Assessment of the Implementation of 2009-2013 National AIDS Programme: Prevention, Treatment and Care in the Penitentiary System of Ukraine

This situation is accompanied by other risks such as high prevalence rates of other blood-borne-virus infections, syphilis, and tuberculosis. Only approximately one-third of prisoners infected with HIV are known to the State Penitentiary Service of Ukraine (SPSU). The National AIDS Program for 2009-2013 has a relevant sectoral program for prisons, entitled "Program to Ensure Prevention of HIV Infection, Treatment, Care and Support for People Living with HIV and AIDS Patients in Penitentiary facilities and Remand Prisons of the State Criminal Execution Service of Ukraine for 2009-2013." This program is currently operating, and GFATM funds are utilized for prevention, treatment, and care and support activities. Additional programs focusing on specific thematic areas, such as training and manuals, have been carried out with the support of UNDP, EC, and national funds. Progress has been achieved in responding to HIV/AIDS in prisons, particularly in offering ARV treatment, prevention, care, and support, and training. However, these efforts are still far below an adequate public health response to the HIV epidemic. A lack of equality of health care comparing community and prison services can be noticed, with prisoners not benefiting from the introduction of evidence-based interventions in the community. Prison staff and administrative personnel are isolated and lacking competences and networks that service providers in the general community have started to develop. The coverage and quality standards of services in prisons should be complementary and moving along the same line as those in the community. Access to and quality of VCT, ARV, should be enhanced, and other evidence-based interventions should be introduced, such as OST, condoms/lubricants, disinfectants, and PNSP. Trainings activities have to be intensified due to the high turnover rate of prison staff. NGOs have played and have to play an important role in the general response to HIV/AIDS. Involvement of civil society is pivotal. Legal structures that hamper adequate and evidence-based responses to the HIV epidemic have to be analyzed in order to overcome these barriers. Finally, gender issues should be carefully looked at, as most of the incarcerated women have children, and parenthood and PMTCT are central issues in the care of female IDUs and female prisoners in general in prisons. The situation in prisons has to be considered in line with other key issues related to the HIV epidemic and injecting drug use (IDU). The prevalence of HIV infection among prisoners is high, and the situation is accompanied by other risks such as high prevalence rates of other blood-borne-virus infections, syphilis, and tuberculosis. The State Penitentiary Service of Ukraine (SPSU) has a responsibility to ensure that prisoners have access to HIV testing, treatment, and care. The National AIDS Program for 2009-2013 has a relevant sectoral program for prisons, which is currently operating. However, the program is facing challenges in terms of funding, and the coverage and quality standards of services in prisons are not comparable to those in the community. The prison staff and administrative personnel are isolated and lacking competences and networks that service providers in the general community have started to develop. The introduction of evidence-based interventions in prisons is essential to address the HIV epidemic. These interventions include ARV treatment, prevention, care, and support, and training. The coverage and quality standards of services in prisons should be complementary and moving along the same line as those in the community. Access to and quality of VCT, ARV, should be enhanced, and other evidence-based interventions should be introduced, such as OST, condoms/lubricants, disinfectants, and PNSP. The high turnover rate of prison staff requires intensified training activities. NGOs have played and have to play an important role in the general response to HIV/AIDS. Invol