Today at the XVIII International AIDS Conference in Vienna, for the first time a plenary session was dedicated to HIV in Prison.

Dmytro Shermebey, one of the leaders of the All Ukranian Network of  People Living with HIV opened the session. He spoke of his personal experience of spending nine years in a Ukrainian prison. While he spoke pictures of prisoners, and prison cells were projected on the massive screens in the plenary hall. Dark spaces filled with emaciated young men, barely over boyhood, with  spider arms, reminiscent of Auschwitz. Prison meant: hunger, lack of sanitation, overcrowding, lack of air. It is not surprising that to be able to cope with those conditions prisoners had to use the most powerful painkiller in the world: heroin. Harm reduction, drug substitution therapies, clean needles and condoms are not available in Ukrainian prisons, and in the majority of prisons around the world. Dmytro recounted how syringes were shared by prisoners. One blunt needle would be sharpened on a stone over and over again in order to be reused .  It is not surprising that HIV prevalence in the global prison population is always much higher then in the general population.

Today plenary showed the world that those young men were clearly not only deprived of their liberty, but also robbed of all dignity, food, and health. Those are all fundamental Human Rights.

Dymitro explained to us that he survived because he fought.  But, many of his friends have died and are still dyeing.

I have been visiting women living with HIV in prison since 2001, when I started working for Positively Women (now Pos UK). Dmytro’s presentation made me appreciate all the good things of British prisons: above all access to ARVs, methadone and, at least in the few female prisons were Pos UK has been doing outreach, peer support. However I also know too well how damaging, traumatizing, and disempowering the experience of prison is,  especially for women .

So many of the women I see in prison have tragic pasts; addiction, abuse – including sexual abuse – neglect, and poverty are recurrent themes. I believe many of them suffer from mental health problems.

One of the biggest problem about the situation of women in prison, even in the UK,  is that it is severely under-researched. For ‘security reasons’, everything about prison is very guarded.

From my experience of supporting hundred of women I can affirm that prison is very hard for any body, but the added burden and terrible anxiety of having to guard the secret of HIV makes it a lot harder.

In the UK prisons women are a fast-growing population. According to the Prison Reform Trust Report of 2006 in England and Wales, the number of women has increased by more of 200% in the past 10 years compared to a 50% increase in the number of men in prison during the same period. At present, there are more then 4,200 women in prison in the UK.

This increase in the UK follows global trends towards a greater use and popularity of imprisonment and a lack of interest in constructive alternatives such as non-custodial sentences. Those would be particularly relevant to drug offenses and non-violent theft. Drug offenders in particular, would be better dealt with by therapeutically addressing their addiction.

Prison has a tremendously harsh effect on women, for several reasons. Firstly, women offenders are often the sole carer of their children, (more often then male prisoners). Their imprisonment and separation from the children can cause major psychological traumas, which are very difficult for both the mother and the children. This has grave repercussion for all of us in the communities were those children live. If they are the head of their household, their incarceration could result in the loss of their home, and serious disruptions to the lives of the children.

Since there are fewer women’s prison, women are more likely to spend time in a prison which is far away from where they live, so that visits from family and friends are extremely difficult. Women in prison can experience profound isolation, which has an effect on their often already compromised mental health. Additionally, because there are few women’s prison, women convicted from a wide range of offences are often imprisoned together. This means that the overall regime will be determined by the maximum-security requirements of a very few high-risk prisoners. Overall, the prison system was designed to deal with male prisoners, because of this it actually often discriminates against women.

If you add to this bleak picture the hurdle of living with HIV, and often of being diagnosed, while in prison, it is clear that there is an extreme urgency for a radical prison reform that takes into account gender equity and the right to health of women prisoners.

A comprehensive reform of the criminal justice and prison system was called for in today’s plenary session by Manfred Nowak, the UN Special  Rapporteur on Torture. He stated: ‘Prison Health is Public Health’.

I applaud the International AIDS Conference for having dedicated for the first time a plenary to Human Rights violations in prison. However I hope that this is not a one off token session. I believe that it is crucial to discuss more of the gender dimension of prison and how it increases women’s vulnerability to HIV and negatively affects physical and mental health.  We still know so little about this, especially on a global scale. Hopefully we will do this in Washington in 2012.


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