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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.
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
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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