Re: HIV Screening of inmates of Jail

[Guest guest]

Dear FORUM,

This is in response to Dr. Sadhu Charan Panda's posting on HIV Screening of

inmates of Jail

Re: /message/9719

Prisoners also have basic human rights. Hence, HIV testing should be voluntary

and they have every right to know the test details. The details of the test has

to be made known to the prisoner not to the prison official. Hope this info.

might be of helpful to you.

We implemented a prison HIV intervention project in the central prison Central

Prison in Madurai (State of Tamil Nadu).

Syed Ahamed

Advocate

Foundation for Human Rights and Development

I Floor, Plot No. 241

K.K. Nagar, Madurai-625 020

Tamil Nadu, India

Mobile No. + 98438 45404

e-mail: <fohrd@...>

[Guest guest]

Dear forum members,

This is in response to the debate of HIV screening in jails.

I totally agree to the issues of Human Rights which is equally applicable to

jail inmates.

But there are situations where the jail Medical officer need to know about the

HIV status of the person as the person in jail might serving a long term

sentence/life sentence and might require to have CD4 test.

Many of the jails are far away from the ART centres where the person has to

visit regularly for the test as well as for recieving the ART.

If the authorities don't know about the status they cannot refer the person to a

hospital where ART is available. Moreover there has so far no special diet

provision for HIV+ ve persons in the jail.

However we have seen that the authorities take special interest to provide non

spicy and fresh food to the prisoner. I have also seen that boiled water is

given to the inmates in some cases and their own fellow prisoner ensure it.

This is all in Orissa context where PLHIVs cover several hundred kilometers to

reach the ART centres. Facilities are expanding but not so much that every

district headquarter where mostly the jails are located will have an ART

facility and CD4 testing facility as well.

One more thing is that the persons having HIV are also given less strenuous work

inside the jail. So it is not always ideal but many a times it is required that

the Jail superintendent and the Jail Medical officer need to know about the HIV

status of a perticular person.

However we should sensitise the jail authorities to avoid situations where we

might confront situations like disclosure of HIV status, stigma, isolation etc.

 

Madhusmit Pati

TSU-Orissa

CARE India Trust

e-mail: <madhusmit_pati@...>

[Guest guest]

Dear FORUM,

Re: /message/9719

I am all in favour of mendatory HIV and hepatitis screening of all jail inmates.

Where is the question of human rights when it is a concern for other inmates and

society as a whole. The members are encouraged to read the study we carried out

way back in 1999 and our findings were replicated by other studies too and WHO.

Singh S, Prasad R, Mohanty A. High prevalence of Sexually transmitted and

blood borne infections amongst the inmates of a District Jail in North India.

Int J STD AIDS 1999 ; 10 (7) : 475-78.

Dr. Sarman Singh, MD. FAMS, FRSTMH, FSIIP

Prof. & Head,

Division of Clinical Microbiology Department of Laboratory Medicine

All India Institute of Medical Sciences P.O. Box. 4938, Ansari Nagar New

Delhi-110 029 (India)

Phone: (0091-11) 2659 4977, 2658 8484

Fax: (0091-11) 2658-8663, 2658 8641

Personal Website: www.drsarmansingh.com

[Guest guest]

Dear FORUM,

Re: /message/9742

I quite understand the view of Madhusmit Pati. If HIV Positive inmates

are to be taken care of then it is imperative that the officials of

the jail know about the status of the inmates.

But when they are given differential treatment like boiled water to

drink and less work, then wont the other inmates also come to know

about their status? What about the confidentiality? How is their

health taken care of without breach of confidentiality?

Priyamvada Chaturvedi

DRISHTIKON

e-mail: <drishtikon95@...>

[Guest guest]

Dear FORUM,

Re: /message/9739

Dr. Sarman Singh's view about madatory HIV test, gives a new dimension to the

issue.

If, mandatory testing is Ok for jail inmates why not for the people in uniform,

why not for doctors, why not for all ?

I have not gone through the findings of the study Dr. Singh refers to; but I

would definitely like to go through it in detail.

Clinically or as a doctor he might be correct, but we cannot be judgemental or

ignore other angles of the issue of mandatory HIV testing.

However, we may counsel the jail inmates through group counseling or one-to-one

counseling to ensure that as many people volunteer for HIV test. But mandatory

testing for every prisoner; I cannot think of it.

Madhusmit Pati

TSU-CARE India Trust

Orissa

e-mail: <madhusmit_pati@...>

[Guest guest]

Dear Mr Madhusmit Pati,

Re: /message/9737

Thanks so much for taking forward the discussion and sharing your experience in

Orissa.

The HIV positive inmates can very well approach the prison medical officer for

referring them to ARV Centre. They can even make request to tranfer them to the

prison which is close to ARV Centre. Many HIV positive prisoners were

transferred to Chennai from other parts of the State of Tamil Nadu to give them

easy access to ART treatment at Tambaram Sanatorium. Fortunately now ARV is

available in many parts of our State.

Definitely HIV positive inmates can share their status with the Prison Medical

officer as well as the Superintendent. In my experience, no prisoners has

refused to share their status with these higher offcials provided if he/she is

properly informed about the benefits of sharing this info.Â

Many groups has high risk than the prison inmates. But they are not compelled to

undergo HIV test. Then why should we make.

One central prison even has a ICTC centre. TANSACS had three pilot HIV TI

projects among prison inmates in the State. Recently It abruptly windup all

these 3 projects saying that the NACO has changed its policy.

Now TANSACS is in the process of mainstreaming HIV in prison department. TANSACS

has not used the rich experience of the NGOs who had implemented these pilot

projects but  reinventing the same wheel.

I personally feel that the rich experience of these NGOs who have implemented

the TI project in the prisons for several years has to be utilized in the

process of mainstreaming.

Inmates infected with TB has provision for special diet. As you rightly said so

far there is no provision made for providing special diet to the HIV positive

inmates. Advocacy at the higher level has to be carried out to extend this

provision to the HIV positive inmates as well. But the prison officials in some

of the prison in TN are extending this provision to the HIV positive inmates as

well.

There is a special ward for TB patients in the prison. Sometimes the HIV

positive inmates also are kept in this cell, so that they get special diet. But

this is dangerous.  Some inmates without knowing the consequences prefer to stay

with the TB patients just to have the Nov-veg meal which is like " Amruth " in the

prison settings.

There is a lot to be done in the prisons. Another area which requires immediate

attention is Juvenile Justice facilities. The adolescent boys in the

correctional homes are also equally vulnerable. We are trying our best to reach

out this population.

Thanks once again for sharing your experience.

Many regards

Syed

 

FOUNDATION FOR HUMAN RIGHTS AND DEVELOPMENT

I Floor, Plot No. 241

K.K. Nagar, Madurai-625 020

Tamil Nadu, India

Mobile No. + 98438 45404

e-mail: <fohrd@...>

[Guest guest]

Dear FORUM,

This is in response to Dr. Sarman Singh, MD. FAMS, FRSTMH, FSIIP

Prof. & Head, Division of Clinical Microbiology Department of Laboratory

Medicine, All India Institute of Medical Sciences

Re: /message/9739

Ethics forms the basis of research on vulnerable poopulations as well as

interventions. Refer to the ICMR Ethical Guidelines for Biomedical Research on

Human Participants (known as the ICMR Code)

....icmr.nic.in/ethical_guidelines.pdf.

Mandatory screening in not in any National Policy and human rights of PLHIV have

been spelt our clearly on NACO website.

http://www.nacoonline.org/Quick_Links/Know_Your_Rights/

Right to Informed Consent

The implications of HIV are very different from most other illnesses. Testing

for HIV requires specific and informed consent of the person being tested and

any research on data of HIV positive people.

 

Right to Confidentiality

A person has the right to keep information on HIV status confidential.  People

with HIV are often afraid to go to court to vindicate their rights for fear of

their HIV status becoming public knowledge. However, they can take the help of

Suppression of Identity under a pseudonym. This ensures that PLHA can seek

justice without fear of social ostracism or discrimination.

Right against Discrimination

The right to be treated equally is a fundamental right whether it's something as

simple as using a public well or something more serious like denial of housing.

 

The jail authorirties/ NGOs/ Medical institutes can arange counselling; and

those who opt for test can get the test done:- and only the person to whom the

result is given is the concerned person. Disclosure is to be done by the

affected person and counsellor can encourage the client for this once he/she is

mentally prepared.

Increasing acces to treatment has to be in an ethical way and protecting rights

of individuals to privacy and confidentiality. You would not want your medical

records to be put up on a notice board. Would you?

There is no casual transmission so why would others need to know your disease?

We are giving free ART only at CD4 < 400 (at the time when person is

sympotmatic). So does early screening of inmates give them better care?

Corecive policies have failed in public health..We all know the experience of

failure of family planning programme in emergency days.

 

Labelling is unthical.

Dr RK Sood

e-mail: drrksood@...

+91 9418064077, +91 9445157327