XVIII International AIDS Conference

The Forgotten Epidemics: HIV and HCV in Prisons, Pre-trial Detention, and Other Closed Settings MOBS01

Bridging Session Back
Location: SR 7
Schedule: 14:30 - 16:00, 19.07.2010
Code: MOBS01
Chair: Joanne Csete, United States
Webcast provided by The Kaiser Family Foundation
Webcast provided by The Kaiser Family Foundation

Rates of HIV and HCV in prisons, pre-trial detention centers and other closed settings are much higher than in the community, and risk behaviours - in particular consensual and non-consensual forms of sexual activity and injecting drug use - are prevalent behind bars. Serious outbreaks of HIV have been documented in a number of prison settings. Nevertheless, few prison systems have implemented comprehensive, evidence-based HIV prevention programmes and taken them to scale. Access to uninterrupted HIV treatment, care and support upon arrest, pre-trial detention, transfer and upon release is also often not guaranteed - despite international recommendations that urge countries to take urgent action to address HIV (and HCV) in closed settings. This session will present examples of successful responses to HIV and HCV in closed settings; examine what else, in addition to comprehensive HIV and HCV programmes, is needed to successfully respond to HIV, HCV and injecting drug use in these settings; address the particular issues related to women in these settings; and debate how we can move from rhetoric to action on HIV and HCV in prisons, pre-trial detention centers and other closed settings.

Presentations in this session:


Slides with audio
Presented by Joanne Csete, United States

Slides with audio

Slides with audio
Results from the Spanish experience: A comprehensive approach to HIV and HCV in prisons
Presented by Mercedes Gallizo Llamas, Spain

Slides with audio
Presented by Albert Zaripov, Russian Federation

Slides with audio
Statements on HIV and HCV in prisons
Presented by Christian Kroll, Austria
Anya Sarang, Russian Federation
Rick Lines, United Kingdom

Slides with audio
Moderated discussion, questions and answers
Christian Kroll, Austria
Anya Sarang, Russian Federation
Rick Lines, United Kingdom
Mercedes Gallizo Llamas, Spain
Albert Zaripov, Russian Federation

Slides with audio

Rapporteur report

Track F report by Eka IAKOBISHVILI


 The session started with an overview of the basic data concerning HIV in prison such as the higher prevalence of HIV and HCV in prisons than in the population in virtually all parts of the world. The criminalisation of vulnerable groups such as sex workers and drug users guarantees that those populations will spend time in prisons where conditions combine to increase risk of acquiring and transmitting infection. The audience was reminded that prison health is public health as prisoners will return to the community. In most prisons, the lack of prevention and treatment is a human rights and public health problem of crisis proportions.

Mercedes Gallino Llamas, the Secretary General of Prisons in Spain, opened the session with a dramatic presentation of what prison harm reduction should look like. Spain has drastically reduced HIV and Hepatitis C through comprehensive harm reduction programs that include methadone, buprenorphine and needle exchange. HIV prevalence among prisoners has fallen from more than 20 percent in the 1980s to 7 percent in 2009. Llamas estimates that each year the harm reduction programs are avoiding 200 seroconversions, a result that is saving the prison system 140,000 euros per person in medical and social support costs.

In stark contrast, Albert Zaripov from Russia described bleak conditions in Russian prisons, where he personally experienced needle sharing among 20-30 prisoners and recent cutbacks have eliminated even ARV treatment for many HIV-positive prisoners. In an emotional plea for assistance Zaripov cited recent deaths of AIDS among prisoners and stated  that the HIV epidemic in Russian prisons is getting worse rather than better. Anya Sarang agreed and noted that the root cause of the prison crisis is the criminalisation of even small amounts of drugs in Russia and an utter lack of political will to provide treatment or to protect human rights.

The session provided a short amount of time to discuss strategies for improving access to prevention and treatment in prisons, with ideas from both panel and audience members focusing on the need for continued advocacy. 


    The organizers reserve the right to amend the programme.

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