Stop AIDS in All Prisons
Each country will tailor its anti-AID legislation to meet its unique circumstances. The following, however, drawn from modified excerpts of the USA HR 1429, may sometimes provide some starting points.
IN GENERAL.—The State Ministry of Prisons (herein after in this Act referred to as the ‘‘Ministry’’) shall develop a comprehensive policy to provide HIV testing, treatment, counseling, and prevention for inmates within the correctional setting and upon reentry. The purposes of this policy shall be:
(1) To stop the spread of HIV/AIDS among inmates.
(2) To protect prison guards and other personnel from HIV/AIDS infection.
(3) To provide comprehensive medical treatment to inmates who are living with HIV/AIDS.
(4) To promote HIV/AIDS awareness and prevention among inmates.
(5) To encourage inmates to take personal responsibility for their health.
(6) To reduce the risk that inmates will transmit HIV/AIDS to other persons in the community following their release from prison.
The policy created shall do the following:
(1) TESTING AND COUNSELING UPON INTAKE.—
(A) Medical personnel shall make available routine HIV testing to all inmates as a part of a comprehensive medical examination immediately following admission to a facility. (Medical personnel need not offer routine HIV testing to an inmate who is transferred to a facility from another facility if the inmate’s medical records are transferred with the inmate and indicate that the inmate has been tested previously.)
(B) To all inmates admitted to a facility prior to the effective date of this policy, medical personnel shall offer routine HIV testing within no more than 6 months. HIV testing for these inmates may be performed in conjunction with other health services provided to these inmates by medical personnel.
(C) All HIV tests under this paragraph shall comply with paragraph (9).
(2) PRE-TEST AND POST-TEST COUNSELING.—
Medical personnel shall make available confidential pre-test and post-test counseling to all inmates who are tested for HIV. Counseling may be included with other general health counseling provided to inmates by medical personnel.
(3) HIV/AIDS PREVENTION EDUCATION.—
(A) Medical personnel shall improve HIV/AIDS awareness through frequent educational programs for all inmates. HIV/AIDS educational programs may be provided by community based organizations, local health departments, and inmate peer educators. These HIV/AIDS educational programs shall include information on modes of transmission, including transmission through tattooing, sexual contact, and intravenous drug use; prevention methods; treatment; and disease progression. HIV/AIDS educational programs shall be culturally sensitive, conducted in a variety of languages, and present scientifically accurate information in a clear and understandable manner.
(B) HIV/AIDS educational materials shall be made available to all inmates at orientation, at health care clinics, at regular educational programs, and prior to release. Both written and audio-visual materials shall be made available to all inmates. These materials shall be culturally sensitive, written for low literacy levels, and available in a variety of languages.
(4) HIV TESTING UPON REQUEST.—
(A) Medical personnel shall allow inmates to obtain HIV tests upon request once per year or whenever an inmate has a reason to believe the inmate may have been exposed to HIV. Medical personnel shall, both orally and in writing, inform inmates, during orientation and periodically throughout incarceration, of their right to obtain HIV tests.
(B) Medical personnel shall allow inmates to request HIV tests if the inmate is sexually active, has been raped, uses intravenous drugs, receives a tattoo, or if the inmate is concerned that the inmate may have been exposed to HIV/AIDS.
(C) An inmate’s request for an HIV test shall not be considered an indication that the inmate has put him/herself at risk of infection and/or committed a violation of prison rules.
(5) HIV TESTING OF PREGNANT WOMEN.—
(A) Medical personnel shall offer routine HIV testing to all inmates who become pregnant.
(B) All HIV tests under this paragraph shall comply with paragraph (9).
(6) COMPREHENSIVE TREATMENT.—
(A) Medical personnel shall make available to all inmates who test positive for HIV— (i) timely, comprehensive medicaltreatment; (ii) confidential counseling on managing their medical condition and preventing its transmission to other persons; and (iii) voluntary partner notification services.
(B) Medical care provided under this paragraph shall be consistent with standard medical practice. Medical personnel shall discuss treatment options, the importance of adherence to antiretroviral therapy, and the side effects of medications with inmates receiving treatment.
(C) Medical and pharmacy personnel shall ensure that the facility formulary contains all approved medications necessary to provide comprehensive treatment for inmates living with HIV/AIDS, and that the facility maintains adequate supplies of such medications to meet inmates’ medical needs. Medical and pharmacy personnel shall also develop and implement automatic renewal systems for these medications to prevent interruptions in care.
(D) Correctional staff and medical and pharmacy personnel shall develop and implement distribution procedures to ensure timely and confidential access to medications.
(7) PROTECTION OF CONFIDENTIALITY.—
(A) Medical personnel shall develop and implement procedures to ensure the confidentiality of inmate tests, diagnoses, and treatment. Medical personnel and correctional staff shall receive regular training on the implementation of these procedures. Penalties for violations of inmate confidentiality by medical personnel or correctional staff shall be specified and strictly enforced.
(B) HIV testing, counseling, and treatment shall be provided in a confidential setting where other routine health services are provided and in a manner that allows the inmate to request and obtain these services as routine medical services.
(8) TESTING, COUNSELING, AND REFERRAL PRIOR TO REENTRY.—
(A) Medical personnel shall make available routine HIV testing to all inmates no more than 3 months prior to their release and reentry into the community. (Inmates who are already known to be infected need not be tested again.) This requirement may be waived if an inmate’s release occurs without sufficient notice to the Ministry to allow medical personnel to perform a routine HIV test and notify the inmate of the results.
(B) All HIV tests under this paragraph shall comply with paragraph (9).
(C) To all inmates who test positive for HIV and all inmates who already are known to have HIV/AIDS, medical personnel shall make available — (i) confidential prerelease counseling on managing their medical condition in the community, accessing appropriate treatment and services in the community, and preventing the transmission of their condition to family members and other persons in the community; (ii) referrals to appropriate health
care providers and social service agencies in the community that meet the inmate’s individual needs, including voluntary partner notification services and prevention counseling services for people living with HIV/AIDS; and
(iii) a 30-day supply of any medically necessary medications the inmate is currently receiving.
(9) OPT-OUT PROVISION.—
Inmates shall have the right to refuse routine HIV testing. Inmates shall be informed both orally and in writing of this right. Oral and written disclosure of this right may be included with other general health information and counseling provided to inmates by medical personnel. If an inmate refuses a routine test for HIV, medical personnel shall make a note of the inmate’s refusal in the inmate’s confidential medical records. However, the inmate’s refusal shall not be considered a violation of prison rules or result in disciplnary action. Coercion for testing will be strictly forbidden.
(10) TIMELY NOTIFICATION OF TEST RESULTS.—
Medical personnel shall provide timely notification to inmates of the results of HIV tests.
(11) REPORTS
(a) Report on hepatitis and other diseases.—
Not later than 1 year after the date of the enactment of this Act, the Ministry shall provide a report on Ministry policies and procedures to provide testing, treatment, and prevention education programs for Hepatitis and other diseases transmitted through sexual activity and intravenous drug use.
(b) Annual reports.—
(1) Generally.—Not later than 2 years after the date of the enactment of this Act, and then annually thereafter, the Ministry shall report on the incidence among inmates of diseases transmitted through sexual activity and intravenous drug use.
(2) Matters pertaining to various diseases.—Reports under paragraph (1) shall discuss—
(A) the incidence among inmates of HIV/AIDS, Hepatitis, and other diseases transmitted through sexual activity and intravenous drug use; and
(B) updates on Ministry testing, treatment, and prevention education programs for these diseases.
(3) Mattes pertaining to HIV/AIDS only.—Reports under paragraph (1) shall also include—
(A) the number of inmates who tested positive for HIV upon intake;
(B) the number of inmates who tested positive prior to reentry;
(C) the number of inmates who opted out of testing.
