Weaning prisoners away from drugs and HIV tough but possible

Drug use among prisoners is a huge problem that leads to HIV transmission in overcrowded jails and weaning them away from it is possible but tough, according to the UN Office on Drugs and Crime (UNODC) regional centre for South Asia here.

As a result, 'all over the world, rates of HIV infection among prison populations are much higher than in the general population,' Jayadev Sarangi of UNODC points out.

'Drug use in general, and injecting drug use (IDU) in particular, as well as violence and the practice of men having sex with men are widespread in prisons, leading to HIV transmission,' Sarangi says. 'Many prisoners share needles to inject drugs. This is also an important mode of HIV transmission.'

Most prisons in South Asia are overcrowded, leading to higher risk of infection. According to the International College for Prison Studies in Kings College, London, in 2004-05 the occupancy levels in prisons were 277.1 percent in Bangladesh, 139 percent in India, 147.4 percent in the Maldives, 142.6 percent in Nepal and 193.2 percent in Sri Lanka.

UNODC is working among more than 20,000 prisoners in South Asia on issues related to drugs and HIV. It has also been building the capacities of 4,250 prison officials, welfare officers, doctors and volunteers to work with prisoners on these issues.

'Currently there is growing awareness and widespread concern about drugs and HIV/AIDS in prisons, though it may take a while to change the legal and institutional framework for working with prisoners,' Sarangi says. UNODC has found that there is an urgent need for training custodial and rehabilitation agencies, and of greater coordination between them.

The process of weaning anyone away from drug abuse involves giving him smaller and smaller doses of the drug. The UN organisation has suggested that these drugs be made available by the authorities to ensure that they are not contaminated, and that voluntary groups be involved in the detoxification process.

UNODC has stressed several other issues that need attention while working with prisoners. These include reduction in overcrowding, other sentencing programmes and separation of juveniles from adult prisoners.

Many people are in prison for the sole crime of being drug users, Sarangi points out. UNODC has suggested that treating these people may be an alternative to imprisonment.

UNODC has also suggested confidential and voluntary counselling and testing for HIV among prisoners. Sarangi says: 'This should be followed by psychosocial support, antiretroviral therapy, improved hygiene, sanitation and diet for HIV-infected prisoners.'

The UN organisation has also suggested similar care for prisoners suffering from other sexually transmitted infections, tuberculosis and hepatitis B and C.

The intervention programme has not reached most of the prisoners in South Asia. But UNODC has found positive results wherever it has reached. 'As people prepare to observe June 26 as the International Day against Drug Abuse and Illicit Trafficking, the need is to expand this and similar programmes many times,' according to Sarangi.