons

The Toolkit was launched at the 2010 International AIDS Conference. It provides information and guidance on conducting situation and needs assessments for the prevention and treatment of HIV infection and tuberculosis in prisons. The document aims 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 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.

Read the full toolkit.