Ashutosh Bhardwaj, Indian Express Nov 12, 2012

A nationwide health survey in jails has found 80 of Chhattisgarh’s prisoners HIV-positive, out of 13,000-odd tested. Prison authorities insist that the inmates had probably arrived already infected, but health authorities don’t rule out the possibility that it was after being jailed that they got infected, with unsafe sex or drug use the likely causes.

This has turned into a contentious issue. The health authorities are contemplating distribution of condoms and syringes, but the jail authorities say there is no reason to do so. Their resistance comes apparently because allowing distribution of condoms would amount to an acceptance of the fact that homosexuality exists in jails.

The 80 found HIV-positive include women prisoners too. “This is the first instance of an ELISA test being conducted in jails anywhere in India. Figures for none of the other states are available,” said S K Binjhwar, additional project director, Chhattisgarh Aids Control Society.

“Of these 80 prisoners, 65 have a CD4 count less than 350. They are being given ART. So far we have tested only those we suspected to be from a high-risk group, but since the infection also spreads to others in jails we are expanding our sample size,” he said. “We counsel them about safe sex.”

The jail administration says the health authorities should focus on sources of infection beyond prisons. “Instead of focusing on jails, the health authorities should focus on red-light areas and drug addicts and on improving the health situation at village level, especially checking quacks who use old syringes. These are the major sources of spreading HIV infection,” said ADG (jail) Giridhari Nayak.

“A jail has a mobile population, like a train. People board at a station and get off at the next. Only a few remain till the final destination,” Nayak added. “Of the total HIV-positive inmates in Chhattisgarh jails, only 12 are convicts while the rest are undertrials; they keep getting released and new ones come in. The infection comes from outside; it is not spreading in jails.”

Dr K K Gupta, Raipur jailor, said that the possibility of homosexual behaviour in jails “is merely hypothetical”. Gupta said, “There is no question of distributing condoms or syringes as such activities are yet to be seen in jails.”

Homosexuality in jails has been discussed globally and opinions have been sharply divided. A California study notes that the rate of HIV prevalence among people who are incarcerated is nearly seven times higher than that of the general population. San Francisco jail authorities installed a condom-vending machine on their premises after HIV infection was found to be rapidly spreading in the area in the 1990s.

In Chhattisgarh, the project began in March 2011, when the state AIDS control soc