HIV prevention, treatment and care in prisons in South-east Asia

NDARC Technical Report No. 290 (2007)

OVERVIEW:

The aim of the review was to gather information relating to HIV prevention, treatment and care in prisons in the WHO South East Asia region. Countries in this region are Bangladesh; Bhutan; the Democratic People’s Republic of Korea; India; Indonesia; Maldives; Myanmar; Nepal; Sri Lanka; Thailand; and Timor-Leste. Countries selected for inclusion in the review were India, Indonesia, Thailand, Nepal and Myanmar. During the data collection phase, Myanmar was excluded due to circumstances beyond the authors’ control, leaving four countries for review.

Relevant published and unpublished reports and information from key experts were sought in order to provide a coherent picture of the current situation relating to HIV prevention, treatment and care in prisons in India, Indonesia, Thailand and Nepal. Information sought for inclusion in the review included:

Community data and information regarding HIV prevention, treatment and care:

• HIV prevalence and distribution in the general community and among high-risk groups such as sex workers, injecting drug users and men who have sex with men.
• HIV prevention strategies available in the community, in particular: 

1. Information, education and communication initiatives, including peer-led interventions,
2. Harm reduction interventions for injecting drug users: Needle and syringe programs; Bleach distribution
3. Condom availability and distribution programs
4. Drug dependency treatment programs: non-pharmacological or abstinence-based treatment services e.g. therapeutic communities; Substitution maintenance treatment
5. Prevention of mother-to-child transmission programs

• The availability and coverage of voluntary counselling and testing services
• The availability and coverage of antiretroviral treatment and other HIV treatment and care interventions

 

Data and information specific to HIV prevention, treatment and care in prisons:

• Prison management, including:

1. Prison administration
2. Prisoner population statistics
3. General conditions in prisons and other correctional institutions: Quality and quantity of food provided; Quality of accommodation; Overcrowding
4. Provision of general medical care

• HIV situation in prison:

1. Policies on HIV testing and availability of voluntary counselling and testing in prisons
2. Policies regarding segregation or integration of HIV-positive prisoners
3. HIV prevalence among prisoners
4. HIV risk behaviours in prison: Injecting drug use; Unprotected sexual activity; Tattooing and other body modification practices

• HIV prevention strategies in prison, including:

1. HIV information, education and communication initiatives, including peer-led interventions
2. Harm reduction programs: Needle and syringe programs; Bleach distribution programs; Condom distribution programs
3. Drug dependency treatment programs: Non-pharmacological or abstinence-based treatment services; Substitution maintenance treatment

• HIV treatment and care in prison:

1. The provision of antiretroviral treatment in prison
2. Assessment and treatment of co-infections
3. Other HIV support and care services
4. Policies regarding compassionate release for terminally ill prisoners

Extensive literature searches were carried out using online databases including Sciences Citations Index and Medline. Relevant websites (e.g. International Centre for Prison Studies; UNAIDS; UNODC Regional Centre for South Asia) were consulted to obtain further data and unpublished reports. Where gaps in the data collected remained, key experts were contacted via email or telephone and requests for specific information were made. Key experts were drawn from a wide variety of sources, including UN and other international agencies, NGOs working in prisons and/or the community in target countries and officials from relevant government ministries and prison administrative bodies.

A discussion of each country’s approach to the issue of HIV in prison is provided at the end of each chapter. A regional summary and recommendations for improved practice conclude the report.

Citation: Larney, S., Morton, P. & Dolan, K. (2007). HIV prevention, treatment and care in prisons in South-east Asia. Sydney: National Drug and Alcohol Research Centre.