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HIV and related
infections in prisoners
Human Rights, HIV
and Prisons
Authors and Affiliations
• 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
,
HIV and related infections in prisoners
“All human beings are born free and
equal in dignity and rights.”
Universal Declaration of Human
Rights
HIV and related infections in prisoners
Cycle of Human Rights Violations
Criminalization of
key populations
Lack of
continuity of
care on release
Abusive police
practices
Intolerable
prison
conditions
Lack of due
process; overincarceration
HIV and related infections in prisoners
Cycle of Human Rights Violations
Criminalization
of key
populations
Lack of continuity
of care and
support on release
21 %
Abusive police
practices
of convictions
worldwide for drug crimes;
Intolerable 80% for possession
prison
conditions and
Other key
health practices
Lack of due process;
over-incarceration
populations
HIV and related infections in prisoners
Cycle of Human Rights Violations
Criminalization of
key populations
Targeting key populations,
Lack of continuity
racial and
ethnic
of care
and
support on release
minorities
CondomsIntolerable
as evidence of
prison
crime
conditions and
health practices
Abusive
police
practices
Lack of due process;
over-incarceration
HIV and related infections in prisoners
Cycle of Human Rights Violations
Criminalization of
key populations
Lack of access
counsel
Lack of to
continuity
of care
and
Lack of pre-trial
release
–3
support on release
million people
worldwide
Disproportionate sentencing
Intolerable
prison
conditions and
health practices
Abusive police
practices
Lack of due
process; overincarceration
HIV and related infections in prisoners
Cycle of Human Rights Violations
Criminalization of
key populations
Lack of
Overcrowding, violence
Health staff, resources
Inadequate food, sanitation, ventilation
Inclusion in national
Segregation of HIV positive inmates Abusive police
Lack of
plans
practices
Voluntary HIV testing
Intolerable
HIV prevention
prison
Treatment: HIV, TB,
conditions
HCV, OST
HIV and related infections in prisoners
t
i
o Rights Violations
Cycle of Human
n
o
f
Lack of
k
continuity of care
e of housing and social
Lack
on release
y
supports
p
High
rate of death from
o
p
drug
overdose on release
u
l
Intolerable a
prison
t
conditions i
o
n
HIV and related infections in prisoners
s
Breaking the Cycle—An Evidence-Based Human Rights
Approach
Decriminalization
Continuity from
time of arrest
Reform police
practices
Follow
Mandela
Rules;
Monitoring
Availability of
counsel, pre-trial
release
HIV and related infections in prisoners
UN Standards on Treatment of Prisoners –
Mandela Rules (2015)
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
Conclusions
• 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.
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HIV and related infections in prisoners