HIV PREVALENCE AND ASSOCIATED RISK FACTORS AMONGST PRISON INMATES IN KUJE FEDERAL PRISON, FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA, JANUARY, 2013.

HIV PREVALENCE AND ASSOCIATED RISK FACTORS AMONGST PRISON INMATES IN KUJE FEDERAL PRISON, FEDERAL CAPITAL TERRITORY, ABUJA, NIGERIA, JANUARY, 2013.

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Summary

In prisons, prevalence of HIV infection, overcrowding and poor prison conditions and diseases are

of public-health importance. This study was conducted to determine HIV Prevalence and

associated risk factors amongst prison inmates in Kuje Federal Prison, a male only prison located

in the Federal Capital Territory, Nigeria.

Cross sectional study design and sample size of 154 were used. Data was collected by quantitative

and qualitative methods. Variables on knowledge, attitude and practice were assessed using

questionnaire, and HIV testing was also done. Knowledge, attitude and practice were scored and

graded. Confidentiality and voluntary participation of respondents were ensured. Quantitative data

was analysed using Epi-info version 3.5.3 and Microsoft Excel for univariate, bivariate and multi

variate analysis, and thematic analysis done for qualitative data.

Mean age of respondents was 31.9 + 7.8 years. 39.6% respondents were currently married. Median

age at first marriage was 26 years (range 16-39) years. Overall HIV prevalence was 4.0% (1.5-

8.6%, 95% CI) with convicts having 3.3% (0.1-17.2%, 95% CI) and awaiting trial inmates having

4.2% (1.4-9.5%, 95% CI). Only 16 (10.4%) knew all the five ways of HIV transmission. Mean

score of HIV knowledge was 42%; 90 (58.4%) had poor knowledge and 3 (1.9%) had good

knowledge. Attitude mean score on HIV was 84%; 120 (77.9%) respondents had positive attitude.

105 (68.1%) had ever been tested for HIV while 94 (61.0 %) knew HIV status. Consistent condom

use 6 months before incarceration was 15.6%. Based on quantitative method, there was no (0%)

heterosexual or homosexual practices in prison; however, the qualitative study found that same sex

relationship exists. Fourteen respondents (9.1% [5.1-14.9%, 95%CI]) had tattoo, and six (4.0%)

had body piercing. Mean score for HIV related good practice was 61% with 17 (11.0%) graded as

having bad practice, 137 (89.0%) had fair practice and 0 (0.0%) had good practice.

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Being younger than 25 years (OR: 1.28, P-value: 0.59), stay in prison less than 3 years (OR: 2.37,

P-value: 0.38), multiple sexual partnership (OR: 4.64, P-value: 0.17), ever had STI (OR: 3.13, P-

value: 0.17), tattoo (OR: 6.0, P-value: 0.09) and body piercing (OR: 5.4, P-value: 0.20) were

associated with HIV status but not statistically significant, while ever attended school (OR: 0.31,

P-value: 0.32), knowledge of HIV sexual transmission (OR: 0.39, P-value: 0.38), ever heard of

condom (OR: 0.14, P-value: 0.18), ever used condom (OR: 0.23, P-value: 0.14), consistent

condom use (OR: 0.51, P-value: 0.5), seems to be protective but not statistically significant at

P<0.05. On Logistics regression, never heard of male condom (AOR 33.1, P-value-0.016) and

previous history of STI (AOR 18.4, P-value 0.05) were significant risk factors.

HIV prevalence in group is above 1% reference for low level epidemics. The correct and complete

knowledge and good practice on HIV were generally poor which shows that more work and

strategies need to be deployed to improve these. Steps should be taken to promptly treat sexually

transmitted infections and make condoms accessible to all. Functional HIV counseling and testing

services should be introduced with a well-designed HIV information, education and

communication packages. More studies are also recommended.

Key words: HIV, Prevalence, Tattoo, Prison, Abuja

CHAPTER ONE: INTRODUCTION

1.1     Background

For centuries history, it has been the recognized right of societies to punish crime and today, the

way to deal with persons who commit serious crimes is through confinements in prisons. When the

British Government assumed the responsibility for the administration of Lagos in 1961, the

evolution of an organized prison system began. The Nigerian prison system was modeled after the

British system. The deplorable conditions of Nigerian prisons with the concomitant high death rate

in most of them led to a setting up of a commission of enquiry in 1920. Post-independence, the

increase in the prison population posed a lot of problems due to filthiness, understaffing and poor

health related condition1. The prisons represent dynamic communities where at-risk groups

congregate in a setting that exacerbates disease and its transmission, including Human

Immunodeficiency Virus and Acquired Immune Deficiency Syndrome (HIV and AIDS).

The sudden emergence of HIV and AIDS in the world, its rapid spread from within and across

nations especially in sub-Saharan African and its increasing burden, in the face of limited

resources, has posed a serious threat to human existence and the attainment of the desired level of

human development. AIDS remains a leading cause of mortality worldwide and the primary cause

of death in sub-Saharan Africa, illustrating the tremendous, long-term challenge that lies ahead fo


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