Upload
trandien
View
220
Download
1
Embed Size (px)
Citation preview
HIV Prevention, care, support and treatment for IDU prison inmates treatment for IDU prison inmates
in Indonesia
Ade Aulia ErwinIDU Intervention Unit – ASA Program
Family Health International
Current SituationCurrent Situation
N ti l E ti ti 6National Estimation 2006
• Number of person with HIV/AIDS : 190,000• Number of IDU : 220,000,• HIV prevalence among IDU : 52%• Number of Prison inmates : 115 000Number of Prison inmates : 115,000• HIV Prevalence among prison inmates : 15‐20%
Prison Situation Prison Situation
• 60‐65% inmates has been convicted on drugs offenses.
• Over capacity (mostly prison in big cities)• HIV high risk practices: share injecting equipment, HIV high risk practices: share injecting equipment,
(drugs, tattoo, piercing) male genital accessories, unprotected sex u p otected se
• Limited budget for health: US$ 0.5o per inmates annuallyannually
• Limited human resources and program capacity
High risk behavior in prisonHigh risk behavior in prison100
80
90 BSS IDU Jakarta, Bandung, Surabaya and Medan 2005
60
70
%)
43 42
353741
3240
50
Perc
ent (
%
Among ever in Prison
18 16
2731
2732
28
20
30
0
10
Ever in Prison Ever injecting drug in Prison Ever getting HIV-AIDS Infromasion inPrison
Jakarta (n = 402) Bandung (n = 343) Surabaya (n = 496) Medan (n=250)
Program Brief
2001Started IDU Intervention in community Started IDU Intervention in community 2003 High HIV cases in prison. FHI initiate HIV/AIDS program in prison setting20042004Advocacy to prison authorities. Expanded HIV intervention in community and prison setting. 2005 2005 Prison HIV National Strategy 2005 – 2008 T h i l i t t t th i i tit ti l it S t Technical assistance to strengthen prison institutional capacity. Support 24 NGOs intervention at 37 city/district and 47 prisons.2008 – 2009
t 8 NGO i t ti t it /di t i t d isupport 18 NGOs intervention at 31 city/district and 34 prisons
FHI Collaboration with Directorate G l f P i SGeneral of Prison System
• Technical assistance in developing Prison National Strategy (2005‐2009)
• Facilitate TOT for prison staffs on Behavioral change, Harm Reduction, IMAI, CST, VCT, TB‐HIV, Addiction CounselingAddiction Counseling
• Development of BCC/HR Module
• SOP Development on VCT, CM and CST
• Technical support in developing national and • Technical support in developing national and provincial prison working groups
ASA PROGRAM COVERAGE: IDU and Prisoner
Sumut
0 500 1000
Jakarta
6 IAs2 IA
(1 IA)
Kepri
0 500
Kilometers
1000
West Java
4 IAs
2 IA
Central Java East Java
3 IAs
Prison Intervention FrameworkPrison Intervention Framework
Detention Court
PrisonPrison
Detention:
Basic Information
Release: Referral Release: Referral
Prison InterventionStrengthen prison authorities
institutional capacity HIV/AIDS & p y
(Strategic plan, workshopCoordination meetingprison AIDS team)
HIV/AIDS & Drugs educationfor prisoners (big group)
Case Management
Capacity building for HIV/AIDS & p y gPrison staff
(Drug dependency, IMAI, HCT, TB HIV)
Drugs education for prison staff
Pre release
NetworkingReferral system HIV d d d d Referral system(service provider)
Resource Mobilization Peer educator
HIV and drug dependency counseling
Intervention Data – by December 08Intervention Data by December 08
Prison working group established 6 provinces Prison have AIDS team 50 prisonsP i ff i d i h IMAI CST HCT TB HIV Prison staff trained with IMAI, CST, HCT, TB HIV 303
NGOs NGOs
Prison staff received HIV/AIDS & Drugs education 1 936 Prison staff received HIV/AIDS & Drugs education 1,936 Prisoners trained: 45,365Peer educator: 586Peer educator: 586
Lesson LearnedPrison HIV program initiate by NGO can be optimize with adequate support from Prisons AIDS team
Involvement of inmates and prison staff in the program is crucial
Support from the Chief Warden and prison staffs are critical to program Support from the Chief Warden and prison staffs are critical to program implementation
Demand on health services are high it is importance to mobilize Demand on health services are high, it is importance to mobilize resources from other provider to support prison programs
NOG take an importance role in facilitate program implementation and NOG take an importance role in facilitate program implementation and endorse networking with health providers outside the prison
NGO works delivered new innovative activates in developing/design NGO works delivered new innovative activates in developing/design prison program (ex: Pre release, post release, TB HIV, MMT, health promotion, counseling, and education)
Challengeg
• Budget for prison program (mainly from foreign Budget for prison program (mainly from foreign funding)
• Cross sector coordination
• Human resource & experiences • Human resource & experiences
• Commitment on program implementationp g p
• Referral to external health services
Recommendation• Due to limitation of human resource within prison system,
NGO involvement in HIV prison program is required p p g q
• Develop referral network for HIV treatment with other institution is a mustinstitution is a must
• Activate prison AIDS working group in provincial level
• Prison HIV program initiate by NGO can be optimize with support from Prisons AIDS team.
• Post release network need to established
• Involving BAPAS (parole & probation office) in prison HIV intervention program is highly recommended.