The issue of HIV/AIDS in prisons has become an important topic worldwide, both in countries where HIV prevalence is minimal as well as where the impact of HIV is much more severe. Especially World Health Organization (WHO) has advocated for guidelines on HIV infection and AIDS in prison. The guidelines covered HIV testing, preventive measures, management and care of HIV-infected prisoners, confidentiality, tuberculosis, and early release policies.
The general principle advocated by the WHO is that of the ‘equivalence principle’: some of the more popular policies are not only ineffective but unnecessary and unjustified. The policies, which have been condemned by international bodies, include mandatory testing, and segregation. (Bartlett et al, 2000). The intention of segregation is that by identifying and separating HIV positive prisoners, the prison will be able to provide increased health monitoring, additional surveillance of high risk behaviors, elimination of transmission within prison, and protection from discrimination or violence from other inmates.
There is a very real concern that not segregating HIV positive inmates will lead to increased prison violence, in that HIV prisoners will threaten cell mates with infection and other prisoners will target HIV inmates for abuse. In this respect, segregation is for the inmates’ protection as much as it is for the protection of the general prison population. It reduces the risk of infection among the general population. Segregation reduces harassments of the infected individuals by non-infected inmates and allows the prison guards to take proper precautions when dealing with the infected prisoners.
In relation to Bartlett, Some countries report considerable success with HIV segregation programs. In Poland, prisoners with HIV were held on a separate, less crowded floor and allowed access to more facilities, such as additional health care staff and recreational activities. The general atmosphere was one of support and specialized care, as opposed to the discrimination and insults endured in the rest of the prison. In Polish institutions where segregation was not initiated, prisoners refused to share eating or toilet facilities, or even shake hands with HIV positive prisoners.
In some cases, medical doctors would refuse assistance and encourage protest from the staff against the non-segregation policy. On the other hand, the lessons of history have shown us that regardless of the noblest intentions of any segregation policy; the reality is that ‘separate but equal’ simply does not exist. It contributes to the stigmatization of HIV positive people and presents numerous logistical problems. (Bartlett et al, 2000).