XVIII International AIDS Conference


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Challenges and achievements on health in prisons: coordinated actions in response to HIV/AIDS and co-infections

L. Pittaluga1, A.M. Mello1, D. Gontijo2, F. Nogueira1, J. Campos3, K. Galbinski2, M. Gloria Filho4, N. Santos4, T. Estrela5, X.P. Bermudez6

1Ministry of Health, STD/AIDS and Viral Hepatitis Department, Brasília, Brazil, 2Ministry of Health, Health Prison Coordination, Brasilia, Brazil, 3Ministry of Justice, Penitentiary Department, Brasilia, Brazil, 4UNODC, Health and Development Unit, Brasilia, Brazil, 5Ministry of Health, The National TB Control, Brasilia, Brazil, 6Pan American Health Organization, Family Health Unit, Brasilia, Brazil

Issues: A total of 471.498 people live under the custody of the Brazilian Penitentiary System. The Ministries of Justice and Health established in 2003 the National Policy for Health in the Penitentiary System in order to organize the access of inmates to public health services. The policy implementation relies on coordination and networking to be effective, a major challenge for various involved actors.
Given the confining and overcrowding conditions of prison settings, the prison population is exposed to health risks factors such as HIV/AIDS and co-infections.
Description: The Brazilian policy for health in prisons has been supported by intersectoral actions aimed at joining political and technical efforts from various programmatic areas of the Ministry of Health, Health in Prison Coordination, HIV/AIDS, Viral Hepatitis, TB; the National Penitentiary Authority; UNODC; and PAHO/WHO.
A major result of the integrated efforts was the Brazilian Consultation on HIV/AIDS in the Penitentiary System. Among the consultation outcomes there were the identification of gaps on the policy implementation, the establishment of recommendations and the consensus of the need to strengthen intersectoral mechanisms.
Lessons learned: To improve real conditions of health in prisons throughout the country it is necessary to develop consistent integrated approach among three government levels, civil society and international organizations. The consultation was an opportunity to identify best practices, detect challenges and gaps and enlighten next steps.
Next steps: A training project for health professionals and prison officers is expected to be implemented in 2010; the National Policy is under revision; a joint proposal for the 10th Global Fund on TB and HIV control in prison settings is being developed; an assessment of health teams working in prisons will be carried out.

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