Abstract
HIV/AIDS is a major healthcare problem in modern correctional setting. In order to counteract it, various educative, preventive and treatment measures are undertaken. However, research shows that in order to efficiently combat the disease, emotional and ethical measures are vital promoting cooperation between the patients and the prison staff and contributing to the general success.
Key Terms
Healthcare — prevention, treatment, and management of illness and the preservation of mental and physical well-being through the services offered by the medical and allied health professions; correctional setting — a penal institution, such as prison, jail, etc; HIV — human immunodeficiency virus, the cause of AIDS (acquired immunodeficiency syndrome); methadone treatment — a course involving a synthetic opioid, used medically as a maintenance anti-addictive for patients on opioids.
Body
In the recent decades humankind has been suffering a yet insufficiently studied and thus unconquered disease: HIV/AIDS is spreading around the planet at an alarming hate, acquiring an epidemic scale. One of the points which concentrate the nidus of HIV/AIDS infection is seen in the places of correctional settings, such as prisons, jails and the like. Prisons act as centers for gathering people who due to their background and life circumstances either already are carriers of infection or face the potential danger of contracting the disease from their cell mates. According to the UNAIDS (2004) data, the overall rates of HIV/AIDS infected patients in prisons greatly outnumbers that among the population out of prisons; the latest research estimates the rate of the HIV among prisoners to exceed the indices of it among general population by more than one hundred fifty percent (Zack & Kramer, 2009).
One of the main dangers of such situation lies in the fact that the larger part of the prisoners are in at a certain point released back into the community and consequently bring all the infections they have acquired during incarceration to the general public. Prisons appear a perfect terrain for onward transmission of the HIV/AIDS infection: overcrowding, drug abuse with application of non-sterile syringes, unprotected sex and male rape, tattooing and piercing with contaminated equipment, traditional prison blood rites involving direct blood exchange, — all those factors contribute to a rapid spread of infection among the inmates. To make matters worse, HIV Apart from prisoners themselves, the prison staff experience the risk of becoming possible victims of HIV as well. All this provides of envisaging prevention and treatment of HIV/AIDS as the greatest issue of healthcare within correctional environment.
In view of the alarming situation, prisons all over the world are taking measures aimed at protecting prisoners and their surroundings from the risk of HIV. Broad HIV educational programs have been launched among prisoners, with the accent placed on tailoring the programs for the target audience half of whom can barely read or write and to many of whom the English language is not native. Means of safer sex are introduced, such as distributing condoms among prisoners; this measure, however, has its opponents, as condoms are often viewed by prison authorities as a container for transporting drugs. Sterile syringes and disinfectants distribution has also brought about controversy, since along with providing a safer method for taking drugs and preventing needle sharing, syringes can be used as weapons. Another method of reducing illegal injections is methadone treatment, available in prisons worldwide with the exception of the U.S. (Kantor 2006)
Along with positive results observed as a result of anti-HIV programs, certain hindrances are singled out on the way to successful anti-HIV campaign. As The Foundation for AIDS Research (2008) remarks, the period of incarceration is a unique opportunity for treating and preventing HIV, as long as a series of aggravating factors are eliminated. Those factors are mostly of ethical and emotional nature, reflecting the popular bias and stigmas prisoners’ society places on the infected patients. Positive results in an HIV test can provoke ostracism, segregation and violence from the other inmates, and lead to limited access to medical care and related services. Besides, the atmosphere of tension and aggression typical of prisons does not contribute to the patients’ trust in the medical personnel and therefore hampers efficient communication and feedback from the prisoners.
Possessing a sufficient range of medical knowledge and equipment in order to counteract HIV/AIDS in prisons, one now faces the challenge of winning the trust of the prisoners. In order to achieve the desired results, cooperation is vital and decisive; for this purpose, a number of measures is to be followed that secures confidence in prison as an establishment that not only punishes but also helps. For one thing, discrimination of prisoners on the basis of their HIV test should be terminated. Placing HIV positive patients in a separate wing of a prison is common practice at certain establishments; this results in a low self-esteem and social judgment of the patients, and moreover, leads to increased risk behavior among the part of prisoners who consider themselves free of HIV infection (The Foundation for AIDS Research, 2008).
Therefore, all the information related to the medical condition of the inmates should be kept strictly confidential to prevent misinformation and stigmatization. For another thing, especial attention should be paid to the post-release patients, so that they do not resume the behavior that places them within the risk of worsening their condition and threatening the health of other members of society. It is often the case that ex-prisoners cannot obtain the necessary medical services due to inaccessibility of health insurance — therefrom arises the need for reconsideration of eligibility for Medicaid conditions. Strong evidence in support of the necessity for improving the emotional and ethical environment around the incarcerated HIV patients is found in the 2007 research conducted by Wilson, Ford, Ngammee, Chua, & Kyaw Kyaw in two Thai prisons and published in PLoS Medicine journal. The researchers emphasize the fact that the atmosphere of peer support and positive attitude of the committed staff members play a crucial role in the success of the treatment procedure; however long it took the prison authorities to gain the trust of the patients, the resulting willingness of the latter to go for medical treatment appeared a triumph of human rights defence (Wilson et al., 2007).
Conclusion
Summing up the abovementioned arguments, one arrives at the conclusion that in order to efficiently fight HIV/AIDS as one of the greatest healthcare problems in correctional setting, technical and medical equipment is not sufficient; it is rather the atmosphere of mutual trust and support between the staff and the prisoners that can help to ensure best performance and result in the global war on the plague of the modern world.
References
Kantor, E. (2006). HIV transmission and prevention in prisons. In HIV InSite Knowledge Base. CSF Center for HIV Information. Web.
The Foundation for AIDS Research. (2008). HIV in correctional settings: Implications for prevention and treatment policy. Issue brief #5. Web.
UNAIDS. (2004). Bringing comprehensive HIV prevention to scale. In 2004 Report on the Global AIDS Epidemic: 4th Global Report (pp. 67–92). Geneva, Switzerland: Author.
Wilson, D., Ford, N., Ngammee, V., Chua, A., & Kyaw Kyaw, M. (2007, June 27). HIV prevention, care, and treatment in two prisons in Thailand. PLoS Medicine, 4 (6), 988-992.
Zack, B., & Kramer, K. (2009). What is the role of prisons and jails in HIV prevention? University of California & San Francisco Center for AIDS Fact Sheet 13R. Web.
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