Canada's Report on HIV/AIDS - 1999

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Unified Action To Combat The Spread Of HIV/AIDS

• Correctional service canada
• Coordination and collaboration
• International cooperation

By developing an accountable, pan-Canadian approach to responsiveness, one that flows from the front lines to the leading edge of policy decision making, the Strategy remains clear in practice but visionary in scope.

Correctional Service Canada

HIV infection is estimated to be 10 times higher within federal institutions than in the general population. The need for accessible and innovative prevention and treatment programs for offenders is more urgent than ever. Correctional Services Canada (CSC) is committed to finding innovative ways to prevent and manage the risk of HIV transmission associated with injection drug use, tattooing, unprotected sex and other high-risk activities. To provide optimal health care to offenders, CSC is developing programs that are unique to the correctional environment. Much of the impetus behind such initiatives comes from the offenders themselves.

For example, this year a peer education and counselling program was implemented at institutions across the country. Other educational developments include video presentations and comic books designed to heighten awareness of HIV transmission in relation to other infectious diseases as well as to substance abuse and sexuality. More targeted program components will address the specific needs of Aboriginal peoples and injection drug users, who are over-represented in prison populations.

To further address the problem of AIDS and drug use, an evaluation of the Methadone Maintenance Program established for heroine- addicted offenders will include a provincial and international review. Approval for the next phase of the program is now being considered. In the interim, new policy allows for approval of Methadone Maintenance Therapy initiation under exceptional circumstances.

Staff education for pre- and post-test counselling is ongoing. Revised policies and procedures are being reviewed and a new policy will be drafted in consultation with key stakeholders to address issues of HIV testing, confidentiality and partner notification. Evaluation is also under way for an anonymous HIV-testing pilot project with Saskatchewan's Prince Albert Health District. Precise policies, procedures and guidelines are now being developed to ensure that offenders' rights are recognized in relation to confidentiality and disclosure surrounding HIV/AIDS.

In close collaboration with key partners in the community, a number of risk management initiatives and recommendations will be considered this year, including an action plan that follows up on the work of two previous reports: "Evaluation of Harm Reduction Measures for HIV/AIDS in CSC" (1998) and "HIV/AIDS in Prisons: Final Report of the Expert Committee on AIDS and Prisons" (1994). To further reduce the spread of HIV in prisons, an automated surveillance system for HIV and other infectious diseases is being developed, along with an effective outbreak investigation model for use in all CSC regional offices.

Standards-of-care guidelines will ensure the delivery of appropriate, equitable and accessible care, treatment and support services for HIV-infected offenders. CSC activities also ensure that care is provided for HIV-infected inmates who rejoin life outside prison. Comprehensive reintegration programs will achieve enhanced continuity of care between institutions and community settings. By working on initiatives from legal, ethical and human rights issues to prevention and education, CSC is continually seeking ways to bring those people at risk to the centre of health care advances in HIV/AIDS.

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