Successful HIV prevention, care and treatment in a Haitian prison
J. May1,2,3, M. Andrews1, P. Joseph4
1Health through Walls, North Miami, United States, 2Armor Correctional Health Services, Miami, United States, 3International Corrections and Prison Association, Edinborough, United Kingdom, 4GHESKIO/ Weill Medical College of Cornell University, Port-au-Prince, Haiti
Issues: In many resource-poor countries with high burdens of HIV infection, care and treatment of prisoners living with HIV/AIDS is very limited. Meanwhile, through the disruption of social networks, economic vulnerability, and gender inequality, incarceration itself contributes to the global burden of HIV. Interventions and resouces directed to prison health programs are often inadequate.
Description: Conditions in Haiti´s National Penitentiary had always been harsh with high prevalence of tuberculosis and serious medical needs. The facility intended for 1,200 prisoners held more than 4,300. Until 2009, ARV therapy was not routinely provided to prisoners with HIV/AIDS. Following advocacy and a formal agreement with the Haitian government, an initiative of HIV prevention, care, and treatment in the prison began through a broad collaborative. Prisoner peer educators provided sensitization and staff received training and resources. In less than one year before the earthquake of Janary 2010 duing which all prisoners fled, 86 prisoners had been identified with HIV and entered into care and treatment.
Lessons learned: A successful program of HIV prevention, care, and treatment is possible within prisons of resource-poor countries.
Next steps: Recovery from the earthquake, rebuild the correctional health care delivery system, and replicate the program to other prisons and countries.
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