July 13, 2016
July 13, 2016
Among the challenges for HIV-positive inmates are lack of food that meets their dietary needs and susceptibility to tuberculosis. The support groups, part of an HIV prevention and care program active in all the nation’s prisons, mitigate those challenges and create awareness about HIV prevention and care.
NAIROBI, KENYA — When Christopher was convicted of robbery with violence and sentenced to death four years ago, he says, he felt like he was in a nightmare.
Christopher has HIV and had to contend with living with that condition in prison for the rest of his life. Death sentences, in practice, mean life imprisonment in Kenya.
But the father of six, who sought partial anonymity due to fear of stigma, says he found some normalcy at G.K. Prison, Kamiti─ commonly known as Kamiti Maximum Security Prison, a facility about 20 kilometers (12.4 miles) from Nairobi, Kenya’s capital city ─ thanks to an HIV support system he found there.
HIV-positive inmates at the prison have support groups that help them cope with the difficulties of living with the illness, especially the challenges that come with living in a prison. There, lack of food that meets their dietary needs and susceptibility to tuberculosis are common challenges. The support groups, which are part of a nationwide HIV prevention and care program in all prisons, mitigate those challenges and create awareness about HIV prevention and care.
According to a survey of 142 inmates in Kenyan prisons, 56 percent reported being HIV positive, with men reporting a higher prevalence than women. The survey, published in April, also found that 16 percent didn’t know their HIV status.
HIV prevalence is high among prisoners because most are from groups that are vulnerable to HIV, including drug users, says Esther Bett, the deputy director for the Resources Oriented Development Initiative (RODI) Kenya, which runs programs to support prisoners with HIV.
Risky behavior among prisoners also makes them vulnerable to HIV infection, Bett says. In a study RODI Kenya carried out together with partner organizations in 2011, a majority of prisoners ─ 63 percent ─ said they knew that sex was sometimes exchanged for money, goods and services, though 95 percent said they were not involved in the exchange. About 14 percent of prisoners interviewed said they had had consensual sex with other inmates. Forty-one percent of prisoners said they share razor blades.
Condoms were available in many prison health facilities, but only 11 percent of inmates reported they were able to access them, the report states. Officials at Kamiti prison, like other prisons in Kenya, say they do not allow condoms because it encourages sexual activity
Mary Chepkonga, the head of the Kenya Prisons AIDS Control Unit, says the support groups are part of the nationwide program established to deal with HIV prevention and mitigation.
“The support groups empower them through encouragement, training in public speaking as well as in business,”Chepkonga says. “The communication skills are meant to help them to share their status with their loved ones and engage in peer education activities, while activities such as poultry keeping provide for their nutritional needs.”
The groups help prisoners accept their health status and forgive themselves, adds Bett, the deputy director at RODI Kenya.
“Within the support groups, someone realizes that there is someone who has gone through this before me and survived the shame and the trauma. There is also trust within these small groups,” she says.
At Kamiti prison, 150 HIV-positive prisoners have formed 10 support groups ─ one for each of the 10 blocks that make up the prison.
Christopher says his support group has taught him how to be at peace with himself and other inmates.
“One challenge that the group helps us deal with is stigma. If you are in a cell with other inmates who are not positive, you can hear them talking about you, which is very difficult,” he says.
John, another HIV-positive inmate who sought partial anonymity, says the group encourages him to take antiretroviral (ARV) medication. Although he was infected with HIV before he entered prison in 2005, he never took any medication.
“The idea that I would suffer horrible side effects if I took ARVs really got into me, so I avoided taking them until I was in prison,” John says. “I was sensitized by the staff and the peer educators about why taking the drugs is important.”
This is a common trend among prisoners, says Mbogo Irungu, an HIV-positive inmate and peer educator. Sometimes inmates are in denial about their status, or try to pretend that they are not sick to avoid stigma, Irungu says.
The support groups have also started enterprises including gardens with vegetables and herbs, poultry raising and shoe and belt making. They sell the shoes and belts in a showroom at the prison and use the money to buy dietary supplements, including milk.
Some prisoners say that even though the services and medicine they receive in support groups are helpful, what they desperately need is food.
“An HIV-positive person needs to be on a special diet which we do not have here,” says Vincent Osente, an HIV-positive prisoner.
“The doctor will recommend a special diet for you, but it can take a period of six to eight months for you to get something, so in my case what happens is I get hungry and weak,” he says.
Paul Kariuki, a counselor at the prison, says all prisoners get a balanced diet, and inmates with HIV are sometimes given a special diet of extra protein or vitamins, depending on what the prison’s nutritionist recommends.
Inmates who need additional food, such as milk and yogurt, have to buy these with their own money, he says.
The prisoners also complain of congestion inside the cells. The rooms are tiny and the windows small, and this increases the chances of the spread of TB, Christopher says.
TB is airborne and can be contracted when someone breathes in air contaminated by TB bacteria, according to the Centers for Disease Control and Prevention, a U.S. entity.
Peter Okello, the deputy head of AIDS Control Unit, admits that congestion is a problem. The prison also lacks isolation facilities for people suffering from TB, Okello says.
Bett says that although there are many improvements in HIV management within prisons, authorities need to make HIV awareness efforts consistent, since prison populations are mobile.
“Prisons have a high turnover, hundreds of inmates are either released or transferred each year, and staff are also transferred or promoted to other prisons. So the knowledge has gone down,” Bett says.
Irungu says that what HIV inmates ultimately need is to be at home, cared for by their families.
“I know it is impossible, but I wish we could get this chance,” he says. “It’s difficult being in prison while your wife struggles, and your children are probably thinking you are a bad person because you are in jail. If I could be with them, it would be easier.”
Lydia Matata, GPJ, translated some interviews from Swahili.