14th International AIDS Conference Barcelona, Spain - July 7-12, 2002

Int Conf AIDS 2002 Jul 7-12; 14:(abstract no. WeOrE1322)

Simooya OO, Sanjobo NE
Copperbelt University, Kitwe, Zambia

ISSUES: Following a national survey of HIV seroprevalance and risk behaviours in Zambian prisons, 27% of inmates were HIV positive while risk behaviours included sex between men, tattooing, injecting drug use and sharing of shaving appliances. No condoms were available in prisons and measures for harm reduction were absent. We concluded that the risk of HIV transmission in the country's prisons was high and a conference to develop a response was subsequently held.

DESCRIPTION: The conference adopted the following measures; intensive HIV/AIDS education, provision of IEC materials relevant to prisons, training of staff and inmates as peer educators and counsellors, provision of voluntary counselling and testing (VCT) and funding for the treatment of STIs and TB. Other policies recommended were use of non custodial sentences for juvenile and first offenders, conjugal visits and release of inmates terminally ill with AIDS. However, participants rejected condom distribution and the provision of sterile needles and bleach as it waw felt that this would encourage illegal acts. Tattooing was banned forthwith. LESSONS LEARNT: Although the model outlined above is commendable, it does not go far enough to address the risk behaviours noted in prisons. In Zambia, like in many other countries, the development of effective and appropriate interventions in jails has been hampered by often competing public health and legal and security concerns. There is therefore little consesus about what should be standard HIV/AIDS prevention and care in prisons.

RECOMMENDATIONS: Given the fact that many prisoners are in prison for a short time only and indeed most return to their families, HIV acquired inside can be readily transmitted outside. Protecting inmates against HIV infection is therefore in the long term protecting society from AIDS. Action to provide inmates with public health measures comparable to those outside jail are needed urgently.

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