1. HIV and related infections in prisoners

2. Human Rights, HIV and Prisons

3. Leonard Rubenstein – Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Pubic Health Joseph Amon -- Helen Keller International Megan McLemore – Human Rights Watch Patrick Eba – UNAIDS, University of Kwa-Zulu Natal Kate Dolan – University of New South Wales Rick Lines – Harm Reduction International Chris Beyrer - Center for Public Health and Human Rights, Johns Hopkins Bloomberg School of Pubic Health, Authors and Affiliations HIV and related infections in prisoners

4. “All human beings are born free and equal in dignity and rights.” Universal Declaration of Human Rights HIV and related infections in prisoners

5. Cycle of Human Rights Violations HIV and related infections in prisoners Criminalization of key populations Abusive police practices Lack of due process; over- incarceration Intolerable prison conditions Lack of continuity of care on release

6. Cycle of Human Rights Violations HIV and related infections in prisoners Criminalization of key populations Abusive police practices Lack of due process; over-incarceration Intolerable prison conditions and health practices Lack of continuity of care and support on release 21 % of convictions worldwide for drug crimes; 80% for possession Other key populations

7. Cycle of Human Rights Violations HIV and related infections in prisoners Criminalization of key populations Abusive police practices Lack of due process; over-incarceration Intolerable prison conditions and health practices Lack of continuity of care and support on release Targeting key populations, racial and ethnic minorities Condoms as evidence of crime

8. Cycle of Human Rights Violations HIV and related infections in prisoners Criminalization of key populations Abusive police practices Lack of due process; over- incarceration Intolerable prison conditions and health practices Lack of continuity of care and support on release Lack of access to counsel Lack of pre-trial release – 3 million people worldwide Disproportionate sentencing

9. Cycle of Human Rights Violations HIV and related infections in prisoners Criminalization of key populations Abusive police practices Intolerable prison conditions Lack of Overcrowding, violence Inadequate food, sanitation, ventilation Segregation of HIV positive inmates Lack of Health staff, resources Inclusion in national plans Voluntary HIV testing HIV prevention Treatment: HIV, TB, HCV, OST

10. Cycle of Human Rights Violations HIV and related infections in prisoners Criminalization of key populationsCriminalization of key populations Lack of housing and social supports High rate of death from drug overdose on release Intolerable prison conditions Lack of continuity of care on release

11. Breaking the Cycle—An Evidence-Based Human Rights Approach HIV and related infections in prisoners Decriminalization Reform police practices Availability of counsel, pre-trial release Follow Mandela Rules; Monitoring Continuity from time of arrest

12. Prisons must be managed in a manner to respect and protect the human rights and dignity of prisoners Prison should be viewed as a place for preparation for reintegration of prisoners into society – minimize differences with outside world Adequate space, food, sanitation No discrimination Health care to meet prisoners’ needs throughout detention and linkages to public health Monitoring and accountability “, HIV and related infections in prisoners UN Standards on Treatment of Prisoners – Mandela Rules (2015)

13. Human rights are both a set of values and legal obligations that require governments to take specific steps to protect, respect and fulfill rights Action can and must be taken at every level to break the cycle. There are excellent models of programs that respect rights, from de-criminalization of drugs to adequate prevention and treatment programs in detention facilities Political will to fulfill rights, resources, engagement of prisoners and people with HIV, and accountability essential., Conclusions HIV and related infections in prisoners