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HIV and Incarceration: Prisons and Detention

UN Special Rapporteur on Torture. HIV and Incarceration: Prisons and Detention. Vienna, 23 July 2010 Manfred Nowak Professor for International Human Rights Protection, University of Vienna Director, Ludwig Boltzmann Institute of Human Rights, Vienna UN Special Rapporteur on Torture.

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HIV and Incarceration: Prisons and Detention

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  1. UN Special Rapporteur on Torture HIV and Incarceration: Prisons and Detention Vienna, 23 July 2010Manfred NowakProfessor for International Human Rights Protection, University of ViennaDirector, Ludwig Boltzmann Institute of Human Rights, ViennaUN Special Rapporteur on Torture

  2. UN Special Rapporteur on Torture • Overview • Fact-finding Missions of current UN Special Rapporteur on Torture • World Prison Population - Relative per 100,000 • World Prison Population - Overcrowding • World Prison Population - Pretrial Detention • Conditions of detention amount to inhuman or degrading treatment • HIV Prevalence in Prisons • HIV Transmission Resulting from Risk Behaviour in Prisons • How to effectively prevent HIV Transmission in prisons? • Example of Best Practice - Spain • Care, Treatment, and Support forPrisoners Living with HIV/AIDS • Conclusions Acknowledgments Ralf Jürgens (co-author, Global Fund), Marcus Day (co-author, Caribbean Drug & Alcohol Research Institute), Andrew Ball (WHO), Fabienne Hariga (UNODC), Annette Verster (WHO), Terry White (East Europe & Central Asia Union of PLWH), and colleagues of the Ludwig Boltzmann Institute of Human Rights.

  3. UN Special Rapporteur on Torture 1. Fact-finding Missions of current UN Special rapporteur on torture Denmark & Greenland May 08 Moldova July 08 Georgia Feb. 05 Jordan June 06 (Russia) Oct. 06 GreeceOct. 10 Kazakhstan May 09 (Cuba) 2009/10 MongoliaJune 05 Guantanamo Feb. 06 ChinaNov. 05 Jamaica Feb. 10 NepalSept. 05 Paraguay Oct. 06 Papua New GuineaMay 10 Uruguay March 09 IndonesiaNov. 07 Sri LankaOct. 07 (Zimbabwe)Oct. 09 Equatorial GuineaNov. 08 Nigeria March 07 Togo April 07 Sudan Oct. 06

  4. UN Special Rapporteur on Torture 2. World Prison Population - Relative per 100,000 Russia 629 Liechtenstein 20 United States 756 St. Kitts and Nevis 588 Burkina Faso 23 Rwanda 604 India 33 Nepal 24

  5. UN Special Rapporteur on Torture 3. World Prison Population - Overcrowding Iran 170 % Benin 307,1 % Bangladesh 302,4 % Uruguay 136,3 % Indonesia 164,7 % Brazil 160 %

  6. UN Special Rapporteur on Torture 4. World Prison Population - Pretrial Detention Nepal 51 % Mali 88,7 % USA 20,8 % Papua New Guinea 49,9 % Jamaica 15 % Sri Lanka 48,7 % Nigeria 65,2 % Liberia 97 %

  7. UN Special Rapporteur on Torture 5.1. Conditions of detention amount to inhuman or degrading treatment - Lack of Bedding Lack ofspace, Prison in Malawi Source: UNODC

  8. UN Special Rapporteur on Torture 5.2. Conditions of detention amount to inhuman or degrading treatment - Overcrowding Colombo RemandPrison, Sri Lanka Kathmandu Police Station, Nepal Source: UN Special Rapporteur on Torture

  9. UN Special Rapporteur on Torture 5.3. Conditions of detention amount to inhuman or degrading treatment - Overcrowding LibertadPrison (Las Latas), Uruguay Source: UN Special Rapporteur on Torture

  10. UN Special Rapporteur on Torture 5.4. Conditions of detention amount to inhuman or degrading treatment - Overcrowding Panti Police Station, Lagos, Nigeria Source: UN Special Rapporteur on Torture

  11. UN Special Rapporteur on Torture 5.5. Conditions of detention amount to inhuman or degrading treatment - Lack ofsanitaryfacilities Lack ofsanitaryfacilities, Papua New Guinea Source: UN Special Rapporteur on Torture

  12. UN Special Rapporteur on Torture 6. HIV Prevalence in Prisons 1) 2008 Report on the Global Epidemic, Adult (15–49) prevalencepercent 2007 2) Zhivago, 2005 ascited in WHTO/UNODC/UNAIDS, EffectivenessofInterventionstoaddress HIV in Prisons, Evidencefor Action Technical Papers, Geneva 2007. 3) Dolan J, Kite B, Aceijas C, Stimson GV. HIV in prison in low-income and middle-income countries. Lancet Infectious Diseases 2007; 7 : 32-43. 4) SG Nagaraj, M Sarvade, L Muthanna, R Raju, S Aju, and NM Sarvade. HIV seroprevalence and prevalent attitudes amongst the prisoners: A case study in Mysore, Karnataka state, India. Paper presented at XIII International AIDS Conference, Durban, July 2000. 5) A. Bobrik et al., “Prison health in Russia: the larger picture,” Journal of Public Health Policy 26 (2005): 30-59. 6) WHO/UNODC/UNAIDS, Effectiveness of Interventions to address HIV in Prisons, Evidence for Action Technical Papers, Geneva 2007.

  13. UN Special Rapporteur on Torture • 7. HIV Transmission Resulting from Risk Behaviour in Prisons • Using non-sterildrug injecting equipment • Sexual contacts (consensual and non-consensual) • Additional factors: e.g. tattooing, sharing of razors, piercing, improper sterilisation of medical and dental instruments

  14. UN Special Rapporteur on Torture • 8. How to Effectively Prevent HIV Transmission in Prisons? • Deprivation of liberty, not liberties • Information and education • HIV testing and counselling • Provision of condoms and prevention of rape, sexual violence and coercion • Needle and syringe programmes (NSPs): 11 countries, e.g. Switzerland, Moldova • Bleach programmes: only if NSPs are not available • Opioid substitution therapy (OST) and other drug dependence treatments: 40 countries • Reduction of Overcrowding

  15. UN Special Rapporteur on Torture • 9.1. Example of Best Practices - Spain NeedlesandSyringes Programme

  16. UN Special Rapporteur on Torture • 9.2. Examples of Best Practices - Spain Methadone Maintenance Programme

  17. UN Special Rapporteur on Torture • 9.3. Examples of Best Practices - Spain HIV prevalence in SpanishPrisons

  18. UN Special Rapporteur on Torture • 10. Care, Treatment and Support for Prisoners Living with HIV/AIDS • Provision of antiretroviral therapy (ART) • Prisonhealthsystemunderauthorityofministryofhealth • Special attentiontofemaleprisonersandchildren

  19. UN Special Rapporteur on Torture • 11. Conclusions • Evidence-based intervention vs moralism • Prison health is public health • Preventionisbetterthancure • Prisonerswith HIV or AIDS have a human righttomedicalcare, treatmentandsupport • Urgent needforcomprehensivecriminaljusticeandprisonreforms

  20. UN Special Rapporteur on Torture Thankyouforyourattention. UN Special Rapporteur on Torture, OHCHR/Genevahttp://www.ohchr.org/english/issues/torture/rapporteur Ludwig Boltzmann Institute of Human Rights, Viennahttp://bim.lbg.ac.at Atlas ofTorturehttp://www.atlas-of-torture.org Presentation & Speech Download:http://bim.lbg.ac.at

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