PRISONERS' HIV/AIDS

PASAN
O R I E N T A T I O N

SUPPORT ACTION NETWORK

PASAN is a community-based organization in Toronto that provides support,
education and advocacy services related to HIV/HCV, harm reduction and
overdose prevention with the prisoner and ex-prisoner populations within Ontario

The Work We Do
Individual Support Services: Community Support Services:
- Individual support & counselling/case management - Resources & educational materials
- Referrals - Training
- Advocacy for medical services - Prison outreach and support program start-up
- Phone support through collect calling - Networking for the development of a continuum of care for prisoners
transferred between regions
Systemic Advocacy: NSP Inside, Segregation, Coroners Inquest, etc.

In-Reach Programming
- HIV/HCV Education - Overdose Prevention/Naloxone Training
- Drug Use – HR framework - Reintegration Plans – informal unless healthcare-related
- Sexual Activity - Informally discuss trends or situations that are happening inside the
- Safer Tattooing/Piercing institution, and how it is affecting prisoners

Ontario Provincial Jail System

- Houses people on remand or detention, including immigration, awaiting trial, sentencing or transfer
- Managed by the Ministry of Community Safety and Correctional Services
- Includes correctional centres, detention centres, jails and treatment centres & “SuperJails”

Federal Prison System

- Houses people serving sentences of 2 yearsTorA L Emore
NT TECHNOLOGY

- Managed by Correctional Services Canada (CSC)

- There are 11 Federal prisons in Ontario: 1 designated for women and 10 designated for men

Prisoners' Rights
- Prisoners' rights are human rights – these rights are, however, often violated (e.g., frequent and extended lockdowns)
- CSC does not make mention of specific rights that prisoners have. They are, therefore, not accountable for upholding anything in particular
- Prisoners can appeal to an Ombudsman or file a human rights lawsuit if their rights have been violated

Typical Day
- Non-conducive to rehabilitation
- 12-14 hours minimum lockup – otherwise locked down
- Yard, lockdown, programs, school, visits, hygiene
- General population vs. Protective custody
- Pat downs, cell searches, strip searches, random urinalysis
- Segregation
- "Crime School"
- Double/triple bunking
 PRISONERS' HIV/AIDS
PASAN
O R I E N T A T I O N

SUPPORT ACTION NETWORK

Barriers to Treatment
- Loss of autonomy: prisoners living with HIV, HCV or any pre-existing health conditions lose the ability to choose their treatment

- Mistrust: prisoners may not trust prison healthcare providers, potentially accessing health services less frequently in prison

- Fear of prosecution/retaliation: prisoners may fear retaliation or punishment for not following the treatment/release plan assigned to them.
Prisoners accessing Harm Reduction services experience increased surveillance – some have their sentences extended; others have their cells
searched more frequently as a result of accessing Harm Reduction services

- Structural/systemic barriers: formal requests are required for accessing services – this can pose a challenge for prisoners with literacy issues
or disabilities where writing/understanding poses a challenge. There are also confidentiality issues (i.e., prisoners having to go through CSC)
and health buildings may be separated from where prisoners are housed

- Stigmatized as "criminals" or "offenders": can lead to prisoners being treated with lack of care/empathy, with increased violence from CO's

Healthcare Problems
- Jails pay for healthcare, not MOHLTC - Cut off pain management medications, forced withdrawals off of drugs
- Written requests to see a doctor - HCV treatment available in federal, not provincial
- Haven’t seen a doctor/no access to specialist - The prison environment does not support equal healthcare
- Receiving only partial or none of their medications - Ageing population
- No blood work or no results - SECURITY TRUMPS HEALTHCARE

Criminalization of HIV
- U=U (Undetectable equals Untransmitable): when a person maintains an undetectable viral load, sex partner(s) cannot transmit HIV
- Changes to laws around HIV status disclosure: individuals are not required to disclose their HIV status during sexual activities that do not
pose “a realistic possibility of HIV transmission” (e.g., anal and vaginal sex where condoms are used, oral sex, and condomless sex where an
undetectable viral load is maintained)
- Prior to U=U findings, people with HIV could be charged for not disclosing their status to a sex partner – many people (including law
enforcement officers) are ignorant of the changes in law around HIV criminalization
- There are still a large number of individuals in federal prisons because of HIV criminalization. For those folks, the barriers to treatment may
be heightened especially around mistrust of prison staff, and confidentiality

Healthcare Inside Written request put

in to see the doctor

Mental, emotional, physical Request goes through many

health is affected hands (or the trash)

Privacy/confidentiality is Waiting process: 1 Week?

not a guarantee Never!

Advocacy Opportunities
- Call institutions to ask questions about medications, processes, bloodwork, etc.
- Political advocacy for MOHLTC to take over healthcare inside
- Collaborate with legal clinics around human rights to healthcare
- Support families experiencing the loss of a loved one inside
- Attend PUBLIC Coroner's Inquest