HIV, drugs and prisons in Russia Anya Sarang

Russia estimated 2 mln IDUs 1,5 estimated HIV cases HIV prevalence in IDUs reaches 75% in some cities HCV prevalence reaches 90% Available drug treatment outdated, ineffective, substitution banned No gov’t funded HIV prevention

government approach: repression and criminalization ~ 1 mln people in prisons??? While drug use per se is not criminal… possession of very small amounts is faults in investigation and courts on drug cases: majority of cases not thoroughly reviewed, based on false evidence, provocation (4 cases in ECHR) Courts as “notary’s offices for prosecutors accusations” high rate of incarceration sentencing no alternatives to sentencing (treatment)

Drugs and HIV prevention Over 55% male IDUs report prisons experience Over 50% inmates on drug related charges (st pete) Prisons as structural factors of HIV/TB transmission: –Drugs are available (study of 7 prisons demonstrates 43% injected in prison, others confirm) –Needles, drug treatment, and prevention not available Drugs were around but you see a syringe is a forbidden thing... With drugs it is possible to hide them somehow, somewhere, but well, how do you hide a syringe? So, if someone somehow got hold of a syringe—maybe they brought it in or stole it from the medical centre—then it was just superachievement. Then that syringe would do the rounds and rounds and rounds of the whole camp. And then you get loads of syphilis, AIDS and... Someone would shoot up once and then in the course of the next 2 months about 20 people would be in the isolation ward with viral hepatitis. (Barnaul, male, 18)

HIV and TB in prisons General conditions unhealthy and humiliating of HIV+ (11% of all PLWHs) active TB 4371 HIV+TB In 2009 TB grew 14,0% in one year

Problems Prevention not available Treatment of HIV regularly interrupted Hepatitis C treatment not available TB treatment of poor quality  Russia is one of the main producers of MDR-TB No integration with outside services: Stop treatment on release: –20% on ART –50% on TB medications Fear: People are afraid to complaint and protect their rights!

Learn about prisons in Russia from first- hand personal testimonials!