HIV education working in SA prisons - study
March 30, 2006 Edition 1
Di Caelers
HIV education programmes for prisoners do work - and help not only the prisoners themselves but also their sexual partners and families who they return to when they're released.
That's what emerged from research on HIV/Aids among South African prisoners set for release.
The researchers are now urging the Department of Correctional Services and other authorities to ensure these programmes become an essential part of health service provision in prisons.
"We need to increase the focus and resources targeting this critical area of public health because the increased health benefits will far outweigh the challenges and transcend the prison walls," said study author Dr Sibusiso Sifunda of the South African Medical Research Council.
These prison communities were not isolated islands or closed-off systems, he warned, and inmates' health problems also impacted on the health of their sexual partners, spouses and families.
The study, the first to examine prevention interventions in respect of sexually-transmitted diseases, including HIV/Aids for male prisoners in South Africa, was released in Durban this morning.
HIV/Aids in South African prisons is notoriously under-researched, but in the study Sifunda makes reference to the general trend "in almost every country", which shows that HIV prevalence among prison populations ranges between five and 10 times that seen in general populations.
For South Africa, where HIV prevalence is among the world's highest, the implications for the disease among prisoners becomes obvious.
Sifunda said the proven success of the education programme, despite constraints like low education levels and a prison population that wasn't static, pointed to the time before prisoners' release as "a window of opportunity" to provide not only critical lifeskills, but also health interventions to help prepare the men before they left prison.
He studied four prisons, two in KwaZulu-Natal and two in Mpumalanga, and found that one-off World Aids Day activities as a method of health education was not enough.
Appropriate health education material was another issue, and existing information, like government-issued leaflets, were usually translated directly from English, without taking context into account.
"The terminology associated with HIV/Aids is a very real problem. A lot of people don't understand the biomedical terms, even the simplest ones, so the information just ends up going over their heads," Sifunda said.
"A lot of the people in prison have very low education levels and if we want to make sure our messages get to where we want them to be, this is an absolute must to address."
The study reports that most inmates will have sex within the first few days of being released, believed by many to be a way of proving that prison hasn't compromised their "manhood". So not only do they risk becoming infected with sexually-transmitted diseases, including HIV and Aids, but they risk passing on diseases they might have had before their conviction, or acquired while behind bars.
Sifunda writes in the study about the view of sex "as a utilitarian transaction" in prison, flowing from the widespread use of sexual favours as a form of payment.
The study concluded that the availability of condoms was unlikely to be helpful without good educational back-up.
The success of the trial HIV education intervention showed up in better practical skills for practising safer sex, and sexual negotiation skills, among the experimental group, along with an intention to reduce risky behaviour in sexual encounters.
Using former inmates on parole in their communities as peer educators was the correct choice, especially those who were HIV-negative and represented "a picture of hope", Sifunda said.
dic@incape.co.za
