REPUBLIC OF SOUTH AFRICA COMBINED SECOND PERIODIC REPORT UNDER THE AFRICAN CHARTER ON HUMAN AND PEOPLE`S RIGHTS and INITIAL REPORT UNDER THE PROTOCOL TO THE AFRICAN CHARTER ON THE RIGHTS OF WOMEN IN AFRICA  There have been improvements in the management of HIV/Aids and TB. 77. Inmates suffering from, particularly, HIV/AIDS and tuberculosis, have received special attention. In 2012/2013, 50% of inmates (76 202/151 905) were tested for HIV. The percentage of HIV positive inmates who were eligible to be placed on antiretroviral treatment was 65% (5 066/7 738). The percentage of inmates with a CD4 count below 350, who are on ARV treatment is 96% (11 814/12 321). Furthermore, 96.79% of inmates (2 565/2 650) who have been diagnosed with mental illness were placed under treatment.57 78. In 2013, the Department of Health issued Guidelines for the Management of Tuberculosis, HIV and Sexually Transmitted Infections in Correctional Centres. The Guidelines provide the general principles for the management and control of TB, HIV, AIDS and STIs in Correctional facilities. The primary audience is health and administrative staff in the Departments of Correctional Services (DCS) and Health (DOH). It is meant to provide guidance on prevention of new infections, early detection through routine testing and early treatment of those with tuberculosis and human immunodeficiency virus infection and disease. 79. The Guidelines provide that • Voluntary HIV counselling and testing must be offered to all inmates at entry, during incarceration, as per request by inmate, as part of routine screening campaigns, as part of integrated primary health care services, and on release. A rapid test is conducted if positive subject to a confirmatory rapid test. In cases of indeterminate or discordant results a blood sample must be sent to the laboratory for an (Enzyme- Linked Immunosorbent Assay) ELIZA test. Inmates whose CD4 count is <350 cells/μL must be started on Antiretroviral Therapy (ART) and all inmates with newly diagnosed HIV must be assessed for TB infection. • Symptom-based TB screening must be conducted on all inmates at entry, during TB screening campaigns, self-reported or peer referred, TB contacts, as part of integrated primary health care services, at least bi- annually and on release. Chest X-ray and GeneXpert® MTB/RIF are complementary. An outbreak is defined as more than two inmates from one cell having TB, requiring investigation in collaboration with the DoH.  Universal screening for anal, oral and genital STIs must be conducted on- all inmates at entry, upon self-presentation and as part of integrated primary health care services, using specific algorithms based on symptoms. • TB diagnosis, all adult inmates with suspected TB must provide sputum samples. If smear or GeneXpert® MTB/RIF positive, TB treatment is commenced. If both specimens are negative in either test, HIV-negative inmates receive antibiotics treatment for 5 days and are then reassessed after completion of treatment. HIV-positive inmates are referred for assessment, X-ray and TB culture. 57 DCS Annual Report 2012/2013 26