How did HIV access Luzira Prisons?

HIV/AIDS           LUZIRA PRISONS

Despite great progress to wipe out the HIV epidemic by 2030, there is a section of the community and the style of infection the world cannot keep ignoring if Uganda has to get rid of HIV.

The country cannot eradicate HIV if it is allowed to continue growing in some sections of the community. HIV IN PRISONS HIV in prisons is a big factor. It includes people who get imprisoned with the virus and those who get infected from prison.

According to the World Health Organisation (WHO) report of 2015, HIV prevalence among Uganda's prisoners was estimated at 15%, which was much higher than the national prevalence, then of 7.3%.

With an estimated 165,000 people entering or leaving prisons a year, over 4,000 inmates are HIVpositive. When they come out, they bring it into society. According to some infected prisoners, they get accustomed to practices, such as sodomy, while in prison.

This can result in contracting HIV. The HIV threat in prisons demands improved healthcare, better supervision, regular sensitisation and quick identification of HIV-positive persons.

SODOMY
In an interview with Sunday Vision, a prison source, who spoke on condition of anonymity, disclosed that the main contributing factor to the spread of HIV is sodomy. "The high HIV incidence in prisons is a clear indication that homosexuality is practised in Uganda's prisons. Yet authorities try to push it under the carpet to preserve their image. How will the health ministry achieve its goal of eradicating the scourge if this is not tackled?" the source asked.

When asked whether there are laws in place to stop acts of sodomy, the source said the laws are weak. According to the source, one of the prisoners approached him complaining of a stomachache. On examining him, he found a foul-smelling discharge from his anus.

"The prisoner confided in me that he feared to be victimised, but he had been sodomised several times," he said.

Victims speak out
Patrick, 21, who is serving a 10-year sentence on robbery charges, says during admission into prison, he tested HIV-negative in an entry screening exercise that included voluntary HIV testing and counselling.

He is now HIV-positive, after being sodomised by a fellow inmate. "It happened while on remand in Upper prison. I am HIV-positive," he said. He said although he reported the assault, nothing was done. Patrick reveals that he got to know of his HIV status after officials from the AIDS Information Centre visited the prison in 2013.

"The inmate who sodomised me died, so I was not surprised by the results. But I blame the prisons authorities," he said. Another victim, John, said he asked for medical circumcision at Murchison Bay prison in 2015, but was required to test for HIV before it could be done.

He tested negative and the prison authorities know this. "A person called Kikomeko forcefully sodomised me. I screamed for help and fellow inmates came to my rescue. I tested negative a month later, but positive in the subsequent tests," he explains.

HIV transmission in prison is not always related to homosexuality. It is also due to negligence of health workers handling prisoners. A female prisoner in one of the upcountry prisons said she was allegedly infected with HIV by a prison nurse who used the same syringe to inject several other inmates.

"More than five prisoners would be injected using one syringe just because they were not enough. It was after we complained to the prison's chief that action was taken against the nurse," she says. Ex-convict speaks out Julius Magada, a former inmate who served a 10-year jail sentence over the killing of a person in a traffic accident, said he used to work as a counsellor for inmates.

He revealed that while cases of same-sex sexual assault are rare, homosexuality is on the rise. "Inmates, concern over the rise in HIV infections among prisoners due to homosexuality is legitimate," Magada said. "Prisoners use gifts, such as bread, soap and money to solicit for sexual favours from vulnerable prisoners," he added. As a peer counsellor in prison, Magada said consensual sodomy is not done openly.

Men hide in isolated places, such as toilets and bathrooms, to engage in it. Sadly, prisons authorities have treated such cases casually. "Those caught are transferred to other prisons instead of being held accountable. I plan to petition the Speaker of Parliament to intervene in such cases," Magada said.

FORMER OFFICER SPEAKS OUT
A former officer in charge of the Upper prison, who spoke on condition of anonymity, cautioned inmates against homosexuality. "While I can neither deny nor confirm homosexuality in prison, we have come to learn that some prisoners are being lured by others into the act," he said.

Johnson Byabashaija, the commissioner-general of prisons, once pointed out that sodomy is his biggest headache. "Homosexuality, an indigenously vile and illicit act, is growing among prisoners, heightening the risk of faster HIV spread within confinement facilities," he said.

Byabashaija attributed the upsurge in the vice to sexual starvation. He, however, said he does not know how and when prisoners engage in the act. Asked why inmates are not provided with condoms to avoid HIV, Byabashaija said that would mean condoning sodomy among prisoners.

"Faced with such grim facts, prison authorities, out of concern for our legal and ethical boundaries, are still engaged in a delicate debate over whether to give prisoners condoms without being seen to promote homosexuality," he explained.

Byabashaija said they are instead encouraging voluntary testing and ensuring that HIVpositive inmates get ARVs. However, the scanty HIV budget and homosexuality stand in the way of mitigation efforts. With a prison population of over 50,000 inmates within its 249 prison units countrywide, Uganda's prisons accommodate 4,811 HIV-positive prisoners.

Of these, 797 are females, while 4,014 are male. The HIV prevalence rate among male inmates stands at 14% and that of their female counterparts is at 24, according to information obtained from the prison's department.