HIV/AIDS in the prison system- Judith Albert

As Dr. White informed us at our most recent meeting, prisons are extremely high-risk environments for HIV transmission. To our surprise, there were no condom distribution in place in the system because that would mean acknowledging that sexual encounter does occur and would offer an opportunity for illicit drug use by hiding in them the illicit material.
I was surprised by the lack of realism expressed by prison authorities in this respect. First of all, my surprise was that out of two evils to prevent, the prison officials chose the least deadly one: drug use. It is known that there are plenty of other ways to prevent illicit drug use other than not distributing possible hiding places for them (e.g. condoms), but there are no other avenues to prevent the sexual spread of HIV.

I was browsing public-health related information on the web on my home country, Romania, with the hopes to do a summer project there when I came across the World Health Organization's project proposal to prevent HIV spread in the prisons of Europe. This is the web-link to the project:

http://www.euro.who.int/Governance/resolutions/2002/20021231_4

I highly recommend looking at this report, it provides a lot of information on HIV/AIDS related projects in the EU Council.

Also, I have found here the joint proposal of the WHO and UNAIDS for HIV/AIDS Prevention,
Care, Treatment and Support in Prison Settings. To my understanding, this proposal is not only for EU countries but for all nations.
Among the many proposals are the following two recommendations:

‘Recognize that consensual sexual activity occurs in prisons, and ensure that consensual

sexual activity is not penalised as this will discourage prisoners accessing

condoms.’

‘Ensure the measures available outside of prisons to prevent transmission of HIV

through the exchange of bodily fluids are also available in prisons. This should

include providing access to the full range of prevention commodities to prevent HIV

transmission through unsafe sex, needle sharing, unsafe tattooing, and joint use of

razors in those countries where these measures are available in the outside community,

e.g., condoms, sterile needles and syringes, razor blades and sterile tattooing

equipment. HIV prevention measures should be accessible in a confidential and

non-discriminatory fashion.’

Hence, there is a general understanding at the international level of HIV spread through unsafe sexual encounters in the prisons. I wonder why our prison system fails to acknowledge that. I also wonder whether this is only the case in our state or other states as well?

Annual UNC HIV Symposium

Hello Everyone:

I would ilke to inform you about the annual UNC HIV Symposium to be held at the Friday Center in Chapel Hill on Monday May 7th from 9 AM to 3:30 PM.

Speakers and talks:

• Roy Gulick from Cornell on New Drugs
• Richard Chaisson from Hopkins on Immune Reconstitution Syndrome
• Peter Leone from UNC on HIV Primary Infection
• Patrician Rivera of UNC on smoking cessation
• Brad Gaynes of UNC on Depression and our usual case conference.

Addiontal talks will be given on the following topics:

• HIV disclosure
• Post traumatic stress disorder
• The combined session on smoking cessation and the role of case management in prisoner release.

The cost is $30 (which includes free parking, breakfast and lunch).

The course will offer free credits for physicians, physician assistants, nurses, pharmacists, counselors, case managers and psychologists.

We hope to see you there!! Please forward this information to anyone you might think would be interested.

For more informatio, or for online registration, please visit...

http://www.gahec.org/cme/

Welcome to the age of CFAR blog communications - Ron Strauss

Dear CAB member and CFAR Colleagues -

Can you believe it - we now have a blog so that we can share news and ideas that relate to the CFAR CAB and HIV/AIDS research in-general. We will use this to let you know of up-coming CFAR speakers or of AIDS-related events or research findings. Hopefully you will find this a lively way to communicate as a group.

More later, Ron Strauss

HIV/AIDS Research Idea - Maria de Bruyn

At the last CAB meeting, we were asked if we had any suggestions for research topics that UNC staff could take on in relation to HIV/AIDS. One area in which almost no research has been done is unwanted pregnancy and how to deal with this for women living with HIV.

Some beginning research on reproductive choice is now showing that, while many HIV-positive women – particularly if they are younger, have a new partner and/or don’t have (m)any children – do want to become pregnant. However, significant numbers of women living with HIV also do not want more children and they may face numerous obstacles regarding termination of unwanted pregnancies. Research on this area and on the effects of unsafe abortion on HIV-positive women’s wellbeing would be a wide-open area for the CFAR.

Topics that could be included:

Clinical service provision

• Unsafe abortion: severity of complications, best treatments
• Reproductive & abortion counselling: message content before and after procedures; specific needs of HIV-positive women; incorporation of reproductive rights
• Abortion methods: comparative efficacy & sequelae among women living with HIV
• Abortion methods: possible special needs (e.g., regarding anaemia, infection prevention, interactions of medication abortion drugs and ARVs)
  

Social science and policy research

• How HIV-positive women cope with unwanted pregnancy
  Social, legal and health-service obstacles to HIV-positive women accessing safe non-discriminatory abortion care and postabortion care
• Social, legal, institutional and funding obstacles to linking HIV/AIDS services and abortion-related care
• Methods, effectiveness and impact of linking HIV/AIDS services and abortion-related care
• Women’s experiences with abortion-related care (especially related to stigma and discrimination)
• Effectiveness & impact of advocacy & policy capacity-building in helping people living with HIV/AIDS enjoy complete reproductive rights.

NC HIV/AIDS LAWS - Maria de Bruyn

A colleague from another state recently wrote me about this: “A colleague of mine who lives in North Carolina told me that his Dr contacted the Health Dept. and told them that he was HIV- positive. They contacted him to tell him about NC law (that it is illegal not to disclose before having sex). Then they wanted him to sign an acknowledgement saying that they came and spoke to him and that if he breaks the law he would be prosecuted. When he refused to sign the acknowledgement from the health dept. the official took the acknowledgement to his doctor and the doctor then asked for him to sign.”
The colleague also sent me a brochure about the law in NC, of which, I must admit, I was painfully ignorant. https://www.law.duke.edu/aidsProject/400_01/NCBarHIVBrochure.pdf

I find this rather shocking; all the responsibility is put on the people living with HIV. If a woman, for example, has a spouse or boyfriend who refuses to use a condom, he could later accuse her of infecting him (even if it was the other way around, he just hadn’t been tested, or had been tested outside NC) and she would be criminalized. This is appalling. Has UNC ever challenged this law or given testimony to the legislature pointing out how the law is in conflict with basic human rights?