HIV Prevalence and Associated Risk Factors among Prisoners in South Indian States: Evidence from HIV Sentinel Surveillance 2019-2020.

Background: Prisoners are considered a high-risk group for HIV, and global data suggest a higher HIV prevalence among prisoners. HIV Sentinel Surveillance (HSS) was initiated as a biennial activity among prisoners in India in 2019 to monitor HIV prevalence levels and trends in Indian prisons.

Objectives: The aim is to estimate the prevalence of HIV and syphilis and to assess the associated HIV risk behaviors among prisoners in South India.

Materials and methods: HSS was a cross-sectional study design conducted in 12 central prisons across six southern states with a sample size of 400 for 3 months in 2019. Male prisoners aged 18 years and above were recruited through simple random sampling. Sociodemographic and behavioral data were collected, and HIV and syphilis testing was done.

Results: A total of 4717 prisoners were included, and overall HIV prevalence was 1.1%, with higher prevalence in Telangana (3%) and Andhra Pradesh (1.9%). Marital status ever had sex in their lifetime, and syphilis positivity was significantly associated with higher HIV prevalence. More than 50% of the prisoners were never tested for HIV. About 1% ( n = 45) were injecting drug users, 81.5% had a regular female partner, and only 15% reported condom usage during their last sex.

Conclusion: Higher HIV prevalence than the general population was observed. A significant proportion of the prisoners exhibited HIV risk behaviors and a major gap in availing of HIV testing and treatment services exists. The findings emphasize the urgent need to intensify HIV testing and IEC to facilitate impactful behavioral change communication.