Prison HIV/AIDS Prevention Programme

The HIV/ AIDS and Sexual health program in Kerala, implemented by the Kerala State AIDS Control Society (KSACS), has been a pioneering effort in the country for initiating a situationspecific intervention in correctional setting. In 1997, the first prison project was launched in the Thiruvananthapuram Central Prison on an experimental basis. Earlier experiences of HIV / AIDS program in Kerala had revealed the fact that prison inmates form a cardinal part of sex circuit, where we could easily build rapport with the core population such as sex workers, clients of sex workers, drug users, pimps etc.

It has been rightly perceived that prison settings could lead to unique situations where expression and practice of homosexual encounters among the inmates could easily emerge and sustain. Annually, there are 15 lakh inmates in 40 odd prisons. The environment presents a captive set of audience for intervention. Majority of prison inmates fall in the age group of 20 to 50 and their unsafe sex practices leading to Sexually Transmitted Diseases including HIV infection is found to be higher. The prison intervention is designed to address the unsafe sexual behavior of prison inmates within the prison and outside the prison, when they are released or going on parole.

Establishing ICTC

In 2008–09, six ICTCs will be established in major prisons in six districts of Kerala and they will provide counseling and testing services to 19 prisons in the State, with the counselors and technicians visiting other prisons in their area and providing the required services. The expected client load in each ICTC is 20 to 25 inmates per day. Prisons to initiate ICTC were identified based on the annual population of inmates i.e., ICTCs will be established in major prisons where there is a minimum of 2000 inmates. These 6 ICTCs can cover 19 prisons across the State.

Following is the list of prisons where ICTCs will be established:

Central Prison, Thiruvananthapuram
Sub-Jail, Kottarakkara
Sub-Jail, Ernakulam
Central Prison, Viyyur
District Prison, Kozhikode
Central prison, Kannur

Selected trained peer-prisoner volunteers will do the demand generation and awareness activities with in the cells. For this, the peer volunteer will be given an incentive of Rs.200 per month. This may be given in the form of required materials like toiletries / books etc. The peer educators will be adequately trained by KSACS.

Space and infrastructure:

The ICTC will be located in health facility and other suitable space available in each prison. KSACS - TSU team has identified suitable locations for establishing ICTC in prisons. Furniture, lab equipments and test kits / consumables will be supplied by KSACS.

Staffing:

The counselors and lab technicians will be appointed by KSACS. They would work in close collaboration with the prison department. They will move to the adjacent jails in the district to do counseling and to draw blood for testing. Counselors will also undertake demand generation activities inside the prisons and visit HIV positive inmates to assess their difficulties and ensure continuous treatment support. An amount of Rs.5000 per annum per prison will be needed for such demand generation activities. Existing prison doctors will act as ICTC manager.

Five counselors have been identified from different ICTCs and transferred to five different prisons. An orientation program was conducted for all the superintendents, welfare officers and ICTC counselors.

It is expected that 1 to 2 % of prisoners may turn out to be HIV positive. Currently only three prisons have a regular doctor. It is necessary to engage a doctor (at Rs.1000 p.m.) to visit those on ART once a month.