1. General Situation (Overview)
Country
Remand Prison
Prisons
Prison Population (by )
Poland 70 85
(2598 women)
Estonia 3 5
3456 (103 female convicted offenders)
Finland
none 26
3565
Latvia 7 14
6544
Lithuania 15
7736
Germany
75056
Sweden
31+7 branch institution
55 prisons with a total of 5020 beds with a 93% “booking rate” and in average 4668 inmates per day
5.036 inmates in the prisons, in custodies and on probation
Norway
50 prisons with an official capacity of 3511.– most of the prisons can admit pre-trial detainees.
Around Around 19,5 % of the prison population are on remand, 19,5 % are foreigners, 5,5 % women.

2. HIV, TB and HCV cases within Prison settings
Country TB
HIV
HCV
Poland
453
1145
2463
Estonia 10
489
N/A
Finland 2 12
Approx 60%
Latvia
411 45
830
Lithuania
110[1]
264
N/A[2]
Germany
Sweden
70-80 (8 new cases)
35% of prison population. Appr-1800
Norway
[1] During period from until in penitentiary system was detected 30 new TB cases
[2] During period from until were detected 2 new HCV cases.

3. PH EG Meetings
May (Riga) - Estonia, Finland, Latvia, Lithuania, Norway, Sweden, Poland, Germany, WHO, UNODC
September (Oslo) - Estonia, Finland, Latvia, Poland, Germany, Sweden, Norway, Belarus, Canada, WHO, LHL (Norway)

4. PH EG activities
Seminar on HIV/AIDS and TB Prevention within Prison system – Olaine Prison Hospital, Latvia
Evaluation for National Response to HIV/AIDS in prison settings in Estonia.(organized by UNODC)
Round Table meeting in London. Discussion on a draft background paper on Prisons and Women’s health and a draft agreement of a WHO Conference Declaration
HIPP Annual Conference “Prisons and Women’s Health” and Network Meeting 2008, in Kiev, Ukraine.

5. PH EG activities (continuation)
XVI BSSSC Annual Conference in Kaunas. Presentation of Project proposal at Project Idea Café
Establishment of Contacts with Belarus and Canadian Prison authorities
Preparation of NDPHS fact sheets (both the English and the Russian version)

6. Planned activities for 2009
Develop a project proposal on HIV/AIDS Prevention among the female prisoners, covering Estonia, Lithuania, Latvia, Poland and Belorussia
Development of NDPHS strategy on Prison Health.
Development of project proposals for Belarusian prisons, with the involvement of SEEC
Health Review and comment on the draft Strategic Goals of participant countries – including coordination of review by Partner countries and organizations as appropriate

7. Planned activities for 2009 (continuation)
Review, analyze, and evaluation of technical reports, research publications and other relevant materials on the issues related heath in prison settings
Advocacy and communication efforts directed to place Health in Prisons near the top of the health and development agendas
Development of project proposals for Belarusian prisons, with the involvement of SEEC
close collaboration with the WHO Health in Prisons Project (HIPP) in supporting NDPHS Partner Countries to address health and health care in prisons

8. HIV incidence rates in prisons
Incidence of HIV in prison:
Latvia: 1/4 of HIV+ in the country have been infected in prison and prisons host 1/5 of HIV+ total population
outbreaks in prisons documented in Lithuania (299 in 4 months) and Russia.
Other infections:
STIs
High TB prevalence in prison
High Hepatitis C and B prevalence
HIV prevalence rates are generally higher among women in prisons

9. Epidemiology: HIV prevalence rates in prisons
Universal and important problem
HIV prevalence in prison higher than in the community
1.5 to 2 times prevalence in the community:
Countries with high prev. and heterosexual transmission predominant
Few /no IDUs in the community
5, 10, 20, times prevalence in the community
Country with IDUs in the community
Lack of reliable data on HIV prevalence in prison
From researches – no monitoring

10. Possible Project Proposal HIV/AIDS prevention, treatment and care for female prisoners
To improve the legal and policy frameworks with the view to establish favourable environments for rapid, large-scale and comprehensive interventions
Gender-sensitive HIV/AIDS and TB prevention and care materials
Capacity development. Strengthen of organizational and operational capabilities of institutions, in order to better perform their functions
To document and disseminate lessons learned within the country and to a wider audience in the Northern Dimension region and beyond 

11. Goal of the Project
To overview and to analyse internationally available and nationally implemented guidelines on HIV/AIDS and TB case management for female prisoners, to support ongoing activities in Lithuania, Latvia, Estonia, Poland and Belarus prison settings and to strengthen those services through training and interactive workshops. To advice on HIV/AIDS and TB case management policy for female prison through Nordic Dimension partnership and to promote the development of National policies’

12. Proposed Objectives
Objective 1 : To develop an enabling environment, which provides conditions that support gender sensitive approaches to HIV prevention, treatment, care and support services to female prisoners
Objective 2: Improve availability and quality of gender sensitive comprehensive packages for prevention of HIV and TB within Prison settings
Objective 3: Sharing the lessons learned
Objective 4: Monitoring and evaluation

13. Major activities
Develop gender sensitive training materials and manuals, locally adapted to specific social and cultural contexts
Conduct training and skills-needs assessment among existing and potential service providers, including primary health care nurses and doctors, social workers
Provision of sexual and reproductive health services, general health services, maternal and child health services, HIV and TB services
Carry out intensified TB case finding, in particular among drug users with HIV who are at particular risk of TB
Drafting recommendations for HIV/AIDS and TB case management implementation for female prisoners
Drafting ND strategy on HIV/AIDS and TB management within Prison settings