Prevalence and associated risk factors of HIV in prisons in Balochistan, Pakistan: a cross-sectional study

Muhammad Dawood Khan; Ahmad Wali; Razia Fatima; Aashifa Yaqoob; Shoaib Aziz

doi:10.12688/f1000research.16994.2

Prevalence and associated risk factors of HIV in prisons in Balochistan, Pakistan: a cross-sectional study

F1000Res. 2018 Nov 20:7:1821. doi: 10.12688/f1000research.16994.2. eCollection 2018.

Authors

Muhammad Dawood Khan¹, Ahmad Wali², Razia Fatima³, Aashifa Yaqoob³, Shoaib Aziz²

Affiliations

¹ Department of Health, Provincial AIDS Control Program, Quetta, Balochistan, 87300, Pakistan.
² Department of Health, Provincial TB Control Program, Quetta, Balochistan, 87300, Pakistan.
³ Ministry of National Health Services, Regulation and Coordination, National TB Control Program, Islamabad, Pakistan.

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.

Keywords: AIDS; HIV; Prison; prevalence; risk-factors..

Publication types

Research Support, Non-U.S. Gov't

Grants and funding

This research was conducted through the Structured Operational Research and Training Initiative (SORT IT), a global partnership led by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization (WHO/TDR). The training model is based on a course developed jointly by the International Union Against Tuberculosis and Lung Disease (The Union, Paris, France) and Médecins Sans Frontières (MSF, Geneva, Switzerland). The specific SORT IT programme that resulted in this publication was implemented by the National Tuberculosis Control Programme of Pakistan, through the support of the Global Fund to Fight AIDS, Tuberculosis and Malaria (The Global Fund, Geneva, Switzerland). The publication fee was covered by the Special Programme for Research and Training in Tropical Diseases at the World Health Organization (WHO/TDR).