Prisoners in the United Arab Emirates who are HIV-positive but not from the country may have been denied regular access to life-saving treatment, Human Rights Watch has warned.

On Monday the organisation claimed that non-national prisoners in at least one major UAE jail have seen delays, interruptions or a complete freeze on their access to antiretrovirals – drugs that suppress the activity of the HIV infection.

UAE citizens have access to free HIV-care programmes.

In a country where migrant workers make up 80% of the population and account for the majority of the workforce, the discriminatory policy could have devastating effects on the health of those living with HIV.

Anyone applying for a work or resident permit in UAE has to have a blood test upon arrival in the country. According to the FCO travel advice for UAE, “those testing positive for HIV or hepatitis are detained and then deported. There is no appeal process.”

Despite claims that HIV treatment is extended to expats, HRW cited multiple sources, including former detainees, who said that denial of treatment is common in prison and those with HIV are kept in an isolated area away from other prisoners, where they face “stigma and systemic discrimination”.

One unnamed ex-prisoner said: “They put you [in the HIV unit] and forget about you.”

HRW said continuity of care is crucial when it comes to antiretroviral treatment because it results in “decreased levels of circulating virus (or viral load), protecting an individual’s immune system, and reducing the possibility of transmission”.

Any interruptions, the NGO warned, “can increase the risk of developing viral resistance and lead to a much higher risk of fatal opportunistic infections”.

At least four prisoners held in Al Awir central jail were denied medication for periods as long as five months recently, HRW said, citing sources close to the detainees.

HRW highlighted the case of an unnamed prisoner whose health had deteriorated dramatically following four months without treatment. Subsequent test results, the campaigner said, “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”.

Three other prisoners told HRW that their health situation was worsening, but prison guards turned a blind eye to their requests for treatment.

An ex-prisoner who served five months in Al Awir Central jail in Dubai and eight months in Abu Dhabi’s Al Sadr prison told HRW he had received no treatment while being held.

“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,” he was quoted as saying. “They treated us like wild and dangerous animals.”

The former prisoner said at least two HIV-positive inmates died while he was held at Al Sadr prison.

“The UAE has an obligation to provide healthcare, including antiretroviral medicines, to all prisoners in their custody without discrimination,” said Michael Page, HRW’s deputy Middle East director.

“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. 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.”

Misconceptions, including the incorrect belief that you can get infected by touching an HIV-positive person, are rife in the UAE, even among university students, according to local reports. In 2015, the Abu Dhabi-based newspaper the National highlighted the case of an Emirati man who contracted HIV at the age of 18 and had been kept against his will at a government facility for at least 16 years.

In a 2018 report on the Middle East and North Africa, the UN’s HIV and Aids agency, UNAids, said HIV is “a hidden epidemic” in the region.

Saeed al-Hebsi, director of human rights at the UAE ministry of foreign affairs and international cooperation, said: “The UAE rejects the allegations put forward by Human Rights Watch. Every person has a right to proper healthcare and we guarantee medical services to all inmates in the UAE prison system. The UAE is determined to uphold the highest standards on the treatment of prisoners and does not discriminate against individuals on the basis of health conditions, in line with our commitment to global human rights.”