This study was undertaken to determine the prevalence of HIV and syphilis among male prison inmates and the prevalence of risk behaviors for HIV transmission. A stratified sampling design was employed with randomly selected male prison inmates in NCR jails as study participants. Data gathering was through face-to-face interviews using a standard interview schedule and blood specimens were collected for HIV and syphilis testing.
From June 1 to July 25, 2003, 380 prison inmates coming from 18 National Capital Region (NCR) jails participated in the study. Most were Roman Catholics, never married with a median age of 28 years. Many reached or finished secondary level of education. The median duration of jail stay was six months. One of every three inmates were detained due to prohibited drug-related charges but 52-62% of the study participants admitted using prohibited drugs in the past 12 months. One inmate used injectable drugs for recreation. During the past year, 20-30% claimed to have experienced STI signs and symptoms.
Only 33-43% of the study participants knew that mutual monogamy, consistent condom use and consistent use of clean needles and syringes prevent HIV transmission. The inmates had many misconceptions on HIV transmission; the most prevalent was the thought that a good diet will prevent HIV transmission. Inmates who were better educated were twice more likely to have no/ minimal misconceptions on HIV transmission.
One of every five inmates received HIV information while in jail, with television as the most cited information source. Those who received HIV information before and/ or during imprisonment had higher level of knowledge on HIV prevention compared to those who did not receive HIV information.
Only 4-9% of inmates exhibited accepting attitude to person with HIV (PWH) and those who were young least supportive of PWH. Inmates who were better educated and those with no/minimal misconceptions on HIV transmission were more likely to exhibit accepting attitude to PWH. There was no association between high level of knowledge on HIV transmission and accepting attitude towards PWH.
A total of 117 (31%) inmates had sex with women in the past three months prior to interview, of which, only 2% consistently used condoms during sex. Before being imprisoned, 11-18% of inmates had sex with other men. Those who were young were thrice more likely to have sex with other men before and during incarceration.
While in jail 5-10% of inmates had sex with other men. In the past month, 15 inmates had sex with other men, most of which were consensual and only four practiced anal sex. Condom use was documented in one episode of oral sex.
All of the 380 blood samples tested negatively for HIV. Nineteen or 5% (95%Cl 308) of blood samples were positive for syphilis. There was no association between having sex with men or women in the past three months and having syphilis.
HIV prevalence among male prison inmates in NCR is still less than 1%. However, the low level of knowledge and the high level of misconceptions on HIV transmission, the occurrence of unprotected sex with men and women, the high level of syphilis (a known co-factor for HIV transmission) and the rampant use of prohibited drugs increase the vulnerability of male prison inmates in NCR to acquiring HIV.
