Is Sodomy Behind HIV Spread in Prisons?

THE four walls of prison became home for Sililo Muyunda (real name withheld), after spending eight years following his conviction for aggravated robbery in 2003.

His experience in prison began with two and a half years at Lusaka Central Prison, before being committed to Kabwe’s Mukobeko Maximum Prison, where he spent six years.

Fortunately, Mr Muyunda, and other inmates received the presidential prerogative of mercy, which saw him walk to freedom in 2011.

However, the existence of homosexuality in prisons may be a subject of debate, as Mr Muyunda’s experience is an eye opener for the need for immediate action to curb the spread of HIV transmission in penitentiary.

With an estimated total population of about 17,000 in the country’s 53 prisons, the HIV prevalence rate stands at about 27 per cent, a figure that is almost double the prevalence rate outside prison which is 14.3 per cent.

Some questions that beg answers include what could be some of the underlying factors leading to high HIV prevalence in prisons?

Could it be that HIV transmission rates in prisons is much higher, or is it that inmates are incarcerated when already infected with HIV?

During a tour of Lusaka Central Prison by the Coalition of African Parliamentarians Against HIV and AIDS (CAPAH) in 2013, a clinician at Chimbokaila Prison clinic Derricks Mwendafilumba said 150 prisoners at the facility tested positive for HIV, while 118 of them are currently on anti-retro viral therapy (ART).

This is against a total population of 1,112 inmates.

However, Mr Muyunda’s first encounter with men who have sex with men was at Lusaka Central Prison where some inmates took aantage of the congestion in the cells to engage in homosexual activities in the night.

He recalls that the condemned section of Mukobeko prisons accounts for the highest cases of sodomy in the prisons set-up.

“When they were caught in the middle of the night, there was a lot of noise because some of them would want to beat the perpetrators while others would want to rescue them.

Because of the congestion, in a cell meant for 30 people there are 70 or even 100 people, so some inmates would agree to engage in homosexual acts,” Mr Muyunda recounted.

At the dreaded Penal Block, an isolated prison from the main prison arena at Mukobeko, acts of sodomy are rampant due to the structural set up because it houses convicts serving long sentences.

“So, sodomy is very rampant and that it is done to ease sexual desire,” he said.

While in prison, Mr Muyunda narrated how he met a ‘couple’, who had been in a sexual relationship for 17 years.

One of them was acting like a woman and adopted feminine characteristics.

His major area of concern now is that despite these practices, coupled with the HIV prevalence rate of HIV in prisons, not many inmates are aware of their HIV status because going for voluntary counseling and testing is a personal decision.

Some ex-convicts who were sent back to prison after committing offences confessed having difficulties adjusting to engaging in normal sexual life with their wives.

During a meeting on Prison Conditions in 2013, PEPFAR representative Kristie Mikus said prisoners are entitled to the highest possible standard of health and access to HIV preventative and treatment measures that are available to the general public.

“Each of us here agrees that this is not acceptable. Prisoners are among the populations most at risk of contracting HIV,” she said.

Ms Mikus said the USA Government, through the Support to the HIVAIDS Response in Zambia (SHARE) project has developed strategic and operational activities in prisons to intensify prevention, care and treatment in prisons.

She called for the need to ensure that prisoners have access to HIV prevention and treatment services.

However, Zambia Prisons Service Commissioner Percy Chato called for the need for more research to establish the extent of homosexuality among male prisoners.

Mr Chato said there has not been any comprehensive research carried out in Zambian prisons on the rate of homosexuality.

He said although the rates of HIV in the Prisons settings are much higher than the prevalence outside prisons, however, homosexuality is a rare phenomenon.

“The prevalence rates of HIV in prisons may be very high, but the existence of homosexuality is a rare phenomenon,” he said.

The Sero-behavioral report of the HIV and AIDS situation in Zambian prisons released in July 2011 also indicates that 24.1 percent of prisoners confessed that many inmates were having sex with each other.

United Nations Programme on HIVAIDS (UNAIDS) country director Helen Frary, is of the view that if Zambia is to attain the Millennium Development Goals (MDG) target of getting to zero HIV transmission, there is need to address the issue of key populations such as those practising homosexuality.

Ms Frary said these people also face challenges in accessing HIV treatment services.

“This is because they fear that the medical personnel may recognise some symptoms which may lead them to believe the patient may be homosexual, she said.

She said the fear of accessing medical services emanates from concerns that they may risk be arrested, if it is proven that they are engaged in homosexual practices, hence the high levels of fear and discrimination among them.

According to the National AIDS Council (NAC), homosexuality is among the six key drivers of the transmission of HIV in the country.

HIV Activist Mannasseh Phiri explained that the biological make-up of the anus makes it more susceptible to bruising if not adequately and artificially lubricated during the act.

He said broken or lacerated skin due to friction in anal sex offers a large surface area for the entry of the HIV virus from an infected person, to one who is not infected.

Another factor could be that some of the men having sex with men, are also known to have sex with men who may be involved in heterosexual relationships with women, making the transmission of HIV more rapid.

Dr Phiri said this is why, in a country like Zambia, it is difficult to establish whether the transmission of HIV is emanating from men having sex with men to bi-sexual men and then into marriages or heterosexual relations, or vice versa.

Despite being over congested, they have a minority voice on the decision to turn back people whom the law deems fit to be imprisoned.

To borrow the words of Lusaka Central Prisons Commander Crispin Kaonga, ‘every one of us is a potential prisoner’, it is therefore essential that efforts aimed at scaling up nutrition for inmates are supported to ensure that despite being offenders of the law, they are kept in optimal health.

Source : The Times of Zambia

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