Simpson Paul L, Gardoll Bree, White Luella, Butler Tony
School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia.
Lancet Reg Health West Pac. 2023 Jun 22;41:100813. doi: 10.1016/j.lanwpc.2023.100813. eCollection 2023 Dec.
Globally, people living with the Human Immunodeficiency Virus (HIV) are over-represented in incarcerated populations. The current study aimed to provide a national (Australian) snapshot of current HIV prison policies against the United Nations' (UN) 15 key HIV interventions for prisons. Publicly available policies, reports, and data were obtained, and interviews were conducted with prison health staff in five of eight Australian jurisdictions. We rated whether policies were compliant, partially compliant, or not compliant to the UN interventions and assigned an overall grade (A to E, where A = most compliant and E = least compliant) for each jurisdiction. Three jurisdictions received a B grade, three received a C grade, and two were not assessed due to insufficient data. In all jurisdictions HIV policies fell short of full compliance to most UN interventions. Prison-based needle and syringe programs and initiatives beyond education to reduce HIV transmission from body modification procedures (eg, tattooing) were absent in all jurisdictions. No condom programme existed in one jurisdiction and access issues were reported in others. Opioid substitution therapy, and peer-education access varied across and within most jurisdictions. Findings indicate that more action is required to meet the UN recommended interventions for HIV prevention in prisons.
在全球范围内，感染人类免疫缺陷病毒（HIV）的人群在被监禁人口中占比过高。本研究旨在对照联合国针对监狱的15项关键HIV干预措施，呈现澳大利亚当前HIV监狱政策的全国概况。我们获取了公开可用的政策、报告和数据，并与澳大利亚八个司法管辖区中的五个辖区的监狱卫生工作人员进行了访谈。我们评估了各项政策是否符合、部分符合或不符合联合国的干预措施，并为每个司法管辖区给出了一个总体评分（A至E，其中A =最符合，E =最不符合）。三个司法管辖区获得了B级评分，三个获得了C级评分，两个因数据不足未被评估。在所有司法管辖区，HIV政策均未完全符合大多数联合国干预措施。所有司法管辖区都没有基于监狱的针头和注射器项目，也没有除教育之外旨在减少因身体改造程序（如纹身）导致HIV传播风险的举措。一个司法管辖区没有避孕套项目，其他司法管辖区则存在获取方面的问题。阿片类药物替代疗法以及同伴教育在大多数司法管辖区内和跨辖区之间存在差异。研究结果表明，需要采取更多行动以落实联合国针对监狱HIV预防的建议干预措施。
