Winning against HIV stigma behind bars

“Fellow prisoners and warders treat us so uncaringly – they stigmatise us,” said Collins Kiwinda*, a prisoner serving time for robbery with violence at Athi River Prison in the capital, Nairobi. “Our relatives never come to see us and find out how we are faring.”

Kiwinda is married, but assumes that his wife has left him – she has not visited since 2002, when he was arrested; his parents and siblings have not visited him for over five years.

A poor diet and cramped cells makes life even more difficult. “When one is sick in prison, food becomes an issue as he needs to eat well to regain better health,” Kiwinda said. “Yet the food offered to us HIV-positive inmates is so poor in nutritional value.”

Pleas for the provision of basics, like beds or mattresses for infected prisoners, have been met with blank stares or replies like: “You don’t deserve any privileges or rights here; after all, you are only a prisoner.”

The recent arrival of Zingatia Maisha (Swahili for focus on life), a group of NGOs in a countrywide project to improve the quality of life of people living with HIV, has boosted morale.

“HIV-positive inmates suffer double stigma – for their being prisoners and for their HIV status,” said Nancy Muchemi, a project officer at the Kenya office of the African Medical and Research Foundation.

“We offer them psychosocial support to relieve their stress, as well as expose them to HIV information: we train them on issues of prevention, safe sex, reinfection, healthy living and adherence to ARV [antiretroviral] drugs.”

Prisoners said the most useful thing the Zingatia Maisha project had taught them was the benefit of forming a support group for HIV-positive prisoners, giving them the opportunity to talk about their thoughts and feelings others in the same position.
The group has also put their case for better meals and health care, and less discrimination. They are pushing for clocks on prison walls to improve ARV adherence – prisoners are not permitted to wear watches, so taking medication at the same time every day can be problematic.

They have invited senior prison staff to their meetings so they can give their views on the prisoners’ requests, and initial efforts seem to be bringing results.

“We are already acting on their concerns. Upon a doctor’s recommendation, those who deserve a special diet have their needs addressed,” the officer in charge of Athi River Prison, Felix Kitema, told IRIN/PlusNews. He said his administration would continue to look into the particular concerns of people living with HIV.

The support group is also reaching out to other prisoners. “We encourage other prisoners to go for VCT [voluntary counselling and testing],” said Benson Wasike*, one of the group’s leaders. “By knowing one’s status and [being] armed with information, stigma and discrimination are likely to go down.”

According to the Kenya Prisons Service, HIV prevalence among inmates is around 10 percent, higher than the national average of 7.8 percent. A 2004 study found that HIV and TB were the leading causes of preventable deaths in Kenya’s prisons.

This feature is used with permission from IRIN/PlusNewswww.plusnews.org

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