(Beirut) – United Arab Emirates (UAE) prison authorities are denying non-national HIV-positive detainees in at least one UAE prison regular and uninterrupted access to lifesaving antiretroviral treatment, Human Rights Watch said today. Detainees living with HIV are also segregated from the rest of the prison population in an isolated area and report facing stigma and systemic discrimination.
Multiple sources, including former non-national detainees in Al Awir Central Jail’s HIV units in Dubai, told Human Rights Watch that, while they are tested for HIV every three to six months, unlike the Emirati detainees held with them, HIV treatment is often delayed and interrupted, and sometimes denied altogether. Sources close to them reported that four prisoners said in September that they had not received any medication for between three and five months and that this is not the first time prison authorities have delayed critical medical treatment.
“The UAE has an obligation to provide health care, including antiretroviral medicines, to all prisoners in their custody without discrimination,” said Michael Page, deputy Middle East director at Human Rights Watch. “Denying, delaying, and interrupting treatment for HIV for non-national prisoners is a flagrant violation of the right to health and potentially the right to life.”
Continuity of care is crucial to effective treatment of HIV, resulting in decreased levels of circulating virus (or viral load), protecting an individual’s immune system, and reducing the possibility of transmission. Interruptions in treatment can increase the risk of developing viral resistance and lead to a much higher risk of fatal opportunistic infections.
One person with direct knowledge of the case told Human Rights Watch that a prisoner who recently fell seriously ill after being denied treatment for nearly four months said his test results showed an elevated viral load and a dangerously low count of infection-fighting CD4 cells, both of which can be warning signs of the possible onset of AIDS, which dramatically decreases life expectancy. Sources said that three other prisoners also expressed concern about their worsening health conditions and that prison officials were apparently indifferent to their repeated requests for appropriate care. Human Rights Watch is withholding details to protect people from retaliation.
Men and women who live with HIV are held in segregated units away from the rest of the prison population in Al Awir – the men in one area and the women in another. They include people serving sentences for nonviolent drug or financial crimes, others convicted of murder and other violent crimes, and others held in pre-trial detention who are sent to the central prison before facing trial or receiving a sentence only because they tested positive for HIV.
One former detainee said Emirati authorities held him in Al Awir Central Jail for five months without charge before transferring him to Al Sadr prison in Abu Dhabi. He said he was kept in solitary confinement for eight months in Al Sadr and received no treatment throughout his year-long detention in the UAE.
He also described the stigma and discrimination he and other prisoners living with HIV suffered in Al Awir: “The guards knew nothing about HIV, they were afraid even to enter our block, they wore special masks and gloves, and talked to us through glass. They treated us like wild and dangerous animals.”
The former detainee said that in al Sadr prison, when the conditions of prisoners living with HIV worsened, prison authorities would place them in isolation cells for several days. He said two prisoners living with HIV died during his stay at al Sadr.
Segregating detainees living with HIV from the rest of the prison population in Al Awir Central Jail also denies them access to the prison library and other amenities, sources said. “They put you there [in the segregated unit] and forget about you,” said another former detainee.
One former detainee in Al Wathba Central Prison in Abu Dhabi said that people living with HIV, hepatitis C, and other communicable disease in al Wathba were also segregated from the rest of the prison population. She is not HIV-positive.
International guidelines on human rights standards in prisons state that prisoners have a right to medical services, without discrimination, at least equivalent to services available to people in the community, including for HIV, tuberculosis, and other infectious diseases.
However, while the UAE provides HIV-positive citizens with free HIV treatment and care programs, and while it claims to do so for expatriates as well, according to local regulations, the government does not grant residency or work visas to persons with certain communicable diseases, including HIV. Moreover, non-nationals already in the country who test positive for these diseases are subjected to deportation proceedings. In 2012, a Gulf News article on the deportation of four female HIV-positive prisoners quoted a Dubai Central Jail prison official citing a decision by the public prosecutor to deport all HIV-positive prisoners, including those serving life sentences.
The denial of adequate medical care in UAE prisons and detention facilities extends beyond prisoners living with HIV and other communicable diseases and is most common in state security facilities, where torture is systemic. In May 2019, Human Rights Watch reported the death of a cancer-stricken detainee, Alia Abdel Nour, following years of mistreatment and denial of adequate medical care by security forces. UAE authorities ignored repeated calls by European Parliament members, United Nations experts, and members of her family for her release on health grounds.
Over the past year, there have also been increased concerns for the deteriorating health of two unjustly detained rights activists, Ahmed Mansoor and Nasser bin Ghaith, who are being held in dismal prison conditions and denied access to health care in Al Sadr and Al Razeen prisons, respectively.
As a UN member state, the UAE committed to joining worldwide efforts to end AIDS as a public health threat by 2030. To honor that commitment, UAE authorities should make sure that all prisoners living with HIV are receiving the critical care they require. The authorities should also allow independent international monitors to enter the country and regularly monitor prison and detention facilities, Human Rights Watch said.
On November 19, 2019, under the patronage of Sheikh Mohammad bin Zayed Al Nahyan, Crown Prince of Abu Dhabi, the UAE will host a forum for global health leaders to share insights and best practices to eradicate infectious diseases.
“Public health institutions and HIV activist networks should pressure authorities to live up to their obligations and to their declarations of tolerance by ending this abusive practice and providing adequate medical care to all prisoners equally,” Page said.