General Situation (Overview) Country Remand Prison Prisons Prison Population (by 31.12.2007) Poland 70 85 89 995 (2598 women) Estonia 3 5 3456 (103 female convicted offenders) Finland none 26 3565 Latvia 7 14 6544 Lithuania 15 7736 Germany   75056 Sweden 31+7 branch institution 55 prisons with a total of 5020 beds with a 93% “booking rate” and in average 4668 inmates per day 5.036 inmates in the prisons, 1.741 in custodies and 13.931 on probation Norway 50 prisons with an official capacity of 3511.– most of the prisons can admit pre-trial detainees. Around 3500 - Around 19,5 % of the prison population are on remand, 19,5 % are foreigners, 5,5 % women.

HIV, TB and HCV cases within Prison settings Country TB HIV HCV Poland 453 1145 2463 Estonia 10 489 N/A Finland 2 12 Approx 60% Latvia 411 45 830 Lithuania 110[1] 264 N/A[2] Germany Sweden 70-80 (8 new cases) 35% of prison population. Appr-1800 Norway   [1] During period from 01-01-2008 until 01-09-2008 in penitentiary system was detected 30 new TB cases [2] During period from 01-01-2008 until 01-09-2008 were detected 2 new HCV cases.  

PH EG Meetings May (Riga) - Estonia, Finland, Latvia, Lithuania, Norway, Sweden, Poland, Germany, WHO, UNODC September (Oslo) - Estonia, Finland, Latvia, Poland, Germany, Sweden, Norway, Belarus, Canada, WHO, LHL (Norway)

PH EG activities Seminar on HIV/AIDS and TB Prevention within Prison system – Olaine Prison Hospital, Latvia Evaluation for National Response to HIV/AIDS in prison settings in Estonia.(organized by UNODC) Round Table meeting in London. Discussion on a draft background paper on Prisons and Women’s health and a draft agreement of a WHO Conference Declaration HIPP Annual Conference “Prisons and Women’s Health” and Network Meeting 2008, in Kiev, Ukraine.

PH EG activities (continuation) XVI BSSSC Annual Conference in Kaunas. Presentation of Project proposal at Project Idea Café Establishment of Contacts with Belarus and Canadian Prison authorities Preparation of NDPHS fact sheets (both the English and the Russian version)

Planned activities for 2009 Develop a project proposal on HIV/AIDS Prevention among the female prisoners, covering Estonia, Lithuania, Latvia, Poland and Belorussia Development of NDPHS strategy on Prison Health. Development of project proposals for Belarusian prisons, with the involvement of SEEC Health Review and comment on the draft Strategic Goals of participant countries – including coordination of review by Partner countries and organizations as appropriate

Planned activities for 2009 (continuation) Review, analyze, and evaluation of technical reports, research publications and other relevant materials on the issues related heath in prison settings Advocacy and communication efforts directed to place Health in Prisons near the top of the health and development agendas Development of project proposals for Belarusian prisons, with the involvement of SEEC close collaboration with the WHO Health in Prisons Project (HIPP) in supporting NDPHS Partner Countries to address health and health care in prisons

HIV incidence rates in prisons Incidence of HIV in prison: Latvia: 1/4 of HIV+ in the country have been infected in prison and prisons host 1/5 of HIV+ total population outbreaks in prisons documented in Lithuania (299 in 4 months) and Russia. Other infections: STIs High TB prevalence in prison High Hepatitis C and B prevalence HIV prevalence rates are generally higher among women in prisons

Epidemiology: HIV prevalence rates in prisons Universal and important problem HIV prevalence in prison higher than in the community 1.5 to 2 times prevalence in the community: Countries with high prev. and heterosexual transmission predominant Few /no IDUs in the community 5, 10, 20, times prevalence in the community Country with IDUs in the community Lack of reliable data on HIV prevalence in prison From researches – no monitoring

Possible Project Proposal HIV/AIDS prevention, treatment and care for female prisoners To improve the legal and policy frameworks with the view to establish favourable environments for rapid, large-scale and comprehensive interventions Gender-sensitive HIV/AIDS and TB prevention and care materials Capacity development. Strengthen of organizational and operational capabilities of institutions, in order to better perform their functions To document and disseminate lessons learned within the country and to a wider audience in the Northern Dimension region and beyond 

Goal of the Project To overview and to analyse internationally available and nationally implemented guidelines on HIV/AIDS and TB case management for female prisoners, to support ongoing activities in Lithuania, Latvia, Estonia, Poland and Belarus prison settings and to strengthen those services through training and interactive workshops. To advice on HIV/AIDS and TB case management policy for female prison through Nordic Dimension partnership and to promote the development of National policies’

Proposed Objectives Objective 1 : To develop an enabling environment, which provides conditions that support gender sensitive approaches to HIV prevention, treatment, care and support services to female prisoners Objective 2: Improve availability and quality of gender sensitive comprehensive packages for prevention of HIV and TB within Prison settings Objective 3: Sharing the lessons learned Objective 4: Monitoring and evaluation

Major activities Develop gender sensitive training materials and manuals, locally adapted to specific social and cultural contexts Conduct training and skills-needs assessment among existing and potential service providers, including primary health care nurses and doctors, social workers Provision of sexual and reproductive health services, general health services, maternal and child health services, HIV and TB services Carry out intensified TB case finding, in particular among drug users with HIV who are at particular risk of TB Drafting recommendations for HIV/AIDS and TB case management implementation for female prisoners Drafting ND strategy on HIV/AIDS and TB management within Prison settings