L’Organisation des Nations Unies pour la lutte contre le VIH/SIDA, l’ONUSIDA, tire la sonnette d’alarme sur la situation des personnes incarcérées dans le monde en matière de VIH. Dans un rapport récent, elle met en exergue les difficultés d’accès aux soins appropriés du VIH dans les systèmes pénitentiaires, qui ne font pas partie intégrante des politiques nationales de lutte contre cette maladie.
Le constat est alarmant. Les personnes incarcérées ont 7,2 fois plus de risques de vivre avec le VIH que les adultes de la population générale. Selon les chiffres de l’ONUSIDA, la prévalence du VIH chez les prisonniers a augmenté de 13% depuis 2017. La situation est d’autant plus préoccupante que les politiques mises en place pour répondre à cette maladie ne prennent pas en compte les spécificités des systèmes pénitentiaires. Le Directeur régional de l’ONUSIDA pour l’Asie-Pacifique et l’Europe de l’Est et l’Asie centrale, Eamonn Murphy, déplore cette situation et considère que « les prisons sont trop souvent ignorées dans les efforts des pays pour répondre au VIH. Une approche multisectorielle et multiforme est nécessaire de toute urgence pour sauver des vies, qui comprend l’accès à des aiguilles et des seringues propres, un traitement efficace de la dépendance aux opioïdes et la réduction de la stigmatisation et de la discrimination ».
Les statistiques sont accablantes. Sur les 104 pays enquêtés par l’ONUSIDA en 2019, seuls 6 disposent de programmes d’échange d’aiguilles et de seringues dans au moins une prison. 20 pays sur 102 disposent de programmes de traitement de substitution aux opiacés dans au moins une prison et 37 pays sur 99 disposent de préservatifs et de lubrifiants dans certaines prisons. Les services de réduction des risques en milieu carcéral sont donc insuffisants.
Face à une hausse de 24% du nombre de personnes incarcérées, soit environ 10,8 millions de personnes en 2021, les systèmes pénitentiaires sont déjà surchargés. La Moldavie est l’un des pays qui ont pris des mesures remarquables pour la prise en charge des personnes atteintes du VIH en milieu carcéral. Avec un taux de VIH de 3,2% dans les prisons contre 0,4% dans la population générale, les 17 pénitenciers de ce pays offrent tous des services de réduction des risques, comme la thérapie agoniste des opioïdes, l’accès aux psychiatres, aux médecins et aux programmes de traitement, l’échange d’aiguilles et de seringues et la prévention, le dépistage, le traitement et les soins du VIH. Pour atteindre l’objectif ambitieux de l’ONUSIDA, qui souhaite que 95% des prisonniers connaissent leur statut sérologique, les gouvernements doivent investir davantage dans la lutte contre le VIH dans les systèmes pénitentiaires.
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