HIV/AIDS and Prisons:
Proceedings of a
Conference held 19-21 November 1990
Edited
by Jennifer Norberrry, Matt Gaughwin and Sally-Anne Gerull
Canberra : Australian Institute of Criminology, 1992
ISBN 0 642 16202 6 ; ISSN 1034-5086
(Conference proceedings (Australian Institute of Criminology); no.4)
The first national Conference on HIV/AIDS and Prisons was organised by
the Australian Institute of Criminology and the National Centre for
Epidemiology and Population Health. It examined many issues deriving
from the relationship between health care in the prison setting and the
management of prisons. Topics covered included overseas management of
AIDS in prisons; risk minimisation strategies including education,
health services, testing and segregation; and the problems of special
groups within the prison population.
Contents
Preface (PDF file size
12Kb)
Jennifer Norberry
Overview (PDF file size
20Kb)
Jennifer Norberry
WHO Global Commission, AIDS Recommendations and Prisons in Australia
Michael Kirby
AIDS in Australian Prisons What are the Challenges?
Robert Douglas
HIV/AIDS in US Prisons and Gaols: Epidemiology, Policy and Programs
Theodore M. Hammett
HIV in British Prisons: Problems Risk Behaviours and Prevention
Kate Dolan
HIV/AIDS and Australian Prisons
Sandra Egger and Hans
Heilpern
National HIV/AIDS in Prisons Information Clearing House
Judi Fortuin
Behind Bars - Risk Behaviours for HIV Transmission in Prisons, A
Review
Matt Gaughwin
Minimising the Spread of the Human Immunodeficiency Virus within the
Australian Prison System
John Dwyer
A Pragmatic Approach to the Delivery of HIV Related Services to
Prisoners
Stephen Kerr
Compulsory Testing and Integration
Michael Yabsley
HIV/AIDS in the Victorian Prison System
Peter Harmsworth
Managing HIV Seropositive Prisoners in South Australia: Some
Successes and Failures
Ann Bloor
The Integrated Management of HIV Infection in South Australian
Prisons: The Medical Perspective
Christopher Liew
Managing a Therapeutic Community: 'K' Division - A Case Study
Paul Hamilton
Management Issues - A Prison Officers Union Perspective
John Doyle
Rights, Duties, HIV/AIDS and Corrections
John Godwin
Prisoners' Rights: Treatment, Testing, Accommodation and Privacy of
Documents
Beverley Schurr
Educational Strategies and Policy Development
Kim Mannion
HIV Education Strategies within Correctional Services - The South
Australian Experience
Ollie Behrens-Peters
Prison AIDS Project: Prison Officer Education
Eileen Adamson
Perception of AIDS in Prisons: Relevance in Developing Educational
Strategies
Helen Close
HIV Minimisation Strategies for Queensland Correctional Centres
Clive Begg
Behind Bars: HIV Risk-Taking Behaviour of Sydney Male Drug Injectors
while in Prison
Alex Wodak
Methadone, Prisons and AIDS
Frank McLeod
Juveniles and HIV/AIDS Policy Development and Practice in Victoria
Lisa Ward and Gerard
Jones
Women Prisoners and HIV/AIDS
Tracie Walsh
Management of HIV in Community Based Corrections
Tony Clunies-Ross
Aboriginals, HIV/AIDS and Prisons
Stanley Nangala
Abstracts
WHO Global Commission, AIDS Recommendations and Prisons in Australia (PDF
file size 56Kb)
Michael Kirby
Kirby discusses: the
nature of the HIV virus and modes of transmission; international data
about AIDS in prisons; the responses of Australian correctional
authorities; recommended guidelines from the World Health Organization,
and other prisoner protection strategies. In particular, he deals with
compulsory testing, condom provision, and intravenous drug users.
(Adapted and updated version of the South Australian Justice
Administration Foundation Annual Oration: "AIDS strategies and
Australian prisons", 1990)
AIDS in Australian Prisons What are the Challenges? (PDF
file size 29Kb)
Robert Douglas
After giving some
background information about the first national HIV/AIDS and Prisons
Conference, Douglas describes the communique which was issued by the
participants. The communique dealt with: the influence of HIV/AIDS in
prisons on the wider community; the realities of prison life; prison
sexuality; drug use in prison; education; detection and management of
HIV positive prisoners; ex offenders; occupational health and safety;
collection of epidemiological information; and the legal obligations of
prison authorities.
HIV/AIDS in US Prisons and Gaols: Epidemiology, Policy and Programs (PDF
file size 59Kb)
Theodore M. Hammett
The authors summarise
the 1990 update of AIDS in correctional settings, a report put out by
the National Institute of Justice. The report covers HIV infection and
AIDS statistics as well as correctional policy issues and options. The
latter include education and training; HIV testing and counselling;
medical care, psychosocial services, housing, and correctional
management issues; and precautionary and preventive measures. Twelve
tables of statistical data from the report, some comparing US and
Canadian systems, are appended. They cover numbers of AIDS cases, data
from mass screenings, and AIDS education programs in US correctional
facilities.
HIV in British Prisons: Problems Risk Behaviours and Prevention (PDF
file size 24Kb)
Kate Dolan
Dolan discusses HIV
problems in British prisons in relation to risk behaviours such as
syringe sharing, sex, and tattooing. She briefly recommends ways to
prevent the spread of AIDS in prisons. Her data are drawn from an
evaluation of syringe exchange schemes.
HIV/AIDS and Australian Prisons (PDF
file size 57Kb)
Sandra Egger and Hans
Heilpern
The authors believe that
segregation of infected prisoners is no solution to the AIDS problem in
prisons. They report on data about testing of prisoners in all
Australian jurisdictions, and say that compulsory testing is the biggest
issue facing prisons. They discuss a number of AIDS containment options,
and strongly criticise the measures adopted in New South Wales so far.
An appendix table provides a state by state comparison of HIV screening
and management in Australian prisons.
National HIV/AIDS in Prisons Information Clearing House (PDF
file size 21Kb)
Judi Fortuin
Fortuin describes the
work of the recently established National HIV/AIDS in Prisons
Information Clearing House. She includes: its aims; its identification
of key individuals and institutions; the type of AIDS information it
believes is needed in prisons; and its plans for future development.
Fortuin applauds the work of the more established United States National
AIDS Information Clearinghouse.
Behind Bars - Risk Behaviours for HIV Transmission in Prisons, A
Review (PDF file size 50Kb)
Matt Gaughwin
Gaughwin focuses on how
to determine the extent of risk behaviours in prisons; the behaviour of
HIV infected prisoners; evidence for prison environments facilitating
risk behaviour; and the possible future of HIV infection in prisons. The
appendices contain a number of statistical summaries compiled from
international research.
Minimising the Spread of the Human Immunodeficiency Virus within the
Australian Prison System (PDF
file size 28Kb)
John Dwyer
Dwyer argues that
education and counselling are key components in minimising the spread of
AIDS in prisons. He also comments on: dealing with sexual activity;
problems associated with intravenous drug use; compulsory blood testing
for HIV antibodies; and advance planning for release from gaol.
A Pragmatic Approach to the Delivery of HIV Related Services to
Prisoners (PDF file size
22Kb)
Stephen Kerr
Many suggestions for
managing AIDS in prisons have been based on fear and stereotyping, and
the nature of prison administration often frustrates the provision of
anything apart from basic and essential services. However Kerr points to
the establishment of a Corrections Health Board in Victoria to overcome
these problems, and also to its initiatives in the HIV prevention arena.
Compulsory Testing and Integration (PDF
file size 17Kb)
Michael Yabsley
Yabsley, NSW Minister
for Corrective Services, points to new restrictions on prisoners'
property as a means of reducing the secreting of needles. He defends his
government's refusal to supply condoms or needle exchange systems, and
outlines his AIDS education and training initiatives as well as his new
compulsory HIV testing program. He argues that his Government's stance
against segregation of HIV positive prisoners demonstrates its ability
to withstand political pressure.
HIV/AIDS in the Victorian Prison System (PDF
file size 29Kb)
Peter Harmsworth
Harmsworth examines the
history of dealing with AIDS infected prisoners; the current legal and
correctional philosophy operating in prisons; and strategies for
managing AIDS in Victorian prisons. The latter include: education;
testing; counselling; accommodation; and infection control guidelines.
He also looks at condom availability and confidentiality.
Managing HIV Seropositive Prisoners in South Australia: Some
Successes and Failures (PDF
file size 29Kb)
Ann Bloor
Bloor outlines the
history of dealing with HIV and AIDS in South Australian prisons, as
well as current policies and strategies. She believes that the South
Australian approach has had mixed success and that more work needs to be
done in the following areas: dealing with fear; communication; specific
prisoner management; and education.
The Integrated Management of HIV Infection in South Australian
Prisons: The Medical Perspective (PDF
file size 33Kb)
Christopher Liew
Liew describes the
development of policies to deal with HIV and AIDS in South Australian
prisons, dwelling on the issues of testing and segregation. He then
discusses a number of medical management issues involving the Prison
Medical Service. These are the HBVAX program; tuberculosis screening;
standard management of HIV infected prisoners; drug use; homosexuality;
HIV, diets and vitamins; equitable access to health care; education and
counselling; stress; industrial and occupational issues; and
confidentiality.
Managing a Therapeutic Community: 'K' Division - A Case Study (PDF
file size 29Kb)
Paul Hamilton
HIV seropositive
prisoners are located in Unit 5 of K Division in Pentridge Prison.
Hamilton describes the operations of K Division in some detail. He
attributes the successful management of seropositive prisoners to the
introduction of a unit management regime as well as to a reverse
integration policy.
Management Issues - A Prison Officers Union Perspective (PDF
file size 16Kb)
John Doyle
Following the
introduction of the integration of HIV positive inmates into mainstream
prison populations, Doyle implemented a safety and education package for
NSW prison officers, on behalf of the NSW Prison Officers Union. Based
on his experience, Doyle discusses: the fears of prison officers;
incidents in which officers have been exposed to blood; government
apathy; segregation versus integration; prisoners' property; trauma
counselling; and AIDS testing.
Rights, Duties, HIV/AIDS and Corrections (PDF
file size 42Kb)
John Godwin
Godwin discusses the
legal duties of prisoner administrators in the context of AIDS
management. These are: the duty of care to prisoners; the duty to comply
with human rights obligations and non discrimination requirements; and
the duty to provide a safe system of work for employees. He also deals
briefly with some other legal and ethical dilemmas arising from AIDS
testing in prisons.
Prisoners' Rights: Treatment, Testing, Accommodation and Privacy of
Documents (PDF file size
40Kb)
Beverley Schurr
Schurr discusses
prisoners' rights enshrined in international and domestic law. The main
issues in relation to HIV/AIDS infected prisoners are: the right to
treatment; the right to refuse treatment and testing; confidentiality of
documents and information; segregated versus integrated accommodation;
and the concept of civil prisoners.
Educational Strategies and Policy Development (PDF
file size 24Kb)
Kim Mannion
Mannion identifies the
major educational stages in the New South Wales policy development
process, which have been significant in: responding to the AIDS issue;
managing AIDS issues in prisons; and effecting lasting changes. The
latter includes the breaking down of traditional departmental barriers.
She uses the Prison AIDS Project to illustrate her points.
HIV Education Strategies within Correctional Services - The South
Australian Experience (PDF
file size 35Kb)
Ollie Behrens-Peters
The author outlines the
beginning and progress of AIDS education programs in South Australian
prisons, for staff and inmates. The program is based on the experiential
learning model. He explains the processes which establishing such a
model necessitates, for example, the negotiation of commitment from
participants. The next step is the development of a prisoner peer
educational model.
Prison AIDS Project: Prison Officer Education (PDF
file size 28Kb)
Eileen Adamson
Adamson describes the
education programs implemented by the Prisons AIDS Project, which were
designed to help officers come to terms with AIDS related issues. These
programs include: information sessions for current officers; primary
training for new recruits; and in particular, the AIDS Management
Course. The latter was based on the idea of training officers so that
they could act as role models and resource persons.
Perception of AIDS in Prisons: Relevance in Developing Educational
Strategies (PDF file size
94Kb)
Helen Close
Close presents findings
from a study of prisoners, prison officers and staff within metropolitan
prisons in Perth. The study not only explored individual knowledge and
perceptions, but also investigated their perceptions of others'
perceptions. If a coordinated and comprehensive educational program is
to be developed, it is necessary to consider the perceptions of the
target groups and to understand why groups perceive issues in different
ways.
HIV Minimisation Strategies for Queensland Correctional Centres (PDF
file size 22Kb)
Clive Begg
Begg reports on Project
STIR (an acronym for Sexually Transmitted Intravenous Risks) which was
established to develop an education strategy for containing AIDS in
prisons, and to investigate existing HIV management practices. The
appendix contains the Project's recommendations. Begg highlights the
issues of sexual activity, intravenous drug use, and the need for more
research.
Behind Bars: HIV Risk-Taking Behaviour of Sydney Male Drug Injectors
while in Prison (PDF file
size 19Kb)
Alex Wodak
The authors give
preliminary results of a continuing study of drug injectors and their
drug taking and sexual behaviour while in prison. They conclude that a
disturbingly high level of HIV risk behaviour occurs, although the data
also suggests that this may be declining. The implications for policy
makers are unclear, but the authors advocate condom and bleach
provision.
Methadone, Prisons and AIDS (PDF
file size 38Kb)
Frank McLeod
McLeod gives an account
of the development and operation of the methadone prison program in New
South Wales, which is mainly supported as an anti-AIDS strategy. He
looks at its benefits, costs, opponents and proponents. McLeod then
discusses other AIDS related strategies: Milton tablets; condoms;
compulsory testing; and education.
Juveniles and HIV/AIDS Policy Development and Practice in Victoria (PDF
file size 41Kb)
Lisa Ward and Gerard
Jones
The paper outlines the
response of Community Services Victoria (CSV) to AIDS issues, in
particular within Youth Training Centres. The authors trace the HIV
policy development process, examine issues which have been especially
hard to deal with, and look at what needs to happen next. CSV's approach
is in accordance with "new public health" principles, which highlight
the importance of advocacy and education.
Women Prisoners and HIV/AIDS (PDF
file size 12Kb)
Tracie Walsh
Walsh addresses women
prisoners' issues in regard to HIV infection. She covers: sexual
activity, including woman to woman sex risks as well as possible
contamination from male partners; needle sharing; and support groups.
Management of HIV in Community Based Corrections (PDF
file size 24Kb)
Tony Clunies-Ross
Clunies-Ross discusses
Victorian policy for the management of HIV infected people in community
based corrections. The policy includes: education and training;
confidentiality; supervision and counselling; the role of community
organisations; and infection control. He also covers the AIDS manual
used by staff, the incidence of AIDS in community based corrections, and
problems faced by staff especially in the country.
Aboriginals, HIV/AIDS and Prisons (PDF
file size 21Kb)
Stanley Nangala
AIDS is a major issue
for Aborigines in prison, particularly given their over representation
as exposed in the Royal Commission's Interim report. Nangala calls for:
alternatives to Aboriginal imprisonment; culturally sensitive health and
education services; improving prisoners' access to items such as condoms
and clean needles; and confidential and voluntary only testing.
