HIV responses are largely failing some of those most at risk. This includes people in prisons. According to UNAIDS, the estimated prevalence of HIV infections among people in prisons and other closed settings increased from 3.8% to 4.3% (between 2017 and 2021). People held in those settings are now six times more likely to be living with HIV than adults in the general population.
Most prison facilities ask prisoners about their HIV status upon incarceration and offer HIV testing to those who do not know their status. However, psychological support and access to HIV treatment are not always available, even for prisoners who already know their status. HIV treatment is provided within prisons.
Lonnie, a human rights activist, shares her experience working within prison facilities and highlights the challenges faced by prisoners in accessing HIV services.
What stops prisoners engaging with HIV services?
“The stigma amongst prisoners themselves is the main reason that stops prisoners from accessing HIV services,” says Lonnie.
Stigma remains a significant barrier to prisoners accessing HIV services. Prisoners may fear being stigmatised and discriminated against, especially by other prisoners, if they share their HIV status or seek out HIV services. This fear can lead to people not getting the treatment and support they need and defaulting on treatment.
How can HIV services be more friendly?
“Upon incarceration, most prisoners are forced to get an HIV test. But they are not offered any counselling or follow-up support,” Leonnie explains.
Psychosocial support is essential for prisoners living with HIV as it can help them to cope with the emotional and psychological challenges they face, such as stigma, discrimination, and loss. In many instances, psychological support can also help prisoners to improve their quality of life and adhere to their HIV treatment.
Healthcare facilities within prisons should be properly equipped, including with enough health professionals.
“There should be a comprehensive healthcare system that has everything required to assist prisoners with HIV services that they need. The ratio of inmates to health professionals is too high, hence it is vital to increase the number of health professionals to ensure prisoners receive adequate healthcare,” Lonnie explains.
Availability of antiretroviral treatment (ARVs) is also an issue. “The supply of ARVs is inconsistent,” says Lonnie. “This means people tend to default on their medication.” It is essential ARVs are made consistently available in prisons to protect people’s health.
Meals in prisons are not always nutritious and this may make taking ARVs difficult and to an extent less effective. This results in prisoners not accessing HIV services to receive treatment because they are not having a balanced diet.
Lonnie says: “A prison diet is not nutritious. This means ARVs are harder to take and less effective. Another reason people default.”
“There is often little access to information on HIV in prisons,” Lonnie explains. This is why it’s vital to “encourage prisons to collaborate with NGOs to provide prisoners with information and support.”
“As a health worker you can use your knowledge to lobby the government for improved health services for prisoners,” Lonnie says. “Ask for health facilities within prisons to be properly equipped, including with enough health professionals.”
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