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Inmates
Because of a penal system inherited from slavery and colonialism, Caribbean inmates face particularly harsh living conditions. In many territories, rehabilitation takes second place to punishment, and the practices of these institutions reflect that ethos. As a result, inmates living with HIV and those who are at risk of contracting HIV while incarcerated face systemic and policy barriers which militate against the provision of humane treatment consistent with the principles of international human rights. Youth are particularly vulnerable as the stigma surrounding incarceration often means that they are treated as outcasts from formal society.
The Pan American Health Organisation, PAHO, reports that in the Caribbean “a series of surveys conducted in 2004-2005 showed that prevalence rates among prisoners varied between 2% and 4%, while in the Dominican Republic and Argentina the rates were 19% and 18.4% respectively.(1) St. Kitts, for instance, has a prison prevalence rate of 2.4%, St Lucia 2%(2) Jamaica 6.7% Trinidad and Tobago 4.9 % SVG, 4.1%(3) The extent of HIV transmission in Caribbean prisons has been little documented, though, some conclusions may be drawn from prison workers who suggest that it is higher than what occurs in the wider society.
A number of concerns related to HIV in prisons remain to be addressed in the Caribbean . Three are of particular importance to CVC. These are prevention, access to treatment in prison and follow up after release. It is known from press reports across the region that the incidence of prison rape, particularly of weaker or less aggressive inmates, is significant, raising the spectre of HIV transmission. Because of the legal framework in most of the Commonwealth Caribbean, where buggery is illegal, the overt distribution of condoms is problematic. Socially, too, the distribution of condoms in prisons is perceived not only as an acknowledgement of homosexual activity but also as an endorsement of it. In the context of very religious societies, this kind of intervention is sometimes actively resisted. Thus, governments feel forced, at least publicly, to deny or oppose suggestions to introduce condoms to prisons.
CVC proposes to document best practices in prevention and care for inmates as well how to deal with the stigma associated with condom distribution in prisons.
(1) Regional HIV/STI Plan for the Health Sector 2006-2015
(2) CAREC Annual Report, 2004
(3) UNGASS 2006, Country Report St. Vincent and the Grenadines
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