Action on HIV/ AIDS in prisons: too little, too late. A report card.

摘要

Key Findings of the 2002 Report Cardud•All Canadian governments are failing to provide the resources, leadership, and vision necessary to address, in a comprehensive and progressive fashion, the issues raised by HIV/AIDS, HCV, and injection drug use in prisons.ud•There is a lack of coordination and harmonization of HIV/AIDS prison programs and services across the country. The standard of care available to prisoners varies widely between jurisdictions, and often between institutions within jurisdictions.ud•Condoms, dental dams and lubricant are still not available to prisoners in New Brunswick, Prince Edward Island, Nunavut, and some institutions in the Northwest Territories.ud•Even where they are available, they are often not accessible enough.ud•Bleach is only made available as a harm reduction measure in BC, Québec, and the federal prison system.ud•Needle exchange or distribution programs have yet to be piloted in Canadian prisons, although the experience with needle distribution programs in prisons in Western and Eastern Europe shows that such programs can be successfully implemented in prison.ud•In most jurisdictions, methadone maintenance treatment (MMT) has become available at least to those prisoners who were on such treatment before being incarcerated. The only exceptions are PEI, Newfoundland and Labrador, and Nunavut, where MMT availability is also extremely limited or non-existent in the community. Alberta, however, will only allow methadone continuation for a maximum of thirty days.ud•Only CSC and BC have policies that enable prisoners to begin MMT while incarcerated. In addition, initiation is sometimes available on an exceptional basis in Quebec, Saskatchewan, and the Yukon. ud•With some exceptions, provision of HIV and HCV prevention education for prisoners is poor. ud•In many jurisdictions, HIV training for prison health staff is rare or non-existent.ud•All jurisdictions provide voluntary HIV testing through the prison health units. Anonymous HIV testing is available in BC, Saskatchewan, and Nova Scotia, as well as in some Québec institutions. Anonymous testing is also being pilot tested in two federal penitentiaries.ud•Significant barriers still exist in most jurisdictions to the optimal use of HIV combination therapies.ud•There are few HIV programs and services designed specifically for incarcerated women and for Aboriginal prisoners.