MOZAMBIQUE: Recognising the reality of HIV/AIDS in prisons saves lives

Maputo, 21 September 2006 (PlusNews) - In Mozambique's Machava Central Prison, the largest jail in the country, sex between prisoners is an unavoidable reality, but little is being done to prevent it, according to inmates and medical staff.

"Some of the younger inmates are forced to sleep with the older ones in exchange for food and protection," said Júlio Vicente Mundai, 41, a mechanic serving an eight-year sentence for stealing a car. Mundai discovered his positive status after taking a voluntary test in jail.

Three aspects of man-to-man sexual activity in prison raise the risk of HIV transmission: anal intercourse, rape and the presence of sexually transmitted infections (STIs).

Homosexuality is taboo in Mozambican society and officials at Machava prison in the capital Maputo, have refused to distribute condoms, saying there was no homosexual activity in the jail.

The UNAIDS position is clear: "Recognising the fact that sexual contact does occur and cannot be stopped in prison settings, and given the high risk of disease transmission that it carries, UNAIDS believes that it is vital that condoms, together with lubricant, should be readily available to prisoners. This should be done either using dispensing machines, or supplies in the prison medical service."

Because prison regulations prohibit conjugal visits, many HIV-positive inmates said they were infected before they were arrested to avoid admitting to homosexual activity in prison.

"Of the tests I've conducted, I've established that although certain inmates were infected before they were detained, the majority had been infected in prison," said chief medical officer of the Machava General Hospital Dr Noorjehan Abdul Magid, who treats most of the HIV-positive inmates. "Homosexual relations are a common practice existing inside prisons."

Overcrowding, violence and high-risk behaviour, such as sharing drug-use paraphernalia and unprotected sex, make prison conditions ideal for the transmission of the virus. Lack of information on HIV/AIDS and inadequate health facilities also contribute to the spread of the pandemic, experts have warned.

Issufo Potina: Free and Healthy

"My story is a story of resurrection," says Issufo Potina, an ex-convict turned AIDS activist in Machava, a suburb of the Mozambican capital, Maputo. "While in jail I started to feel sick - my health condition was getting worse by the day." Falsely accused of killing his wife, Potina was freed after spending 14 months in jail, already ill. His family advised him to consult a traditional healer. "I was given herbs but my health worsened instead of improving." Potina has experienced the stigma and discrimination that society often expresses towards people living with the virus. "Even my mother's church friends have abandoned her. She's been discriminated against for having an HIV-positive son." His mother has stood by him, and in 2002 encouraged him to seek help from the DREAM Centre in Machava where he began taking antiretroviral medication. Four years later, Potina acknowledges that while ARVs are a treatment for HIV/AIDS, family, friendship and affection form an important part of the treatment.

However, the prevalence of HIV in the country's prisons remains unclear.

SIGNS OF CHANGE

The Drug Resource Enhancement against AIDS and Malnutrition (DREAM) centre, run by Communita de Santo Egidio, an Italian Catholic NGO, offers programmes to prevent mother-to-child HIV transmission, antiretroviral (ARV) treatment projects and provides nutritional support to HIV-positive people in local townships. But its activities in the prison do not include the distribution of condoms.

Amós Sibambo, National Assistant Executive Secretary of Rensida, a network of organisations of people living with HIV/AIDS, maintains that "The distribution of condoms in the prison will not promote homosexual practices, but it will rather contribute towards prevention."

The DREAM centre is only 300 metres from Machava and twice a month, on Saturdays, 26 inmates living with the virus go to the centre for monitoring and to receive their supply of the drugs.

Issufo Potina, 30, started taking the life-prolonging medication while he was incarcerated for allegedly killing his wife. He was freed 14 months later with the assistance of a priest, and is now an AIDS activist.

Potina recalled how difficult it was to be HIV-positive in prison, without proper nutrition and in an unhygienic environment. The DREAM centre offers each patient a 35kg package containing rice, soya, peanuts, sugar, oil, milk and soap, as well as health education classes at the prison.

Magid believes conditions are slowly changing. "There was a time when many people died in prison due to a lack of care, but this is now happening less frequently. We are gradually achieving something."

Theme (s): Care/Treatment - PlusNews,

[This report does not necessarily reflect the views of the United Nations]