HIV prevention methods a challenge to prisoners

 

In prisons across the world, the HIV and AIDS pandemic presents a major challenge. HIV prevalence within prisons is often far higher than in the general community, and prisons are a high-risk environment for HIV transmission. However, when it comes to tackling the pandemic, prisoners are often neglected and overlooked.

The number of prisoners living with HIV varies between countries. 

America has the highest prison population in the world, around 1.5 percent of whom are HIV positive while the prevalence rates for some Sub-Saharan African countries is also high. An estimated 41.4 percent of incarcerated people in South Africa are infected with HIV, according to UNAIDS.

Prevention programmes that have been shown to reduce HIV transmission are rarely available for inmates, and many prisoners with HIV are unable to access life-saving antiretroviral treatment. In many parts of the world, prison conditions are far from satisfactory and HIV positive inmates barely receive the most basic healthcare and food.

One of the primary routes of HIV transmission is through sexual intercourse. In many prisons, consensual sexual activities are common among inmates even though they may be forbidden under prison rules. It is difficult to determine to what extent such activities occur, as those involved risk punishment if exposed to fellow inmates or prison officers.

Although there is evidence that sex in jails is a fact and not fiction, the issue of whether condoms should be distributed in prisons is still debatable.

In some countries, having sex in prison is a punishable offence while in Namibia, sodomy is constitutionally illegal and that’s why some people are of the opinion that supplying condoms to male inmates is tantamount to encouraging prisoners to break the law, as many would end up sodomising each other in the cells.

Various reports by the Parliamentary Standing Committees and the Namibia Legal Assistance Centre acknowledge that prisoners engage in sexual activity in jail and the spread of HIV infection in these institutions is evident. The true state of affairs is that infection and re-infection is taking place in prisons.

Two years ago, a male inmate from the Windhoek Central Prison involved in a polyamorous relationship involving four men was fatally stabbed when the relationship went sour. It was alleged that one of the men could not accept their relationship had gone bad, after which a fight broke out leading to the death of one.

In another case reported in the media earlier this year, an inmate appeared in the Gobabis Magistrate’s Court on a charge of sodomy. These cases are just few cases among thousands of cases of sodomy and rape that are allegedly taking place inside Namibian prisons. Although a few cases come in the open, most of them go unreported.

Prisoners are entitled to human rights even when in prison. This is so because human rights are universal. This means that every person, including a prisoner, has human rights, no matter who he is, where s/he lives or his/her class, race, sex, age, social status, etc.

In 1996, the United Nations Commission on Human Rights (UNCHR) stated that: “By entering prisons, prisoners are condemned to imprisonment for their crimes; they should not be condemned to HIV and AIDS. 

There is no doubt that governments have a moral and legal responsibility to prevent the spread of HIV among prisoners and prison staff and to care for those infected. They also have are responsibility to prevent the spread of HIV among communities. Prisoners come from the community, and they will eventually return to it. Protection of prisoners is thus protection of our communities”.

Prisoners have the same right to protect themselves from HIV and AIDS as other people outside prison. 

This protection comes in the form of HIV education and the provision of condoms.

The Namibian policy on HIV and AIDS states that all convicted prisoners, awaiting trial inmates and prison staff are entitled to have access to the same HIV-related prevention information, education, voluntary counselling and testing (VCT), means of prevention, treatment, care and support as is available to the general population.

This is a comprehensive approach to HIV and AIDS in prisons. Education and VCT are fairly easily offered in the prisons. 

But there is a challenge with it comes to prevention. 

A prevention approach commonly used in Namibia is the “ABC” approach, which stands for Abstinence, Be Faithful and Condomise. The argument has always been the issue of condom distribution in Namibian prisons.

So, my point of view in this regard is that whether it is right or wrong morally and ethically to distribute condoms in prisons, we cannot afford to risk our future and lose lives to adhere to the moral, ethical and religious convictions of only a certain section of society.

The distributions of condoms in prisons will offer a sensible step towards a comprehensive approach to prevention of the spread of HIV within our prisons and our country.

January 2014
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