The Kenya HIV Modes of Transmission Survey lumps together its estimates of the respective contributions of men who have sex with men along with prison populations, as if the two groups are somehow inseparable. And there is often the implication that, where HIV prevalence is high in prison populations, it is as a result of sexual transmission, through men having sex with men, specifically.
So it’s unusual to find an article that discusses HIV rates among prisoners, such as this one from Uganda, where transmission is thought to result from sharing sharp objects, razor blades, needles and the like. Apparently, prisons can’t always afford to provide enough of these instruments, so they end up being shared between prisoners. This could be quite a risk, not just for HIV but also hepatitis and other blood-borne diseases.
HIV prevalence in Ugandan prisons is just over 11%, about twice the national level. Also, prison populations are predominantly male, whereas HIV prevalence is a lot lower among men in the general population.
Prisoners on antiretroviral drugs also say they are also poorly nourished and, as a result, fear taking their drugs, which have can have serious side-effects when taken on an empty stomach. However, this phenomenon is by no means confined to prison populations. Most HIV treatment programs place a high emphasis on supplying drugs but less emphasis on general health and nutrition.
Now that it is recognized that prisoners can face serious non-sexual HIV transmission risks, let’s hope the small step is made to recognizing the serious non-sexual risks that non-prisoners face in health facilities, cosmetic service outlets, traditional medicine practices, tattoo parlors, etc.