JOHANNESBURG, 26 July 2011 (PlusNews) - Obtaining HIV treatment
in jail is becoming easier as about 9 percent of South African
prisons now offer antiretroviral (ARV) drugs in-house.
Leeuwkop Prison, north of Johannesburg, where minimum-security
prisoners tend horses and cattle and raise crops, is the latest
jail to launch its own antiretroviral clinic - one of 22 such
in-house HIV treatment centres, according to the Department of
Correctional Services' 2010 annual report.
The prison has also begun providing inmates with condoms, as have
others, including Johannesburg Prison in the city's largest
township, Soweto, said Gauteng correctional services spokesperson
According to South Africa's Institute for Security Studies, the
country's 240 correctional facilities house 160,000 prisoners - a
third more than they were originally designed for.
At Leeuwkop, 13 percent of the 4,500 prison population are
HIV-positive. Although the HIV prevalence among Leeuwkop's
prisoners is not far off South Africa's national HIV prevalence
rate of about 18 percent, limited studies among some of the
country's prisons have found HIV prevalence rates of as high as
"Correctional services are a microcosm of the country; what we
see in our country will be found in our facilities - even disease
patterns," noted Nontsikelelo Jolingana, chief deputy
commissioner (CDC) of development and care for the Department of
According to Jolingana, the department is also working to
accredit at least three more facilities in Gauteng province.
Changing of the guard
Just five years ago, South African courts ordered the government
to take steps to provide all prisoners with access to treatment.
The judgment followed a court case involving 13 HIV-positive
inmates and the AIDS lobby group, the Treatment Action Campaign.
Before the Leeuwkop ARV clinic was launched, the prison's more
than 300 HIV-positive inmates on treatment had to be shuttled to
an inner-city Johannesburg health facility, posing major logistic
and security problems for correctional services.
"The prison's clinic benefits the whole process - it increases
access to treatment and care, and compliance with treatment for
prisoners," said Gloria Lekubu, regional HIV and AIDS coordinator
for Correctional Services in Gauteng.
Lekubu added that not only would the clinic mean fewer security
risks but also that the Department of Correctional Services would
save money it previously had to pay the Department of Health for
treating prisoners in public clinics.
The Department of Correctional Services dedicates about 10
percent of its annual budget to prisoner care, which includes
access to medical services.
For HIV-positive inmates such as Prince, it also takes a lot of
stress out of treatment. "In South Africa, there's an
overcrowding of prisoners, which makes it difficult for us to get
treatment," he told IRIN/PlusNews. "In a day, there may be 30 to
40 of us who need to go to the clinic, and there's a shortage of
"The new clinic means I will be counselled in time, I will see a
doctor in time and there won't be a shortage of ARVs."
South African health NGO, the Aurum Institute, helped finance and
design the clinic, said Gillian Gresak, deputy director of HIV
and Tuberculosis treatment, balancing security concerns and
According to the World Health Organization's Stop TB department,
overcrowding, poor nutrition, and high alcohol and drug use in
prisons, make prisoners very susceptible to developing active TB,
with the rate of new TB infections on average 23 times higher
than in the general population.
Inadequate TB control measures are another risk factor.
Typically, many health facilities keep windows open to prevent TB
infection, which can be spread by coughing, but in many prisons,
windows were not designed to open, Gresak told IRIN/PlusNews.
Another infection control measure, the use of ultraviolet lights
indoors, was also ruled out as the lights could be dissembled and
used as weapons, added Aurum operations manager Joyce Lethoba.
Ultraviolet lighting has been shown to reduce TB transmission by
up to 70 percent in hospital wards by killing the bacteria that
Instead, Aurum designed outdoor waiting rooms much like those
pioneered by Medecins Sans Frontieres in its HIV/TB clinics in
South Africa's Western Cape. With a separate area to collect
potentially infectious sputum samples, the waiting rooms allow
for maximum ventilation with minimum security risks, Lethoba
Aurum has been in talks with the Department of Correctional
Service to support the establishment of future prison clinics in