Etude sur la possibilité de programmes de distribution de seringues stériles et de préservatifs pour les détenus
Cette étude explore la tendance des comportements à hauts risques au sein des prisons et évalue le niveau d’acceptation des détenus et des gardiens vis-à-vis des PES. Pour en savoir plus, en anglais, veuillez lire les informations ci-dessous.
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HIV prevalence within the prison setting throughout the world is estimated a lot higher than among general populationi. This is mainly caused by the high rate drug offences among people who use drugs which result in imprisonment. In Indonesia, more than a quarter of inmates in the prison settings are arrested due to drug-related offences.
Prisons or correctional facilities are where at risk population is concentrated. The estimated HIV prevalence within the prison setting in Indonesia is ranging between 1.1% among male inmates and 6% among female inmates. Sexually Transmitted Infections, such as syphilis, reaches 5.1% among male inmates and 8.5% among female inmates.
In 2009 Banceuy Prison had 7.2% HIV prevalence with 21% contributed by injecting drug users among the inmatesiv. Apart from that, the inmates in Banceuy Prison have the history of unprotected sexual activities all the way from their previous injecting drug use history (18%), unprotected sex (42%) and tattooed not by professional tattoo artist (61%).
This burden is a serious challenge for an institution like prison with limited resources. Meanwhile, generally prison setting has already carried double burdens such as over- capacity, indecent sanitation and inadequate health service. If these issues are not being tackled properly, the risk of HIV infection will be increased during the imprisonment period.
There are many successfully implemented Harm Reduction related programs within the prison settings. However, Sterile Syringes Service (SSS) program and condom distribution program are still among the polemic. There is a strict prohibition of drug distribution inside the prison setting, thus it is assumed that there is no demand for sterile syringes to inject drugs. In that regards, SSS is deemed as an unnecessary program for inmates.
But in reality, evidently many inmates are found using drugs inside the prison and using syringes collectively. This happens mainly in prisons with large population of inmates.
This also shows that there is a drug cycle within the prison setting. The using of injected drugs without sterile syringes can escalate HIV infection. That is the reason why SSS for inmates is necessary. With that in consideration, and based on the research done collectively by Directorate General of Penitentiary and Correctional Facility and HCPI (2010) it is highly suggested that a trial on SSS program within the prison setting in need should be implemented, with provision of policy management as the umbrella for the overall SSS program implementation.
Sex is the basic need of human just like food, water and staying healthy. This condition will motivate human beings to fulfill their needs. But within the prison settings, sexual need is a need that has a great challenge to be fulfilled. Being in a limited environment with the same sex peers for a certain period of time has made it possible for same sex intercourse to happenix. The fact that many prisons in Indonesia have over-capacity problem has worsened the situation.
Sexual activities inside the prison throughout the world have become something very common despite the fact that most prisons prohibit sexual conducts within the setting. This leads to lack of condom supply in the settingx.
Condom is a contraceptive means which also can be used to prevent HIV infection and other Sexually Transmitted Diseases. Promoting condom use to inmates can prevent various infections, but at the same time will be deemed as legalizing free sex. This needs different and proper promoting strategy.
From the research done by the Directorate General of Penitentiary and Correctional Facility, Ministry of Law and Human Rights and HCPI in 2010, SSS trial is recommended for prisons indicated with injecting drug use issue. The goal is to enforce service procedure and to learn about the effects. The recommendation of this SSS trial took into consideration any possible rejections and/or hesitance on the effectiveness of this SSS program in suppressing HIV infection. Class IIA Prison in Denpasar has, in fact, already started condoms distribution program.
Banceuy Prison is a correctional facility functioned as narcotics prison which most inmates are drug offenders from users, dealers to wholesalers/producers. Banceuy prison has over-capacity issue. Ideally this facility caters for 700 inmates, but to date it caters more than 1,400 inmates. With such characteristic in Banceuy prison, it is necessary to conduct an assessment on injecting drug use and unprotected sex related high risk behavior among its inmates. This exercise is necessary to assess the feasibility of SSS program and condoms distribution program for inmates within the prison setting.
Goals
- To learn about the general description of injecting drug use and sexual conducts within the prison setting.
- To discover the numbers of inmates who need and are interested in the respective program.
- To address the challenges and obstacles in the implementation of SSS program and condoms distribution program within the prison setting.
- To give recommendations on appropriate Harm Reduction strategies to be applied within the prison setting in relations to sterile syringes and condoms distribution.
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