Informed Consent
Thank you for speaking with us. We are speaking with prisoners about the conditions in jails and their
experiences receiving health care. We would like to interview you as a part of this research, and we
will write a report based on our interviews. We hope to obtain better information on health in jails so
that we may make recommendations in our report for improving human rights and health conditions.
We can’t offer you any direct assistance, but by talking to us, the hope is that you will help us to push
for changes in laws and practices.
We Criminology students from The University of The Cordilleras. We don’t work for the government
and we’re not funded by anyone. We are independent .We anticipate that the interview will take about
one hour. You can stop the interview at any time or take a break. Some of the questions we ask might
be about very personal matters. You should feel free to take your time in answering or not answer, if
you wish. Everything you tell us will be kept confidential. We won’t use your name in the report, and
instead will use a pretend name. We won’t include information that identifies you specifically. You do
not have to talk to us if you don’t want to. Do you have any questions for me? Do you agree to be
interviewed?
Date
Prison
Prisoner Category
Unique Prisoner Code
A. Demographic Information
A1. Age
A2. Sex
A3. Country of origin
A4. Education level
A5. Marital status
A6. Occupation prior to arrest
B16. Did you suffer a serious injury or health problem because of the
beating?
B17. If so, did you receive any medical care?
B18. Have you appeared before a judge?
If YES, go to B19
If NO, go to B20
B19. How much time passed between your arrest and your first appearance before
a magistrate or judge?
B20. Do you or did you ever have a lawyer?
If YES, go to B21
If NO, go to C22
B21. Is/Was your lawyer government-provided or private?
WE aRE now going to ask you some questions about your health and access to health care. If you
prefer, you are welcome to skip any question you would rather not answer.
C. Medical Care
C22. Did you receive any medical tests when you first entered this prison?
If YES, go to C23
If NO, go to C24
C23. What were you tested for?
C24. Have you had health problems in prison?
If YES, answer C25 – C28 for each health problem
If NO, go to C29
C25. What type of health problems have you experienced?
C26. Did you receive treatment for the problem?
C27. What kind of treatment?
C28. Where did you receive treatment?
Now WE want to ask you some questions about HIV and TB. If you prefer, you are welcome to skip any
question you would rather not answer.
C29. Since your most recent incarceration, have you been tested for TB?
If YES, go to C30
If NO, go to C37
If respondent HAD TB UPON ARRIVAL, go to C34
C30. What was the result of that test?
C31. If you tested positive, did you start treatment after being diagnosed?
C32. If yes, was treatment ever interrupted?
D. Physical Abuse
D48. Since your most recent incarceration, have you been beaten by prison
officers?
If YES, ask to D49
If NO, skip to D52
D49. How many times?
D50. Did you suffer a serious injury or health problem because of the
beating?
D51. If so, did you receive any medical care?
D52. Since your most recent incarceration, have you been beaten as a form of
punishment by another inmate with disciplinary authority?
If YES, ask D53
If NO, skip to E56
D53. How many times?
D54. Did you suffer a serious injury or health problem because of the
beating?
D55. If so, did you receive any medical care?
E. Cell Conditions
Thank you for answering those questions, now I want to ask you some
broader questions about your life in prison.
Prison Conditions
What are conditions like in the prison? What are the major problems in your opinion?
Where do you sleep? In what type of cell? How large is the cell? How many other people sleep
there?
What type of bedding do you have? How frequently is the bedding changed or cleaned?
*How much time do you spend each day in your cell?
Are men and women held together? Are convicted prisoners and remandees? Are juveniles and
adults?
How many times a day do you receive food? What does the food consist of? Is it sufficient?
Where do you eat?
How much water do you receive each day?
What are the sanitary facilities like?
Are there washing and bathing facilities? How often are you allowed to wash?
How often do you get a clean change of clothes?
Do you have a razor or other shaving instrument?
Does the prison provide you with: soap, toothpaste, toilet paper, sanitary napkins (for
females)?
Which cells or cellblocks are the worst?
Medical Treatment
Tell me about any medical treatment you’ve received in prison and what that experience
was like.
Were you provided with any information on HIV/AIDS in prison? Describe.
*Tell me about the experience of being tested for HIV. What was the motivation for being
tested? What was your experience with the test? Did you receive counseling (did someone
explain the results to you and give you information about HIV)? What was the consequence of
the testing? Did you tell people of your HIV-positive status? Did other people know of your
status?
Is the HIV treatment ART ever misused? (For example—given to other people or made into a
drink?)
How do you think you might have been infected? How do you know?
Have you ever been treated for an STD while in prison?
*Tell me about the experience of being tested for TB. What was the motivation for being
tested? What was your experience with the test? What was the consequence of the testing?
Are any isolation facilities or procedures in use for TB patients? Are people with active or
suspected TB moved to a separate wing or room? What are conditions like there? How long to
TB patients stay there?
Tell me about the last time you were sick in prison. What were your symptoms? How did you go
about trying to receive care? What treatment did you receive?
How long does it take to receive services after you’ve requested them? Have you ever been
denied access to services while in prison?
Have you ever been forced to take medication against your will?
Do you have any medical conditions that you know about for which you are not currently
receiving treatment? What is the condition?
Have you been satisfied with the medical treatment you’ve received in prison? If not, have you
filed a grievance? With whom? Was it addressed to your satisfaction?
Inmate-on-Inmate Violence
What are the biggest problems between inmates?
Do some inmates intimidate, control, or take money from other inmates? Please describe.
Is there any form of inmate self-government, or unwritten prison rules? Please describe.
*How many inmates are members of prison gangs? Are you a member? What do the gangs do?
Over what do they have power?
Do some inmates have weapons? Please describe.
Have you heard or seen any inmate-on-inmate assaults? Please describe.
Are you aware of any incidents of sexual violence? Have you ever been involved in any sexual
encounters in prison without your consent? With whom? Please tell me about this incident. Did
you tell anyone about it? Did you receive any medical care afterwards?
Is there much gambling and, if so, what happens when inmates run up large debts?
Activities in Prison
Have you ever faced any type of harassment or discrimination in prison? What do you think the
cause was? Have you ever faced any harassment based on your health (HIV or TB) status?
Conclusion
Thank you very much for your time. As I mentioned earlier, we will use the information you have given
us, without your name, to help prepare a report to make recommendations for improving prison health
conditions. Do you have any questions?