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A Rapid Situation Assessment of HIV/STI/TB and Drug Abuse Among Prisoners in Uganda Prisons Service

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A Rapid Situation Assessment of HIV/STI/TB and Drug Abuse Among Prisoners in Uganda Prisons Service The Republic of Uganda UPS/UNODC RSA 2008 A Rapid Situation Assessment of HIV/STI/TB and Drug Abuse among Prisoners in Uganda Prisons Service Final Report Uganda Prisons Service United Nations Office on Drugs and Crime PEM Consultancy P .O. Box 9000 Kampala. Uganda [email protected] March 2009 A Rapid Situation Assessment of HIV/STI/TB and Drug Abuse among prisoners in Uganda Prisons Service A Report submitted to UPS – Kampala Uganda And UNODC ROEA-Kenya Nairobi i Assessment Team Principal Investigators Roles Institution Dr Jim Arinaitwe Principal Investigator Director PEM Consultancy, a subsidiary of Capacity Systems Link (U) Ltd Dr Nazarius Mbona Tumwesigye Co-Principal investigator Makerere University School of Public Health-Uganda Co-Investigators Mrs Mary Kaddu Co-investigator Independent Consultant Dr Michael Kyomya Co-Investigator/Study UPS Administrator Dr Michael Nswemu Kaggwa Under Study Team UPS Ms Evelyn Akello Under Study Team UPS Laboratory Staff Mr Perez Mutebi Research Assistant Data Collectors Dr Joseph Andama Research Assistant Dr Alex Kakoraki Research Assistant Mr Elly Mutegeki Research Assistant Mrs Kettie Bagamba Research Assistant Mrs Rose Mugisha Research Assistant Ms Teddy Namakula Research Assistant Mr. Joshua Oluka Research Assistant Ms. Rhoda Bukanza Research Assistant Ms Florence Nabatanzi Research Assistant Ms Sarah Kyazze Research Assistant Ms Beatrice Ocom Research Assistant Mrs Margaret Odongwen Research Assistant Mrs Palia Amayo Research Assistant Mrs Justine Ariko Research Assistant Advisors Dr Denson Nyabwana Assistant Commissioner UPS Health Dr Reychad Abdool Regional HIV/AIDS UNODC ROEA-Kenya Adviser Mrs. Jane- Marie On’golo National Programme UNODC ROEA- Kenya Manager Mr David Katuntu Technical Assistant CDC –Uganda Oversight Dr Johnson Byabashaija Overall Supervisor Commissioner General –UPS ii Acknowledgement PEM Consultancy would like to first and foremost extend her gratitude to the Commissioner General of Prisons for his foresightedness. His efforts to seek funding from United Nations Office on Drugs and Crime (UNODC) are well acknowledged. The political and administrative support provided by the Commissioner General of Prisons throughout the whole process of designing, implementation and final report writing made this assessment a reality. His involvement is an indication of how this valuable information will be utilized to inform advocacy, policy and programmatic interventions to scale up HIV/STI/TB and Drug abuse response in Uganda Prisons Service. We acknowledge the positive reception by UNODC which enabled the implementation of a nationwide assessment. This would have been out of reach under the Uganda Prisons Service budget. We would also like to acknowledge the participation of WHO, UNFPA, UNAIDS, CDC and ICRC in the protocol development process. Their contributions enabled the contents and format of the protocol to meet the standards as required by the National Council for Science and Technology. The technical input from these partners helped shape the final assessment report. Last but not least PEM Consultancy is very grateful to the inmates and staff of the Uganda Prison Services for their precious time they took off from their schedules to answer the questions in the study. Without their cooperation the study would not have succeeded. iii Table of contents Acronyms.......................................................................................................................... vii Executive Summary.........................................................................................................viii 1.0 INTRODUCTION .................................................................................................. 1 1.1 Background............................................................................................................. 1 1.2 Uganda Prisons Service (UPS) ............................................................................... 2 1.3 Justification............................................................................................................. 3 1.4 Overall Objective.................................................................................................... 3 1.4.1 Specific Objectives......................................................................................... 3 2.0 METHODOLOGY ................................................................................................. 4 2.1 Study design and data collection techniques. ......................................................... 4 2.2 Study area and population....................................................................................... 4 2.3 The RSA Team. ...................................................................................................... 4 2.4 Sample size determination and sampling methods. ................................................ 5 2.4.1 Sample size determination .............................................................................. 5 2.4.2 Sampling methods........................................................................................... 5 2.5 Community mobilization for the study................................................................... 8 2.6 Interview Process.................................................................................................... 8 2.7 Standard Operating Procedure for collection and handling of specimens.............. 8 2.7.1 Blood specimen for HIV and syphilis testing................................................. 8 2.7.2 Sputum specimen for Mycobacterium tuberculosis testing.......................... 10 2.8 Data Management and Analysis ........................................................................... 10 2.9 Ethical considerations........................................................................................... 10 2.10 Study Limitations.................................................................................................. 11 3.0 RESULTS ............................................................................................................. 12 3.1 Characteristics of respondents .............................................................................. 12 3.2 Prevalence of HIV, syphilis and tuberculosis....................................................... 14 3.2.1 Prevalence of HIV......................................................................................... 14 3.2.2 Prevalence of syphilis................................................................................... 14 3.2.3 Prevalence of Tuberculosis........................................................................... 17 3.2.4 Drug abuse in Uganda Prisons...................................................................... 17 3.3 Knowledge, Attitude, Practices and Behaviour .................................................... 18 3.3 Knowledge, Attitude, Practices and Behaviour .................................................... 19 3.3.1 Knowledge about HIV/AIDS........................................................................ 19 3.3.2 Attitudes relating to HIV/AIDS.................................................................... 23 3.3.3 HIV/AIDS related behaviour and practices .................................................. 23 3.3.4 Knowledge about STI ................................................................................... 25 3.3.5 Knowledge about Tuberculosis (TB)............................................................ 25 3.4 Status of HIV/STI/TB/Drug abuse prevention and care services. ........................ 28 3.4.1 Prisons AIDS Control Programme (PACP).................................................. 28 3.4.2 Prisons Health Service (PHS) ....................................................................... 29 3.4.3 Status of essential preventive, care and social services ................................ 36 3.4.5 Prison Specific Factors ................................................................................. 38 4.0 DISCUSSION....................................................................................................... 40 5.0 CONCLUSION..................................................................................................... 43 6.0 RECOMMENDATIONS and ACTION POINTS................................................ 43 7.0 REFERENCES: .................................................................................................... 45 iv 8.0 APPENDICES ...................................................................................................... 47 Appendix 1: Terms of Reference...................................................................................... 47 Appendix 2: Task Force.................................................................................................... 50 Appendix 2: Task Force.................................................................................................... 50 Appendix 3: Questionnaire ............................................................................................... 51 Appendix 4: FGD and KII guide ...................................................................................... 70 Appendix 5: Checklist....................................................................................................... 72 v List of Tables Table 1: Distribution of sample size by region, prison unit and gender............................. 7 Table 2: Respondents by background characteristics by sex...........................................
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