A rights-based approach to fighting HIV/AIDS in Ugandan prisons

Over at Global Pulse, Human Rights Watch researcher Katherine Todrys guest blogs on the HIV epidemic in Uganda’s penitentiaries. Uganda, she explains, has often been presented as a success story in the global fight against HIV/AIDS, and has received over $1 billion from the US for AIDS programs. Many HIV-positive Ugandans have been excluded from these efforts, though, including gay men, drug users, sex workers, and prisoners.

In sub-Saharan African prisons, the prevalence of HIV ranges from twice as high to fifty times as high as levels for the non-imprisoned in the same regions. As part of her research on prison health monitoring for a new Human Rights Watch report, Todrys toured 16 Ugandan prisons and interviewed 164 inmates. Overcrowding, poor ventilation, sex trading, and lack of condoms led to increased infections. Yet despite high rates of transmission, only one of the 223 prisons in Uganda has a medical facility equipped to provide adequate treatment for HIV/AIDS and tuberculosis. Only one-tenth of one percent of PEPFAR funds to Uganda are directed towards prison health.

According to Todrys, “There is a better approach: fund human rights-based approaches, which emphasize government accountability and evidence-based programs—that is, programs that have been shown to work. Pressuring the Ugandan government to end abusive practices that increase HIV transmission, for example, costs very little compared with treating HIV after infection has occurred.”

The abuses that must be addressed include the slow-moving criminal justice system that leads to overcrowding in prisons, the criminalization of men having sex with other men, which leaves all-male prisons devoid of condoms, and forced labor in prisons that worsen the health of those suffering from HIV/AIDS. Ugandan HIV programs must be scaled up to address the massive HIV epidemic in prisons, and Todrys insists that a rights-based approach is the only way to reach this marginalized population.