Positively UK Women and HIV Prevention in Prisons UK perspective Sophie Strachan

Positively UK – Who we are Positively UK champions the rights of people living with HIV and related health conditions. We provide specialist and peer support, advocacy and information, campaign against discrimination, promote positive attitudes and equitable access to health, and strive to increase the involvement, voice and visibility of people living with HIV.

Prison Provision We deliver one to one peer led support in: HMP Holloway for over 20 years HMP Downview since 2005 HMP Bronzefield since 2009 Currently setting up peer led support for HMP Pentonville (male prison)

Issues in UK prisons Non adherence to treatment regimes Breaches of confidentiality Poor HIV knowledge from health professionals Poor standards of care: not equal to healthcare of general population Inconsistency of prison officers working practice when escorting prisoners to hospital appointments Discrimination from staff and inmates Poor compliance to harm reduction policies from healthcare and prison staff Continuity of care when released or moving prisons

Challenges to effective prevention Lack of recognition by UK government of Gender based violence linked to HIV prevalence in women (is recognised internationally) High rates of sexual and physical trauma in childhood and adulthood, as well as post traumatic stress disorder. Poor referral systems Presentations of depression and other mental health problems not being dealt with : not being assessed and referred quickly enough

Gaps in provision No specialist consultants or nurses within some prisons Non existent support systems in place for people living with HIV in prisons No local or national policy for HIV in prisons Health care not effective in meeting the needs of people living with HIV Education delivery to prison staff and prisoners allowing discrimination to continue, further isolating people living with HIV in prisons

Good Practice Collaborative working partnerships with multi sectoral agencies and departments internal and external to prisons Access to specialist consultants, registrars, nurse and health advisor in a prison settings Peer led support by Positively UK providing information, advocacy and education to HIV+ prisoners Education-training provided to prison staff and prisoners on HIV awareness, confidentiality treatment adherence, non discriminatory practice from Positively UK NAT ‘Tackling blood borne viruses in prisons’ guidelines for best practice in prisons Long term condition management model

Positively UK Sophie Strachan