Injecting drug use, sexual risk, HIV knowledge and harm reduction uptake in a large prison in Bali, Indonesia

• Published in: International journal of prisoner health 2016-01, Vol.12 (1), p.27-38
• Main Authors: Sawitri, Anak Agung Sagung, Hartawan, Anak Agung Gede, Craine, Noel, Sari, Ayu Kartika, Septarini, Ni Wayan, Wirawan, Dewa Nyoman
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adult; AIDS; Bias; Criminology & forensic psychology; Cross-Sectional Studies; Drug abuse; Drug use; Female; Harm Reduction; Health & social care; Health risks; HIV; Human immunodeficiency virus; Humans; Indonesia - epidemiology; Interviews as Topic; Male; Methadone; Narcotics; Needle Sharing; Needles; Pine needles; Prisoner health; Prisoners; Prisons; Qualitative Research; Questionnaires; Reduction; Risk; Risk behavior; Risk reduction; Risk taking; Sampling; Self Report; Sexual Behavior; Sexual intercourse; Sexually transmitted diseases; STD; Substance Abuse, Intravenous - epidemiology; Substitutes; Treatment programs; Uptake
• ISSN: 1744-9200; 1744-9219
• DOI: 10.1108/IJPH-05-2014-0011

Purpose – The purpose of this paper is to describe HIV-related risk behavior and knowledge of HIV among inmates of Kerobokan prison Bali, Indonesia. Design/methodology/approach – A cross-sectional survey of inmates of using a structured questionnaire and sample framework to reflect narcotic use among inmates and the prison gender mix. Findings – Among 230 inmates recruited to the study self-reported prevalence of injecting drug use was 7.4 percent (95 percent CI 4.0-10.8percent). Respondents who participated in a prison based methadone treatment program were all still injecting drugs, these made up 13/17 of the IDU. In total, 47 percent (95 percent CIs 45-55 percent) of respondents who reported injecting also reported sharing needles within the last week. Sexual intercourse while in prison was reported by 3.0 percent (95 percent CI 0.82-5.26 percent) of study respondents. One-third of non-injectors were unaware of the preventative role of condom use. This study suggests that despite harm reduction initiatives within Kerobokan prison HIV risk behavior continues and there is a considerable lack of awareness of the importance of condom use in preventing HIV. Research limitations/implications – The authors relied on self-reported risk behavior that may be subject to reporting bias. The sampling strategy may not reflect the true ratio inmates using or not using narcotics. Practical implications – The current harm reduction approach, including methadone substitution treatment should be optimized within the Indonesian prison setting. Originality/value – This is the first study reporting HIV-related risk behavior from an Indonesian prison with an established methadone substitution program.