The Department of Correctional Services (DCS) does not know how rife HIV/Aids is in South Africa’s 240 prisons, but will shortly undertake a national HIV prevalence survey in a bid to ”allay speculation”.
”In order to allay the speculations on the HIV prevalence rate in correctional facilities, the minister of correctional services and the national commissioner … have approved the undertaking of an HIV prevalence survey amongst offenders and staff,” says departmental spokesperson Bheki Manzini.
Manzini says the survey will be piloted in Gauteng during April and May. Based on these results, it will be expanded nationally.
He says initial results can be expected towards the end of September, and will help inform the department’s HIV/Aids strategy in a country that has among the world’s highest infection rates and where the majority of prisoners — young, uneducated black men — fall into a high-risk category.
Manzini says the department does not have official statistics on the exact number of prisoners infected with the disease.
”Not all the offenders in the correctional centres have disclosed their HIV status, [and] it is therefore a challenge to come up with a conclusive number.”
Mortality rate
Manzini says the DCS has always been concerned about the increasing mortality rate among offenders, which has risen during the period 1995 to 2004 from 1,65 deaths per 1 000 prisoners per year to 9,1 deaths per 1 000 per year, according to the Judicial Inspectorate of Prisons.
”However, the increasing mortality rate cannot directly be linked to HIV/Aids. Research studies to determine the increasing mortality rate and its link with HIV/Aids have not been undertaken.
”The causes of death on the death certificate are not indicated as HIV/Aids and it is therefore difficult to directly link it to HIV/Aids,” Manzini says.
A controversial study at Durban-Westville Medium B prison by KC Goyer et al, under the auspices of the health economics and HIV/Aids research division of the University of KwaZulu-Natal, showed a 30% infection rate among about 300 inmates following voluntary, anonymous testing.
The 2001 study was designed to quantify and analyse the HIV/Aids epidemic among inmates.
The DCS banned the Durban-Westville report and to this day denies such a survey had taken place, with inspecting Judge Hannes Fagan, in the immediate aftermath of the report being presented to DCS, also forced to retract an extrapolation that as many as 60% of the country’s prisoners could be HIV-positive.
Manzini says the DCS is not aware of any prevalence survey conducted at Durban-Westville, adding that once the ”necessary approval processes” have been completed, the results of the new survey will be made public ”at a time and place yet to be determined”.
He says HIV-positive offenders are currently being referred to the Department of Health’s anti-retroviral (ARV) therapy treatment sites.
However, the DCS is getting approval for accredited ARV sites in prisons. The first such site is accredited and is operational in Bloemfontein.
Difficulties the DCS faces in the roll-out of ARVs include transporting offenders to external sites, shortage of professional staff such as dieticians and pharmacists, and prisoners not possessing identity documents.
Funding
Mark Schlachter, a spokesperson for the United States embassy in Pretoria, confirmed that the DCS received $1-million from US President George Bush’s President’s Emergency Plan for Aids Relief in 2005.
”The partnership with the DCS is one aspect of a comprehensive US programme to address under-served high-risk populations. Prisoners are a critical target group for HIV prevention, palliative care and treatment,” Schlachter told the South African Press Association.
He said the US intends sharing the lessons learned through this activity with prison systems around the world in the hope of extending promising practices and successful interventions.
”The key question is whether or not there will be sufficient interest among prisoners, as this will be a strictly voluntary activity,” said Schlachter.
Manzini says testing will be ”totally” voluntary, with consent forms having to be signed.
Prison staff and offenders in Gauteng have been informed through ”vigorous” information sessions at all prisons ahead of the pilot survey.
”Before commencing with the testing, a group pre-test counselling session will be conducted with those participants to explain the process, etc. Confidentiality will be adhered to throughout,” he says.
Manzini says the provision of ARVs at prisons is guided by the Department of Health’s national policy.
”All offenders do have the right to access to medication that could assist in promoting their health and ensure that they are living a productive life for as long as they can. These medications include the provision of anti-retroviral therapy when necessary upon the recommendation of the medical practitioner.”
The legally guaranteed provision of ARVs is increasingly becoming a vexed issue among prisoners, with 119 HIV-positive offenders at Durban-Westville prisons last week embarking on an aborted hunger-strike to highlight their grievances. — Sapa