HIV on the decline in Kerobokan

The number of inmates with HIV at Kerobokan Penitentiary has declined for three years running due to awareness campaigns and on-site programs for drug addicts, officials say.

One such scheme, the prison’s methadone maintenance treatment (MMT) program, targeted inmates who were active injecting drug users (IDUs) to stop the spread of HIV through needle-sharing, according to the prison’s chief physician, Anak Agung Ngurah Hartawan.

Under the program, injecting drug users were given methadone orally, producing a high similar to that of putauw, the low-grade heroin favored by the nation’s addicts.

“The harm reduction program introduced by the prison autho-rities has received strong support from the inmates — that’s the reason why the HIV rate has dropped to its present level,” Hartawan said.

Harm reduction programs were aimed at mitigating the spread of HIV and other contagious diseases among inmate drug users without necessarily curbing their addictions, he said.

The program included measures such as MMT and needle exchange programs (NEP), which gave IDUs clean needles in exchange for used needles.

According to a survey of 210 randomly selected prisoners, 4.3 percent of inmates in Kerobokan had HIV in 2010, down from 6.1 percent in both 2009 and 2008.

“This consistent drop suggests that we are starting to contain HIV transmission in the prison population,” Hartawan said.

HIV prevalence peaked in 2004 when the annual survey said 40 inmates tested positive for the disease.

“The results of that survey were a wake-up call for local officials on the terrifying speed of HIV transmission in the prison population as well as to the fact that active drug users continued their dangerous habit of needle sharing while they were incarcerated,” he said.

In response, Kerobokan launched its MMT program in 2005, one among the nation’s first prison-based harm reduction initiatives.

More than 200 inmates were enrolled in the MMT program as of February.

“Methadone is a great help for me in coping with drug withdrawal,” Dayu Rupini, an MMT participant, said.

Rupini, a former NGO activist sent to Kerobokan for drug possession, previously participated in an MMT program outside prison.

“I abandoned the therapy when I began using crystal methamphetamine,” she said.

“This prison-based MMT program is very important for inmates who want to piece their lives back together again,” Rupini added.

Kerobokan, which was designed to hold 323 inmates, presently houses 1,001 convicts.

“The overcrowded prison presents us with an increasing challenge in implementing harm reduction programs,” Hartawan said.