HIV/AIDS is a serious problem for prison populations across Europe and Central Asia.
In most countries, rates of HIV infection are many times higher amongst prisoners than amongst the population outside prisons.* This situation is often exacerbated by high rates of Hepatitis C and/or (multi-drug resistant) Tuberculosis in many countries. In most cases, high rates of HIV infection are linked to the sharing of injecting equipment both inside and outside prison walls and to unprotected sexual encounters in prison. In a majority of countries, adequate preventive measures have not been introduced in prisons, although they have been successfully introduced in other prison systems and shown to be effective. As a result, people in prison are placed at increased risk of HIV infection, and prisoners living with HIV/AIDS are placed at increased risk of health decline, of co-infection with Hepatitis C and/or TB, and of early death.
The failure to implement comprehensive programmes that are known to reduce the risk of HIV transmission in prisons and to promote the health of prisoners living with HIV/AIDS is often due to lack of political will or to policies that prioritise zero-tolerance to drug use over zero-tolerance to HIV/AIDS. In some cases, it is the result of a lack of state resources and technology to meet the overwhelming need. In some cases it is both.
This public health crisis requires urgent attention and action from all governments.
Under national and international law, governments have a moral and ethical obligation to prevent the spread of HIV/AIDS in prisons, and to provide proper and compassionate care, treatment, and support for those infected. What needs to be done is clear: policies and programmes that effectively reduce the spread of HIV in prisons and provide care, treatment and support for prisoners living with HIV/AIDS already exist in several countries and should be replicated elsewhere.
People in prison have the same right to health as people outside, and the lives and health of people in prison are connected to those of people outside prison in many ways.If we protect them, we also protect our broader communities. Protecting prisoners will also protect prison staff, who also have a right to be protected against HIV/AIDS, Hepatitis C, and TB in prisons, and whose needs are entirely compatible to those of the prisoners in this respect.
As the representatives of 55 governments from Europe and Central Asia gather in Dublin this week to discuss "Breaking the Barriers" in the fight against HIV/AIDS, we call upon them to begin by breaking down the barriers over which they have total control - the barriers that have thus far prevented comprehensive HIV/AIDS services from being implemented in prisons.
* Studies in various countries in Western Europe, Eastern Europe and Central Asia have found rates of HIV infection between 0-17% among prisoners.