Working with Different Groups

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Presentation transcript:

Working with Different Groups Module 3 (g) Prisoners and PrEP

Prisoners: Assumptions and stereotypes What do you think of when you think of prisoners? Would you be comfortable providing healthcare to prisoners? What kind of stigma do you associate with prisoners? What rights do prisoners have with regards HIV services? Do you think PrEP is a sound prevention option for prisoners?

People in prison They are vulnerable to HIV: Rape and lack of consensual sex Poor access to condoms Power relationships between prisoners Drug use Tattoos Overcrowding and violence Coinciding sub-groups: MSM, sex workers, PWIDs https://www.avert.org/professionals/hiv-social-issues/key-affected-populations/prisoners Avert.org

Prisoners’ rights in South Africa Strong support for prisoners’ rights in South Africa - backed by the Constitution A lot of advocacy work has resulted in access to healthcare and HIV services in prison Everyone who is detained, including every sentenced prisoner, has the right to conditions of detention that are consistent with human dignity, including at least exercise and the provision, at state expense, of adequate accommodation, nutrition, reading material and medical treatment. Section 35(2)(e) Constitution of South Africa [Insert country specific information] Davies NECG et al. PLoS ONE 2012

The Good News The Not So Good News http://www.gov.za/speeches/correctional-services-making-strides-towards-improved-healthcare-inmates-19-apr-2016

Prisoners – What do we know? Very little research specifically on prisoners part of sub-groups in research e.g PWIDs, MSMs Prisoners and PrEP: the primary issue relates to access to healthcare in prison, and specifically HIV prevention and treatment programmes Need consistent provision of ART and PrEP TB and HIV: co-infection in prisons is high

References Davies NECG, Karstaedt AS. Antiretroviral Outcomes in South African Prisoners: A Retrospective Cohort Analysis. Lama JR, ed. PLoS ONE. 2012;7(3):e33309. http://www.gov.za/speeches/correctional-services-making-strides-towards-improved-healthcare-inmates-19-apr-2016-0000 Lancet Series: HIV and related infections in prisoners July 14, 2016

Acknowledgements With thanks to: The Southern African HIV Clinicians Society Wits Reproductive Health and HIV Institute (Melanie Pleaner)