Vulnerability and HIV risk of prison inmates: a study in Maharashtra prisons in India

Abstract

The AIDS epidemic has recently drawn attention to the alarming health situation in many prison systems. For those prisoners infected with HIV, a sentence of imprisonment may shorten their lifespan and in the extreme, result in death, due to the lack of adequate health care, overcrowding, inadequate nutrition, and presence of infections. The risk is no less for other prison inmates, particularly in the absence of any HIV preventive measures inside the correctional setting. The present PhD study is primarily based on a MPhil study by the researcher on access to health care by HIV positive inmates in prisons in Maharashtra. One of the results of the MPhil study was the absence of knowledge and awareness of prisoners regarding HIV/AIDS. Thus, it was felt that a study is essential to measure the knowledge, attitude and understanding of HIV prevention of the prison inmates. Further, prison inmates are especially vulnerable to HIV in the prison setting considering the fact that homosexuality in prison is a hidden truth. Finally, prisoners have inalienable rights conferred upon them by international and national human rights framework, they have a right to health care, and they most certainly have a right not to contract disease in prison. The turnover and constant movement of prison inmates in and out of the prison makes it all the more important to implement HIV prevention strategies within the prison so that it does not spread into the outside community. Assessing knowledge, attitude and understanding of HIV/AIDS prevention is essential to understand the vulnerability and HIV risk of prison inmates. It is also important to device an effective HIV/AIDS prevention strategy inside prisons and to prevent the spread of the virus when prisoners are released in the outside community. Thus, from a public health point of view, a study of knowledge, attitude, behaviour and understanding of prevention of HIV of the prison inmates is essential. It is in this scenario that the present PhD study attempted to explore the knowledge, attitude, understanding of HIV prevention and vulnerability and HIV risk of prison inmates.