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ID: HR19-843

Presenting author: Dina Masalimova

Presenting author biography:

Dina Masalimova has worked for PF "AIDS Foundation East-West in the KR" from 2010. She currently holds the position of the Project manager and is responsible for coordinating the organization's prison-based activities.

Access to harm reduction and HIV treatment and care services among prison outcasts

Dina Masalimova, Natalya Shumskaya

Kyrgyzstan is one of the few countries worldwide offering a variety of HR and HIV treatment and care services in prisons. Prisoners are offered such services as exchange of syringes, Naloxone distribution, OST, and HIV treatment based on the same criteria as in the wider community. However, the 2016 IBBS showed increase in prevalence of HIV (11.3% vs 7.6% in 2013) and hep C (42.8% vs. 34.5% in 2013). This might mean that not all prisoners are able to utilize the above mentioned services.
In most post-Soviet prisons, there is a certain social hierarchy system followed. The lowest rank is prison outcasts. They represent around 8% of all prison population. They are considered the most vulnerable sub-population. The reasons for their vulnerability are: layered stigma and discrimination from prisoners and prison staff, social isolation, worst living conditions, high prevalence of mental problems, and etc.
The 2018 peer-led assessment held by the USAID-funded HIV React Project reached 79 prison outcasts in two pilot facilities. The number of registered cases of HIV among outcasts is 2 times higher than among general prison population, # of PLHIV with their VL suppressed among outcasts is 1.5 times lower. 70% of outcasts report regular or occasional injecting drug use. Less than half say that they have uninterrupted access to needles and syringes. None of them reported having any access to Naloxone.
Following the assessment the Project developed an advocacy plan for improving access to services for prison outcasts and decrease the number of new HIV cases among the them. It includes efforts to arrange near-client harm reduction and HIV treatment services, create favorable and free of stigma and discrimination environment for their implementation and ensure pre- and post-release support to the outcasts. The plan will be implemented by the Penal Medical System and local NGOs.