Abstract
Background: The prevalence of HIV is 0.1% in Pakistan, with epidemicity in high-risk groups. The infection is on verge of transmission from key populations to the general population through people who inject drugs and sexual transmission. Prisoners are vulnerable to infectious diseases like HIV. This study was conducted in four prisons in Balochistan, Pakistan to determine the prevalence of HIV and associated risk factors. Methods: This cross sectional study was conducted from March to June 2018, in the prisons of Balochistan. WHO-approved rapid diagnostic kits were used for determining the prevalence of HIV and structured interviews were conducted for the assessment of risk factors. Results: Out of 2084 screened prisoners, 33 (1.6%) were found to be positive. A subset of 104 interviews was analyzed for risk factors of HIV. Among HIV-infected prisoners 68.8% (OR 4.48; 95% CI 1.41-14.2) had extramarital sex, 43.8% (OR 2.09 95% CI 0.69-6.28) had a homosexual experience, and 50% had a history of needle sharing (OR 43; 95% CI 7.77-237). About 94% (OR 16.42; 95% CI 2.09-129.81) of prisoners had a history of drug addiction of any type while 50% (OR 13; 95% CI 2.82-60.01) of HIV-infected had a history of using injectable drugs. Around 75% of HIV-infected prisoners had spent 1-5 years in prison, and 25% had spent more than 10 years. Conclusion: The high prevalence of HIV in prisons of Balochistan demands that preventive and treatment strategies should be designed and implemented carefully, allowing early diagnosis and treatment initiation to minimize the spread of infection among the prisons and ultimately their onward transmission into the community.
Highlights
IntroductionHIV infection causes AIDS and is epidemic throughout the world
Globally; about 36.7 million people were living with HIV
In Pakistan, an estimated 0.13 million peoples are infected with HIV, out of which only 17% are registered with the AIDS Control programme and 54% of total registered people currently living with HIV/AIDS are getting treatment from antiretroviral therapy (ART) centres
Summary
HIV infection causes AIDS and is epidemic throughout the world. The prevalence rate of HIV is 0.1% in Pakistan (http://www.unaids.org). The prevalence of HIV is 0.1% in Pakistan, with epidemicity in high-risk groups. This study was conducted in four prisons in Balochistan, Pakistan to determine the prevalence of HIV and associated risk factors. WHO-approved rapid diagnostic kits were used for determining the prevalence of HIV and structured interviews were conducted for the assessment of risk factors. Conclusion: The high prevalence of HIV in prisons of Balochistan demands that preventive and treatment strategies should be designed and implemented carefully, allowing early diagnosis and treatment initiation to minimize the spread of infection among the prisons and their onward transmission into the community
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