More Women Living with HIV in Ugandan Prisons

The majority of prisoners in Uganda’s prisons are not adhering to HIV/AIDS prevention messages, the Uganda Prison Service has said.

Uganda Prison Service, Spokesman, Frank Baine said most of the prisoners are either illiterate or semi-illiterate and therefore are not easily convinced about the risk factors and HIV/AIDs prevention messages.

Baine told a Science Journalists café in Kampala on Wednesday that some prisoners still believe that those with signs and symptoms of HIV were bewitched. Others, he said still think messages about HIV prevention were a myth.

Some prisoners according to Baine are negative deviants’ who are not scared of contracting HIV.

His message comes amidst concern about perceived high cases of HIV/AIDS among inmates in prisons.

Some MPS in July said some prisoners were contracting HIV in prisons suggesting that there could be incidents of homosexuality in the cells.

Ibanda North MP, Xavier Kyooma went to the extent of suggesting that all prisoners remanded or sentenced to jail terms should be subjected to HIV/AIDs tests so that they are isolated.

Though he was mindful of the fact of stigma and stigmatization, Kyooma said those who get into prison HIV-free should get out without the virus.

Parliament’s HIV/AIDS Committee report quoting the Uganda Prison Service’s Sero-behavioral survey report 2019 said 15% of the population in prison were HIV positive compared to 12% among the men and women of the prison service.

A High Court Judge, Margaret Mutonyi last month suggested that all inmates, not just those charged with sexual offenses, should be checked for HIV, hepatitis, and TB. She suggested that young offenders particularly risked violence including sodomy by hardcore offenders with whom they share cells.

The national HIV prevalence is estimated at 6.5%. The prison report said About a fifth (20.5%) of prisoners had comprehensive knowledge about HIV/AIDS, and this was less among female than male prisoners.

The report said 56.8% consistently used condoms while 61.6% knew that having only one uninfected sex partner can reduce the risk of HIV infection.

According to Baine, prisoners facing or convicted of rape, and aggravated defilement charges constitute 65 percent of the prison population living with HIV/AIDS.

While Uganda Prison Service has ruled out possibilities of co-infection of the virus among male prisoners, in 2020 the Uganda PEPFAR office in Kampala said prisoners are key population members, mostly menwho move within both prison and community settings, including approximately 150,000 prisoners cumulatively per year in Uganda.

CDC Uganda Associate Director for Science, Dr. Lisa Mills told PEPFAR Uganda Science Summit that prisoners and prison staff have double or higher the national adult prevalence of HIV (15.0% and 12.0% versus 6.2%.

She said the excess burden of related infections was among those involved in illicit drug use and MSM behavior than national estimates.

Dr. Mills said prisoners had high HIV incidence (1.46%), especially men less than 30 years. “More than 50% of recently infected prisoners had been in prison less than 6 months, suggesting ongoing transmission in prison settings.

Epidemic control efforts in Uganda may fail if 90-90-90 targets not achieved in prisons” she said.

She suggested the need for systematic HIV & TB prevention, testing, treatment, and related services tailored to the challenges of prison settings.

As part of the finding, the Uganda Prisons Service PEPFAR program strategy was revised, enabling direct government-to-government funding for more than 200 prisons to provide HIV testing, care, and treatment services for all prisoners within the prison system using the hub-and-spoke model.

The model decentralized ART management. More than 30 Uganda Prisons Service sites are supposed to receive accreditation to administer antiretroviral therapy directly.

From the Uganda prison point of view, Baine revealed that 80 percent of the prisoners admitted understand that they have HIV when they are being tested.  He insisted that HIV was more among female inmates than their male counterparts.

Dr. Nelson Musoba, the Director General of the Uganda Aids Commission does not rule out the fact there could be homosexuality practices in Uganda’s prisons.

He said there are laws that prohibit the prison service from providing some preventive measures like condoms to inmates to fight the spread of the virus.

He added that there are several other prevention interventions that the prisons can access like HIV testing and counseling, circumcision, and creating awareness to manage the spread of the disease among prisoners.

He said 99 percent of HIV diagnosis is done at inmates point of entry into detention centers.

The 2013 survey indicates that the national prevalence of HIV on average is 6.5 percent where men constitute 5.9 percent and 8.3 percent for women.

The same survey shows that there is a high prevalence rate in prisons with 11 percent for men and 13 percent the women which is higher than the national prevalence.

The survey also showed that places that are highly populated in the country have higher prevalence rates.

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