OPINION

By Dr Nelson Musoba

According to the Uganda Prisons authorities, Uganda has about 76,000 prisoners in the different prisons throughout the country. A previous study conducted across Uganda Prisons by the Ministry of Health and Uganda Prisons Services (UPS) together with our development partners showed a high prevalence of HIV among female (24%) and male (14%) prisoners as well as prisons staff (12%).

These percentages are considerably high when compared with the average national HIV prevalence of 5.5%.

As Uganda AIDS Commission, we are happy with the HIV response mechanisms within prisons in the country which have enabled the prisons authorities to efficiently identify those in need of HIV prevention, treatment and care services. For example, according to the latest statistics from the Ministry of Health, 100% of all prisoners know their HIV status.

Knowing one’s HIV status is the entry point to any effective HIV prevention, care and treatment services. It starts with taking an HIV test and following the guidance given by the health worker. Under Uganda Prisons, it is mandatory for all new prisoners to undertake an HIV test, and those found to be HIV negative encouraged to remain so while those found to be HIV-positive are initiated on antiretroviral treatment.

Still from the same statistics, we see that 98% of all those who are HIV-positive within the prison settings have managed to be enrolled onto effective HIV treatment. Furthermore, 94% of those on HIV treatment have been successful in suppressing the HIV virus within their bodies.

As the overall co-ordinators of national HIV response, we are pleased with the HIV response within prisons which has enabled those who need HIV treatment to be able to access it in a timely manner.

Suppression of the HIV virus within one’s body is very critical to our HIV prevention efforts as a country because evidence confirms that those who are suppressing the virus in their bodies with the help of antirtroviral treatment are not able to pass on the virus to someone else. Up to 94% in prison settings have attained this viral suppression status. This achievement is highly commendable.

Being able to suppress the HIV virus requires a certain discipline that involves using the ARVs properly and consistently as advised by the health worker. Being able to say no to any high-risk activity such as drug abuse, alcoholism, multiple sexual partners, etc. Fortunately, all these are factors that the prison setting is able to guard against.

Recently, the HIV committee of Parliament presented a report about the HIV situation in selected prisons. Among the key findings was the low knowledge levels about HIV and its transmission among the prisoners.

This low level of HIV knowledge and high HIV prevalence could be explained by the sections within our communities that the majority of these prisoners emerge from.

These are mainly sections with high illiteracy levels and with limited access to any public health awareness campaigns and services.

As the Uganda AIDS Commission, we continue to work with all partners to identify creative communication and service delivery approaches to ensure that all sections of the community regardless of the social status access knowledge and services for effective prevention, care and treatment of HIV and AIDS. At policy level, we take persons in prison settings to be a high priority population for our HIV prevention, treatment and care interventions.

They are part of what we call thehigh-risk category.

This category includes other groups such as commercial sex workers, people who inject themselves with drugs, fishing communities, long-distance truck drivers, widows, widowers, adolescent girls and young women.

The Ministry of Health together with our development and implementing partners is implementing a comprehensive prevention and treatment programme targeting all these high-risk categories, including those in prisons.

Our partners, including the Makerere University School of Public Health, Ministry of Health and our development partner, the Centers for Disease Control and Prevention (CDC) and, working with Uganda Prisons Services (UPS) have embarked on a comprehensive multi-disease survey which will assess the HIV, TB and COVID-19 situation and services in prison settings so as to generate more evidence on the impact of the ongoing interventions and the remaining gaps so as to inform further sharpening of our interventions for these diseases in prison settings.

I, therefore, appreciate the efforts of our parliamentarians and other leaders in ensuring that as a country we remain on track to end AIDS as a public health threat by 2030. This must inevitably involve routinely reminding ourselves and pointing out the gaps that need to be addressed.

The writer is the director general, Uganda AIDS Commission