XIX International AIDS Conference

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A situational assessment on TB, HIV, syphilis, hepatitis C and hepatitis B infections and associated risk behaviour among prisoners and prison officers in Swaziland

P.M. Dlamini1, P. Dlamini2, M.Z. Mnisi3, S. Bertrand4, F. Hariga4

1United Nations Office on Drugs and Crime (UNODC), Health, Mbabane, Swaziland, 2His Majesty's Correctional Services, Health & Administration, Mbabane, Swaziland, 3Ministry of Health - Swaziland, Swaziland National AIDS Program, Mbabane, Swaziland, 4United Nations Office on Drugs and Crime (UNODC), HIV and AIDS Section, Vienna, Austria

Background: According to 2006/7 Swaziland Demographic Health Survey, Swaziland has the highest HIV prevalence worldwide among adults aged 15-49 years (26.1%) and has the highest Tuberculosis incidence rates (1,198 cases/100,000/year). The study investigates the epidemiological situation of Communicable Diseases such as HIV, TB, Viral Hepatitis and Syphilis in prisons settings.
Methods: A cross-sectional and descriptive study targeting all prisoners with more than three (3) months stay. Employed Probability Proportional to Size Sampling method: total of 490 prisoners (92.8 % male and 7.2% female) and 263 officers (76.3 % males and 23.7% females) from 9 Correctional Centres were interviewed using a structured questionnaire adapted from UNODC Toolkit for Knowledge and Risk Behaviour. A Blood sample per participant was collected to test HIV, Syphilis, and Hepatitis B and C. Sputum samples were collected to test Tuberculosis. Quantitative data was analyzed in SPSS V.14 and Stata Version 11.
Results: Prevalence for HIV among prisoners aged 15-49 was 34.9% (70.5% on females & 34.3 % on males) and 26.9% among officers; for Syphilis was 11.8% among prisoners & 17.1% among prison officers; for Hepatitis B was 10.4 % among prisoners & 8.1 % among prison officers; and Hepatitis C was 0.2 % among prisoners and 0.4 % among officers. TB Incidence was 3570/100,000 among prisoners & 1900/100,000 among officers. Compiled “risk score” for Correctional Centres showed Centers with a higher risk score had higher proportion of HIV-positive prisoners. Knowledge and misconceptions about transmission & prevention of diseases were identified.
Conclusions: Differences in disease prevalence (age & gender) were observed among Centres, and involvement in transactional sex and narcotic drug abuse was highly prevalent. Gaps in knowledge of disease's modes of transmission and limited comprehensive approach to health care exacerbate transimission. Hence, combination prevention interventions should be implemented in prison settings alongside education programs & intensified Health Screening.

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