Treatment that prevents HIV is well accepted by inmates
The first study in the world to analyze whether or not people in prison would accept the treatment that prevents HIV (PrEP) obtained a strong response. The research was carried out in 16 prisons in Zambia, where 93% of those who would be eligible to receive it agreed to start the medication.
PrEP (acronym for HIV pre-exposure prophylaxis) is an antiretroviral treatment scheme that is administered for an indefinite period of time to those people who do not have the virus, and provides protection that has been quantified around 99%.
For now, regardless of the country, this treatment is not provided to everyone, but only to those who are at high risk of contracting HIV, such as those who are partners of people with HIV, those who engage in sex work or those who do not They use a condom during their sexual practices.
PrEP Project
Between October 2020 and March 2021, a research team carried out a program to offer PrEP in 16 prisons in Zambia, according to information from the Be in the know website, which specializes in HIV-related issues.
The first part of the project consisted of education and counseling sessions on HIV and PrEP, delivered by other inmates trained for it. In a next step, some 12,400 inmates (95% were men) were assessed for HIV risk, and those at high risk were offered screening tests. In total, about 2,600 tests were carried out.
Those who tested positive on these tests were linked to necessary medical care, and those who tested negative were reassessed to see if they were candidates for PrEP. According to Zambia’s Ministry of Health guidelines, a total of 1,280 people were candidates for the treatment, and 93% of them decided to take it.
A necessary measure
In Zambia, prisons hold particularly high numbers of people who are at high risk of acquiring HIV, such as sex workers, people who inject drugs, gay men and other men who have sex with men, as these populations They are often criminalized. Despite this, prisons do not provide tools to prevent HIV, such as condoms and lubricants.
It must be considered that not all sexual acts in prisons are consensual. While some estimates indicate that, in the sub-Saharan African region, 1 in 5 people have arranged sex, forced sex, transactional sex and rape are common. Added to this is the fact that inmates share equipment to inject drugs or get tattoos, so their risk of HIV increases even more.
In the study on PrEP, of the 1,190 people who agreed to take the treatment, 1,151 were men and 39 were women, it can be said that these were all women in the study population.
Of the total number of people considered in the research, 13.7% were HIV positive. But the rate of positive results was higher in women (20.6%) than in men (13.2%).
Lessons learned
The research team highlights three findings. One is that uptake of PrEP was very high despite the fact that there are no spousal visits and that sexual relations between men are prohibited by law in the country.
Second, the authors hypothesize that the fact that condoms are not available in prisons may have influenced the uptake of PrEP. Finally, they considered very important the participation of peer educators (i.e., other inmates) in the information and follow-up of this strategy.
At AHF Latin America and the Caribbean we know that tools like PrEP are highly effective if they reach the populations that need it. But another fundamental tool is the detection of the virus, in order to be able to act accordingly. Remember that we do free HIV detection tests, and we also have free condoms. Look for our offices in your country or write to us by Whatsapp and find out about our services.