HIV Prevention, Treatment and Care in Prison Settings: Public Health and Human Rights Approach AIDS 2016 Conference Durban, South Africa 20 July 2016 Ehab Salah, Adviser, Prisons and HIV UNODC Vienna

Addressing HIV in Prisons Guiding Principals Prison health is public health Human rights based, evidence informed and gender sensitive approaches

The Right to Health The right to enjoy facilities, services and conditions at the highest attainable standards of health -Availability -Accessibility -Acceptability -Quality

The Principle of Equivalence Prisoners should enjoy the same standards of health care that are available in the community, and should have access to necessary health-care services free of charge without discrimination on the grounds of their legal status. Health policy in prisons should be integrated into and compatible with National Health Policy.

A MULTI FACTORAL ISSUE REQUIRING A MULTIDISCIPLINARY RESPONSE Public Health Occupational health Criminal Justice Gender policies Human Rights Prison management

Upholding the Rights of People Living in Prisons The revised UN Standard Minimum Rules for the treatment of Prisoners (Nelson Mandela Rules) Political Declaration on HIV and AIDS: Intensifying our Efforts to Eliminate HIV and AIDS The Rules for the Treatment of Women Prisoners and Non- custodial Measures for Women Offenders (the Bangkok Rules) The UNAIDS Strategy acknowledges existing gaps in health services in prisons and closed settings.

Sustainable Development Goals To end AIDS, TB and combat hepatitis and other communicabl e diseases To reduce inequalities, eliminate discriminatory laws and policies To promote the rule of law to ensure equal access to justice for all, To empower all women and girls Including those in prisons and other closed settings

HIV in prisons - Gaps Health care in prison settings is typically limited and not equivalent to those provided in the community Lack of continuity of care Health care in prisons is often provided by the ministry responsible for prison Lack of SRH and PMTCT Mandatory HIV testing and lack of confidentiality

UNODC’s Support to Countries Develop normative guidance on HIV in prisons Promote - human rights based, age - gender responsive and evidence-informed approaches Support to review, adapt, develop and implement effective legislation, policies and strategies including on alternatives to imprisonment Build capacities of government agencies, CSOs and other national partners

Way Forward Evidence-informed, rights-based, age and gender-responsive HIV prevention treatment and care Improved quality and coverage of comprehensive HIV services Criminal justice reform programmes including alternatives to incarceration Prison reform initiatives including improving the working and living conditions Strategic information to guide policies, strategies and actions To end the AIDS epidemic by 2030

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