Establishment of “triangular clinics” (TCs) in detention centers is officially underway in 14 provinces after a trial run last year in the Central Prison of Tehran (also known as Fashafoyeh).
“Following the successful execution of the pilot project last year, the plan will now be implemented in penitentiaries across the country,” said Dr. Mehrzad Tashakorian, deputy for Health, Correction and Rehabilitation at the Iran Prisons Organization, reports Mehr News Agency.
The clinics in a three-pronged strategy seek to address injecting drug users through a harm reduction approach, provide services for treatment of sexually transmitted diseases (STDs) and treatment, care and support for people with HIV/AIDS. Prevention and care are integrated and the TCs seek to incorporate many of the key elements that underpin successful HIV prevention strategies.
The innovative idea was introduced in an experimental study in 2002 by Arash and Kamiar Alaei, doctor brothers in Kermanshah, northwest Iran, the results of which were published in the WHO website.
The problems of drug abuse are complex and interconnected, requiring an integrated, multifaceted and comprehensive approach. The TC project has incorporated some of the key elements of the best practices in HIV prevention and care vis-à-vis injecting drug abusers. These include advocacy to create a public health policy environment that promotes HIV prevention among drug abusing populations, the integration of services and adopting a “patient-centric” approach.
The problems of drug dependence, STDs and HIV are all behavioral in nature and hence the clinics will function as centers for treatment of behavioral diseases. By grouping the three, it would be possible to provide comprehensive and integrated services. Moreover, avoiding direct reference to HIV reduces social stigma.
“Precautionary measures in detention centers will lessen the burden on the Health Ministry,” said Tashakorian. Prisons are bottlenecks for disease diagnosis and control, which turn far more costly once prisoners return to the society.
Risk assessment and risk reduction counseling, voluntary counseling and testing, harm reduction, substance abuse treatment, registration at the HIV unit, medical services, prevention of mother-to-child HIV transmission and postexposure prophylaxis (PEP), referral services, supportive therapies and HIV prevention are among the services provided by TCs.
