While it is true that prisoners deserve their jail sentences, it is also sad to see their way of life. They are behind bars for the many offences they have conducted and lead a horrendous life. Most of the time, the stronger ones overpower the weaker ones, resulting in violence. Some of them even force unwanted sex against the other inmates, leading to STI and HIV.
Worldwide at any given time, there are approximately 10 million prison inmates, with an annual turnover of 30 million. Prison inmates are vulnerable to risk behaviours including drug abuse and HIV. Although no reliable estimates are available for the South Asian region, in most countries, drug use and unsafe sexual practices are well-recognized problems in prison settings.
Everywhere in the world, rates of HIV-infection among prison populations are generally much higher than in the general population. Drug use in general, and injecting drug use in particular, as well as violence and the practice of men having sex with men are widespread in prisons. Multi-person use of contaminated drug injecting is an important mode of HIV transmission among prisoners. HIV is also transmitted in prisons through unsafe sexual behaviours, sometimes associated with sexual violence.
The high degree of mobility between prison and community means that communicable diseases and related illnesses transmitted or exacerbated in prison do not remain there. When people living with HIV are released from incarceration and return to their sexual and/or needle-sharing partners in the community, their partners face increased risk of HIV infection while they may not be aware that they are at risk.
The baseline KAP (knowledge attitude and practice) survey administered to 1386 prisoners in select prison sites of India, Nepal and Sri Lanka through a purposive sample conducted by UNODC under project RAS/H71 revealed:
• A high number of married inmates, which means that the risk of transmission to partner/ spouse is HIGH
• Onset of drug use and initiation into sex is as early as 15 years of age
• Knowledge/ information on HIV transmission is not significant
• The presence of risk behaviours like unprotected sex, consumption of drugs, injecting of drugs and sexual harassment is reported
Out of the 56 jails in the state of Maharashtra, Arthur Road Jail in Mumbai is the only one to have an Integrated Counseling and Testing Centre (ICTC) for the prison inmates. This centre was set up by Mumbai District AIDS Control Society (MDACS).
The Need
Prisoners live in a confined environment. There is no source of information or exposure during the period they spend in prison. They are from the SEC C and D category from a low socio economic background. Most of the prisoners are uneducated while a few of them have attended primary school.
MDACS STRATEGY
As part of the ongoing mainstreaming interventions for the year of 2011-2012, the IEC cell of MDACS conceptualized an HIV/AIDS awareness and sensitization campaign for prison inmates in Arthur Road Jail. Observations of sexual harassment (unsafe sex) of newcomers by old prisoners or vice versa, men having sex (unprotected sex) with men have been surfacing, which resulted in the IEC cell in selecting this particular target group for the intervention.
Mainstreaming workshops were planned as joint venture of MDACS & Mumbai Sarvodaya Mandal, as Mumbai Sarvodaya Mandal had earlier obtained the permission of higher authorities of prison (Pune) to conduct the social activities in the jails spread all over Maharashtra.
INTERVENTION SETTING
Arthur Road Jail is only for male prisoners. There are 4 circles in the jail i.e. Circle No. 6, 7, 3, 11 and there are 200-250 prisoners in each circle. The jail houses around 2000 male prisoners.
Arthur Road Jail authorities were supportive of this intervention and provided MDACS and Mumbai Sarvodaya Mandal permission to conduct the workshops so that key HIV/AIDS related information will be reach to all the prisoners.
The Programme
Three workshops were conducted in all for the prison inmates and the number of people who attended them was 1100.
Workshop 1: This was conducted for General Prisoners
Workshop 2: This was conducted for those prisoners who were psychologically disturbed
Workshop 3: Murderers were given knowledge of HIV/AIDS in a separate workshop
Each workshop followed an interactive pattern of disseminating information:
• Sessions on HIV/AIDS, STDs
• TV Spots related to HIV/AIDS were screened
• Q &A sessions & Quiz competition
• Prize Distribution [stationary material were distributed as many of them are attending literacy classes run at the jail)
• Poster Exhibition
IMPACT
What made us proud
• The entire programme was in an audio visual format. All the services such as ICTC, Myths/Misconceptions, ART and STI were explained through AV Advertisements. This made it very interactive and engaging.
• Also, songs based on HIV such as 'Tod do deewaren' which is a star-studded song was played. This motivated them and brought about a very strong response.
• A Q&A session was conducted and prisoners were asked questions on HIV on the basis of the entire programme conducted. It was a pleasure to see that they all gave correct answers. Those who answered were presented with one story book (based on value education), a basic Hindi textbook, a notebook and pen to educate themselves.
• Many of them got motivated & joined Literacy classes. Our activity was helpful to achieve targets of Jail authority also.
• The prisoners came up on stage and shared their experiences, performed condom demos, sang songs, affirmed that they will get tested, assured that they would tell their friends and fellow inmates about the services and safety measures.
• It was indeed a proud moment to get across to such a difficult population.
• We are glad we could add value to criminals and help them become better individuals.
IMPACT ANALYSIS of intervention (STARTED IN MID SEPTEMBER 2011)
• Monthly average client in ICTC is between 120-135 patients.
• In September 2011 during the Programme (within 15 days) 163 clients got tested.
• For the first time clients visited for STI (35 patients registered & referred to JJ Hospital for further testing & all found negative)
• In October 2011, 138 clients visited ICTC
• After the program 2 PRISONERS of Psychiatric barack came forward to work voluntarily to spread awareness about HIV/AIDS namely:
i. Mohammad Irfan Mohammad Latif Khan - O/S. 302 IPC
ii. Shashikant Sarangdhar Buba - O/S. 380 IPC
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