ID: 912

Type of submission: Oral

Conference track: Practice

Topics: Harm Reduction Services and Service Provision; Prisons and Detention

Presenting author: Ina Tcaci

Presenting author biography:

National HIV/AIDS coordinator with UNODC Moldova, having extensive experience in public health programs and promotion of human rights especially for PWID and PLWH

The Impact of adopting evidence-based HIV harm reduction programs in prisons

Ina Tcaci, Veaceslav Paladi

Issue
HIV prevalence amongst inmates PWIDs accounts to 16%(IBBS2013). Creating demand for harm reduction services and medical ARV treatment with limited resources is difficult and depends on the willingness of the detainees to overcome the criminal subculture and discrimination barriers. Continuous risky behaviours and lack of counseling on treatment options or referrals upon release may impede PWID’s rehabilitation process.
Setting -
Moldova faces one of the most severe prevalence of MDR TB in Europe. Up until recently penitentiary system was renowned for high levels of TB infections.
Project -
Since 2011 UNODC provides support to the Department of Penitentiary Institutions in Moldova and CSOs with the financial contribution from OFID and HPCs. As of 2016 the DPI implements 13 out 15 key interventions from the comprehensive package. Inmate participation in facilitated by CSO involvement, creating a peer-to-peer network of inmate-volunteers. By allowing the interventions from the comprehensive package prison authorities managed to change the attitude of PWIDs for seeking medical assistance and reduced stigma and discrimination that HIV/AIDS prisoners were facing;
Outcome -
Since 2011, NSP scaled from 7 institutions to 17, there are on average 1600 monthly beneficiaries of the NSP program, compared to the average of 500 monthly officially documented PWIDs. All NSP sites are equipped with Naloxone for overdose management. NSP sites also distribute condoms, on average 35,000 yearly.
Since 2011, OST was extended from 5 institutions to 13. Case management approach, implemented jointly with CSOs has reduced significantly drop-out rates. Participation in increasing 62 (monthly) patients in 2013 to 85 in late 2015. The lasting effect is achieved by providing quality referral upon release. Adherence to the treatment is ensured by the CSO
Impact:
IBSS data confirm positive trends. HIV prevalence 4.2%(2007) to 1.9%(2012). HCV prevalence 21%(2007) to 8.6%(2012). Integrated HIV knowledge indicator 30.8%(2007) to 42.2%(2012).