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Welcome to the EuroPris Knowledge Management System. The table below shows questions and responses from European National Agencies. Select a question for more information or use the filters on the left to narrow down questions based on Agency or Category.
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Introduction: In Lithuania the National Drug Prevention and Drug Control Strategy Action Plan is submitted to the Government of Lithuania for approval. Harm reduction strategies and services make a significant part of the Plan. Accordingly, the Lithuanian penitentiary system is considering the broader application of harm reduction mechanisms (syringe/ needle exchange, condom distribution, naloxone-on-release, etc.) in the country's prisons. It is important, whilst planning the scope, to know the best practices of other countries on this matter.
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Which harm reduction mechanisms are implemented in prisons of your country?Our healthcare is delivered via one of NI’s Health Trusts which includes physical, mental and addictions services. Drug therapeutic services are also provided through the Health Trust along with Opiate Substitution Therapy.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).No
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).All new committals are screened for blood borne viruses including HIV and appropriate treatment provided (through the Health Trust)
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, through the Trust. Addiction services are available in all of our establishments
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Which harm reduction mechanisms are implemented in prisons of your country?Testing and treatment for HCV and HIV.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No. Possession of needles, paraphernalia and syringes are not allowed
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).No
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No, since condoms are supposed to be used in smuggling of drugs. From a health perspective and due to the risk of spreading STD we have argued for distribution, but at the same time the health care staff don´t look upon it as a question for the health care service.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).All persons arriving at a remand prison are offered testing for HCV and HIV. This offer is repeated at arrival to a prison.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).To prescribe pharmaceuticals used for OMT You must work at a unit that are registered for providing that treatment. Only one prison (another at its way) are registered as such an unit. Even if the treatment is started in prison there are no obligation for the general health care system to continue providing the treatment. So in practice OMT can be given in Swedish prisons if the treatment is prescribed by the general health care service with acceptance from the consulting physician at the prison.
In Spain, there are 69 penitentiary centres dependent on the General Secretariat of Penitentiary Institutions (Ministry of the Interior).
Which harm reduction mechanisms are implemented in prisons of your country?In our country, there are the following harm reduction programmes: • Health education programme, implemented in all centres, aimed at the development of external and peer-to-peer training workshops. • Syringe exchange programme, implemented since 1997, distributes syringes anonymously, in addition to promoting the transition to other less risky routes or the enrolment in low-level treatment programmes. • Although it was implemented previously, information on this programme has been systematically collected since 2011.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Although the programme is implemented in all centres, it is currently active in only 14 centres, with 1726 exchanges having taken place over the last year. At present, injecting drug users are a minority group among drug addicts. This explains the progressive reduction in the programme.
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).It is not a programme that is specifically implemented. In our syringe exchange programme, along with the syringe and needles, all the material necessary for a sterile injection (distilled water and filters) is included.This exchange is anonymous and not limited in number in order to minimise the risk of reuse of the material.
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Condoms are distributed free of charge in all centers. Hygiene kits, distributed monthly, include condoms. In addition, one condom is included in the syringe exchange packs and 2 in the intimate communication rooms. Inmates can also access the health services at any time to request the ones they need.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).In all of our centres, HIV testing is not carried out by rapid tests but by serology (ELISA and subsequent confirmation of a positive result by Western-Blot). All inmates are offered a screening test on admission to prison. This test is repeated on an annual or biannual basis, although it may be less frequently, depending on whether they have engaged in risky behaviour.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).The methadone maintenance programme, at least as a low-level programme, has been in place in all the centres under this General Secretariat since 1996. Throughout 2020, a total of 4971 inmates were treated in this programme. Although currently in the minority, other treatments for opiate dependence are also offered in all centres, included in programmes considered to be of a higher level of demand, such as naltrexone (high level) or buprenorphine/naloxone (low-medium).
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The total number of penitentiary institutions in our country – 17.
Which harm reduction mechanisms are implemented in prisons of your country?In order to reduce the spread of HIV infection, viral hepatitis, the penitentiary system has applied the comprehensive package of services offered to the Intravascular Drug Users, which has the greatest impact on HIV prevention transmission, which consists of 15 interventions: 1. Information, education and communication 2. Voluntary HIV counseling and testing 3. Treatment, care and support 4. Prevention, diagnosis and treatment of tuberculosis 5. Prevention of vertical transmission of HIV virus (mother to fetus) 6. Syringe and needle exchange programmes (from 1999 in 15 penitentiary institutions, 1960 beneficiaries) 7. Condoms distribution 8. Prevention, diagnosis and treatment of STIs diseases 9. Prevention of sexual aggression 10. Treatment of drug dependence (including replacement treatment with Methadone (2005), (from 2005, in 13 penitentiary institutions, 485 cumulative beneficiaries since 2005, 99 permanent beneficiaries) and more recently with Buprenorphina (2019-33 permanent beneficiaries) 11. Prevention (including vaccination), diagnosis and treatment of viral hepatitis (antiviral treatment of viral hepatitis C among inmates was applied in 2017, have benefited from the treatment 247 prisoners) 12. Post-exposure prophylaxis 13. Prevention of HIV infection through (invasive medical services, including dental) 14. Preventing spread through piercing, tattoos, etc. 15. Protecting staff from the occupational risks
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, the program is implemented in 15 of 17 penitentiary institutions (except of Penitentiary nr. 10 – Goian (which is a juvenile penitentiary) and Penitentiary nr. 16-Pruncul which has the status of a penitentiary hospital).
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).-
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, the program is implemented in 15 of 17 penitentiary institutions (except of Penitentiary nr. 10 – Goian (which is a juvenile penitentiary) and Penitentiary nr. 16-Pruncul which has the status of a penitentiary hospital).
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, in 16 penitentiary Institution except P10-Goian, which is a juvenile penitentiary.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, in 13 from 17 penitentiary institutions except of Penitentiary nr. 10 - Goian, Penitentiary nr. 8 and Penitentiary nr.12 from Bender (placed on the left side of Nistru river) and Penitentiary nr.2 – Lipcani (which is the most farthest penitentiary)
The total number of penitentiary institutions in our country – 17.
Which harm reduction mechanisms are implemented in prisons of your country?In order to reduce the spread of HIV infection, viral hepatitis, the penitentiary system has applied the comprehensive package of services offered to the Intravascular Drug Users, which has the greatest impact on HIV prevention transmission, which consists of 15 interventions: 1. Information, education and communication 2. Voluntary HIV counseling and testing 3. Treatment, care and support 4. Prevention, diagnosis and treatment of tuberculosis 5. Prevention of vertical transmission of HIV virus (mother to fetus) 6. Syringe and needle exchange programmes (from 1999 in 15 penitentiary institutions, 1960 beneficiaries) 7. Condoms distribution 8. Prevention, diagnosis and treatment of STIs diseases 9. Prevention of sexual aggression 10. Treatment of drug dependence (including replacement treatment with Methadone (2005), (from 2005, in 13 penitentiary institutions, 485 cumulative beneficiaries since 2005, 99 permanent beneficiaries) and more recently with Buprenorphina (2019-33 permanent beneficiaries) 11. Prevention (including vaccination), diagnosis and treatment of viral hepatitis (antiviral treatment of viral hepatitis C among inmates was applied in 2017, have benefited from the treatment 247 prisoners) 12. Post-exposure prophylaxis 13. Prevention of HIV infection through (invasive medical services, including dental) 14. Preventing spread through piercing, tattoos, etc. 15. Protecting staff from the occupational risks
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, the program is implemented in 15 of 17 penitentiary institutions (except of Penitentiary nr. 10 – Goian (which is a juvenile penitentiary) and Penitentiary nr. 16-Pruncul which has the status of a penitentiary hospital).
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).-
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, the program is implemented in 15 of 17 penitentiary institutions (except of Penitentiary nr. 10 – Goian (which is a juvenile penitentiary) and Penitentiary nr. 16-Pruncul which has the status of a penitentiary hospital).
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, in 16 penitentiary Institution except P10-Goian, which is a juvenile penitentiary.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, in 13 from 17 penitentiary institutions except of Penitentiary nr. 10 - Goian, Penitentiary nr. 8 and Penitentiary nr.12 from Bender (placed on the left side of Nistru river) and Penitentiary nr.2 – Lipcani (which is the most farthest penitentiary)
The Corps of Prison and Court Guard (hereinafter only “the Corps”) has currently in its administration 18 prison facilities. You can find more detailed information on individual prison facilities on this link: https://www.europris.org/agency/general-directorate-of-the-corps-of-prison-and-court-guard-sk__trashed/?tab=establishments.
Which harm reduction mechanisms are implemented in prisons of your country?The mechanism of harm reduction which are applied within the Corps, in a broader sense can be considered the establishment of so called drug-free zones and voluntary drug and alcohol treatment.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Such program is not implemented in the Slovak prison facilities.
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).Such program is not implemented in the Slovak prison facilities.
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Prison facilities ensure the availability of condoms in the form of individual purchases by the accused and convicted persons (hereinafter only “inmates”) or via the parcels sent to the inmates.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).Within the prevention measures, the inmates are tested for the presence of antibodies to HIV/AIDS in the blood, which indicates the HIV infection. In case, there is a suspicion that an inmate is infected with HIV or has the AIDS disease, the doctor shall suggest a blood test, inform him/her on the nature of the examination and request his/her approval for the blood sampling. The blood sampling and its testing is performed in the Prison Hospital and Prison Trenčín. The blood testing is also performed whenever the inmate requests it. In case the inmate does not agree with the blood testing, the doctor shall note down this fact in the Accompanying Medical Record with stating the reason and request his/her signature. When providing the health care, the doctor shall repeatedly suggest the blood test with adequate emphasis on its importance to the inmate who had refused the blood sampling. The doctor shall keep record on the repeated suggestions in the original record on the refusal of the blood taking for testing.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Such program is not implemented in the Slovak prison facilities.
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There are 9 prisons in Latvian Prison Administration.
Which harm reduction mechanisms are implemented in prisons of your country?Harm reduction programs in Latvian Prison Administration are implemented by the Centre of Addicts of Olaine prison. The target audience of the program – inmates who have been found to be at risk of using alcohol, narcotic, psychotropic or toxic substances. The structure of the addiction reduction program is the following: 1) sub-program “Adaptation”, the aim of which is to evaluate the inmate’s compliance with the addiction reduction program and its subprograms. 2) sub-program “Atlantis”, the aim of which is to promote understanding of addiction, its causes, ability to recognize and accept it. Develop the ability to control behaviour that provoke a risk increase and recognize signs/risks of relapse. 3) sub-program “Pathfinder”, the aim of which is to initiate the change process of a prisoner, maintain the motivation to live without addictions and criminal offenses, as well as to create preconditions for successful integration into the society after the release from the prison. 4) integrated in the sub-program “Atlantis-Pathfinder” – it is implemented for groups of inmates who must be kept separate from other inmates. Sub-programs are implemented for adult women and men. The measures of the addiction reduction program (dynamic safety, process of prisoners’ placement, static safety, agenda etc.) are aimed at reducing the possibility for inmates to use addictive substances (alcohol, drugs, tobacco products etc.) during the sub-program.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).The program is not implemented.
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).The program is not implemented.
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).The program is not implemented.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).Upon entering the prison, every prisoner is offered to pass a HIV test (a laboratory test instead of express HIV test) which the prisoner may refuse, as well as a prisoner may pass a HIV test at any time during his or her sentence.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Prisons provide an accomplishment of the methadone program, while a prison doctor cannot prescribe a methadone program. The program appointment and planning takes place by contacting a narcology service in the respective region where the respective prison is located. At the moment, in the Latvian Prison Hospital of Olaine prison the methadone program is being implemented for 4 prisoners (data as of May 2021).
122 prisons in England and Wales
Which harm reduction mechanisms are implemented in prisons of your country?The main harm reduction interventions are provided by substance misuse services which are part of prison healthcare, commissioned by the National Health Service as part of the public health service for all citizens.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes for all facilities, but provision of bleach has not been audited or scrutinised recently so there is uncertainty about actual provision
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes for all facilities. Condoms may be distributed by prison healthcare services.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes all new receptions to prison are screened for risk and may be tested for HIV. In England there is also a programme to find and treat Hepatitis C cases, with an ambition to eliminate this infection.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, opiate substitution treatment is available in all prisons. Medications provided include methadone but other treatments are also available depending on assessment of the presenting patient Additional Resource: https://www.gov.uk/government/publications/drug-misuse-and-dependence-uk-guidelines-on-clinical-management
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Which harm reduction mechanisms are implemented in prisons of your country?• The Ministry of Justice has issued guidelines that standardise the advice, care and treatment of addicts in Austrian prisons (prison on remand, execution of sentences, and execution of measures). In these guidelines, on the one hand, the basic attitude is communicated to respect addiction or dependency as a disease, which results in the right of the persons concerned to receive adequate advice, care and treatment; inside and outside the penal system the principle of equivalence or equal treatment applies. Addicts should not be discriminated because of their illness, for example with regard to relaxation of the prison system, work, training and leisure. The paradigm of respect should also replace the paradigm of abstinence in prison – also with view to the possibility of substitution treatment. In the further treatment of addicts after relapses, which are part of the clinical picture of an addiction from a medical point of view, the reaction should not be punitive, but should follow primarily the principle of therapeutic expediency. • Assessment of drug use and drug-related problems at prison entry. • To ensure the necessary cooperation between all actors in the health and social sector. There are cooperation models between prison administrations and relevant institutions, mainly at regional level. Networking and cooperation also takes place via the offices of the governments of the individual federal Länder and the district authorities. Health care for addicted inmates in prisons is provided by health services and therapeutic offers, both are partly provided by external providers. In addition, as part of the preparation for release from prison, external addiction support facilities offer specific advice services aimed at optimizing the inmate’s contact to addiction support or further medical treatment after release. • At commencement of detention, care packages are issued to the inmates when entering a prison, including condoms and educational materials on HIV, AIDS and hepatitis. In order to minimize damage, free and unobserved access to condoms and lubricants must be ensured in prisons (please see question 5). • Residential drug treatment (drug free units / drug free wings) • Counselling on drug-related problems • Preparation for release (referrals to external services, social integration interventions) • Pharmacologically assisted treatments (detoxification, OST, …) • Infectious diseases interventions (HIV-/ HBV-/HCV- testing, Hepatitis treatment, ART therapy for HIV)
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No.
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).No.
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).At commencement of detention, care packages are issued to all inmates when entering a prison, including condoms and educational materials on HIV, AIDS and hepatitis. In order to minimize damage, free and unobserved access to condoms and lubricants must be ensured in all prisons.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).Tests for the infectious diseases HIV, HBV, HCV and Tbc are routinely carried out in all 28 prisons after entering prison as a detainee.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Generally, substitution therapy can be restarted or continued while detention, and is carried out in principle in all prisons across Austria. The most frequently used substitution drugs in prisons are methadone, L-polamidon, substititol, as well as suboxone and subutex or bupensan.
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In Catalonia there are currently 9 regular prisons, and 4 open prisons. There is one psychiatric unit within one of the prisons and a prison hospital pavilion attached to a regular hospital.
Which harm reduction mechanisms are implemented in prisons of your country?Health education sessions addressed to all inmates; Leaflets with information on different health subjects; Distribution of hygienic packs for individual use to all inmates (see answer to question 4); Substitution treatments; Syringe exchange programme
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, there is a syringe exchange programme implemented in all prisons. It was first introduced in 2004 and has been in place to date.
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).An accurate personal hygiene is required from all inmates. To this end, the prison administration provides all inmates with personal hygiene products. From the first moment an inmate arrives at the prison, s/he is provided with a linen and towels set as well as with a hygienic pack. The hygienic pack contains shower gel, shampoo, shaving cream, 3 safety razors, tooth brush, tooth paste, deodorant and 8 toilet paper rolls. In addition, they will also be given 2 litres of bleach and garbage bags. The bleach is given as a cleaning product so that the inmate can use it in the way s/he deems it necessary (to clean the floor or the toilet, and could also be used to clean the syringe if needed by the inmate).
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, a condom distribution program is implemented in all prisons.
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).We do not have a rapid HIV testing programme because when an inmate first arrives to the prison, s/he is offered the possibility to undergo a set of different tests to discard any infectious diseases including HIV. The collection of samples is taken in the prison by the health staff and then sent to the laboratory of the nearest hospital. Participation in the set of tests upon entry is entirely voluntary and the inamte's participation rate is of 85%.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Yes, a methadone substitution therapy program is implemented in all prisons.
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Which harm reduction mechanisms are implemented in prisons of your country?Opioid substitution treatment (OST) is the main measure in the prison drug policy. Individual packages containing a condom and a lubricant, are freely available in the medical service of each prison. These same packages are also in the rooms for conjugal visits at free disposal of the prisoner and his/her partner. Information leaflets are available to the prisoners containing harm reduction information. A special booklet was designed together with a community service to make sure that the messages given to the prisoners in the booklet were adapted to the target group, in terms of words used and explanations given. The graphics in the booklet were made by the prisoners themselves and printed in Dutch, French and English.
Do you have a needle and syringe exchange program implemented? If yes, please indicate the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).No, since research and expert opinion shows there is very low injecting of drug use in Belgian prisons (2% prison population)
Do you have a bleach distribution program implemented? If yes, please specify the scope program is implemented in all facilities, in several (indicate the number) facilities, etc).Bleach tablets are available for prisoners in the medical service, but there is no general distribution program in place.
Do you have a condom distribution program implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).In all prisons individual packages containing a condom and a lubricant, are freely available in the medical service. These packages were specially designed for our target group together with a community service. The little package also graphically explains the correct use of the condom and lubricant. These same packages are also in the rooms for conjugal visits at free disposal of the prisoner and his/her partner
Do you have a rapid HIV testing program implemented? program is implemented in all facilities, in several (indicate the number) facilities, etc).No, we do not have a rapid HIV testing program.
Do you have a methadone (or other medication) substitution therapy implemented? If yes, please specify the scope (program is implemented in all facilities, in several (indicate the number) facilities, etc).Opioid substitution treatment (OST) is accessible in every prison. Detox, maintenance and initiation of the treatment is possible.