Barriers to health in the community may mean that women have lacked access to health care before detention. In some contexts, the initial health screen might therefore be their first contact with health services. Due to the increased risk of physical, sexual and psychological violence in the community there should be specific screening for this upon admission and access to confidential psychological and medical support. Women may also be more at risk of drug and alcohol misuse and so, as well as assessment for rehabilitation, they should also be offered screening and any required prevention, treatment and care for HIV, Hepatitis B and other sexually transmitted infections (STI’s).
Although the initial health screening on admission should determine the reproductive health history of the woman detainee, including current or recent pregnancies, childbirth and any related reproductive health issues, it must be stressed that the individual retains her right to confidentiality of her sexual health history. This includes a specific prohibition of virginity testing. Virginity testing is discriminatory, humiliating and causes pain and suffering as well as being an intrusion of privacy. It may be considered a form of cruel, inhuman or degrading treatment or torture, and also rape.
There should be free sanitary towels and hygiene facilities provided for women, and advise on health and nutrition for pregnant women, breastfeeding mothers and for babies, children. Children accompanying their detained mother must also have access to an initial medical screening, and ongoing health care to ensure their physical, mental and social development. This should preferably be by a paediatrician.
Prison health services must provide preventive health measures that are specific for women including cervical smears (Papanicolaou or Pap test) for cervical cancer, breast and other gynaecological cancers. To protect the dignity and privacy of women during consultations and treatment there should be sufficient numbers of female health care staff appointed to prisons housing women. In situations where only male health staff are available there should at least be a female chaperone present during consultations and examinations.