UN agencies to survey Sindh prisons for HIV prevalence

KARACHI: Following an alarming HIV outbreak in Larkana's Ratodero town, the United Nations Office on Drugs and Crime (UNODC), UNAIDS and the local AIDS control authorities have decided to launch a comprehensive ‘HIV Biological and Behavioural Survey’ in the five major jails of Sindh to ascertain the prevalence of HIV among the prisoners, UN officials in Pakistan said on Monday.

“In the wake of devastating HIV outbreak in Ratodero taluka, the UN agencies including UNODC Pakistan and the UNAIDS in collaboration with local authorities have decided to ascertain the prevalence of HIV, viral hepatitis and tuberculosis among prisoners in Sindh. An HIV Biological and Behavioural survey would be launched soon to ascertain the number of prisoners with these diseases”, an official of United Nations in Pakistan told The News. Shockwaves were generated globally following the news of the devastating HIV outbreak in the Ratodero where 778 persons including 640 children have so far tested positive to HIV as experts from four continents including Africa, Europe, America and Asia converged in Larkana to probe the lethal outbreak which is still a mystery for both Pakistani and the international experts.

The UN official, who was not authorized to disclose identity, told this scribe that the integrated biological and behavioural survey has been planned jointly by the UNODC and UNAIDS to study the prevalence of HIV, and comorbidities like TB and Hepatitis C among prisoners and behaviors that place these prisoners at high risk to these diseases. “We have selected five prisons including Central Prison Karachi, District Jail Malir, Center Prison Hyderabad, Central Prison Larkana and Central Prison Sukkur, which have an estimated population of number of around 28,000 prisoners”, the official said and added UNAIDS would provide funding for the survey under Unified Budget Results Accountability Framework (UBRAF) while UNODC would provide technical assistance. The study,spread over a span of 6-8 months, would further determine the gaps and introduction, scaling up of comprehensive intervention for prevention, treatment and care of HIV, TB & Hepatitis C in prisons, the UN official added.

The UN official said in 2012, UNODC Pakistan Country Office commissioned a bio-behavioral study in five prisons in Sindh to explore HIV risk, vulnerability and prevalence among prisoners. “Surprisingly, the overall HIV prevalence across the five prisons was 2.3%, considerably higher than the overall national prevalence of HIV among adults (15-29) which is less than 0.1%. Central Jail Hyderabad reported the highest HIV prevalence among the prisoners at 3.7%, followed by 2.9% in Central Jail Sukkur”, the official claimed. Similarly, a cross sectional survey of 14 prisons in the Sindh from November 2008 to January 2009 revealed that of the 7,539 prisoners screened for HCV, 965 were tested positive for Hepatitis C which was 12.8 percent of those screened, the official said adding that Hepatitis C prevalence in the prison population of Sindh is higher than the national prevalence of 4.9% amongst general population.

“At the same time, jail inmates are exposed to risk factors leading to tuberculosis and are also engaged in activities which make them prone to HIV/AIDS, therefore it is important to know the prevalence of jail inmates suffering from HIV with comorbidities like TB so that they could be addressed in one package of interventions to prevent their spread among prison inmates” the official added.

But officials of the Sindh AIDS Control Programme (SACP) claimed there are hardly 100 prisoners with HIV languishing at these five major prisons and the number has remained constant due to high security and monitoring, the rate of spread of infection to other inmates has also dropped drastically during last couple of years. “According to our database, there are around 29 prisoners with HIV at Central Jail Karachi, around 32-34 at District Jail Malir, five to six patients with HIV positive status at Central Prison Hyderabad while there could be hardly one or two prisoners with HIV positive status at Central Jail Malir”, Sikandar Iqbal, an official of Sindh Aids Control Programme told The News.