F. Risk of HIV infection in prisons

There were a total of 23,536 prisoners nation-wide as of October 1996, about 5 per cent of whom were HIV positive at that time. At the end of 1996, 43.7 per cent of the prison population were drug offenders. Of these, 51.4 per cent were classified as 'addicts', 33.9 per cent as 'addicts-cum-traffickers' and 15.7 per cent as 'traffickers'.

Information on the nature and level of drug treatment provided during their term of imprisonment was not accessed. However, it appears that some consideration is being given to extending the therapeutic community concept to prisons.

Prison populations are routinely tested for HIV. Mandatory HIV testing is also undertaken within the criminal justice system more broadly. Some key informants thought that confidentiality is not well protected regarding HIV test results and HIV status more generally.

Injecting and non-injecting drug use is reported in prisons. Needles and syringes are smuggled in and, given their scarcity and the unmet demand, are highly valued commodities. Each needle and syringe is likely to be used many times by many different persons, without any capacity for blood decontamination between usage. This poses substantial risk for the transmission of HIV and other blood-borne disease. As a result of these findings, correctional authorities have imposed strict policies and control measures in an effort to ensure that drug use is minimised or eliminated in their institutions.

No information could be accessed as to whether there is any evidence of spread of HIV and other blood-borne and sexually transmitted diseases in prisons. Nor was information able to be accessed about any evaluation of the effectiveness of these measures.

A total of 5,063 inmates (including 135 women) who have served their jail sentences in the nation’s prisons since 1989 have been confirmed as HIV carriers. Of this number 68 men and 4 women who developed full blown AIDS had died while another 3,850 including 127 women had been released after completing their sentences. As of January 11, 1997 there were 1,218 HIV positive prisoners including 8 women in the prisons.

Government officials suggest that the rate of HIV transmission within prisons is “not that high”. However, available data shows that HIV prevalence increased in prisons from 890/26,000 to 1,300/26,000 over a period of just one-year (IMR/WHO, 1998).

While HIV screening is compulsory for all patients admitted to drug rehabilitation centres, only those prisoners who are identified as involved in the injection of drugs are screened when entering prisons. It is reported that pre-and post-test counselling is provided to all prisoners who are tested.

Non-governmental organisations may provide drug use-related risk reduction information to people in prisons but this is not part of the official programme of activities. Non-governmental organisations advise on the adoption on universal precautions in the case of blood spills and provide training to counsellors, however, the constant and rapid turnover of staff reportedly makes it difficult to build upon and sustain a high level of knowledge and skill among prison personnel.