On Language And How The Uganda Prisons Service Report 2018 Is Useful

The Observer, a Ugandan Daily, on June 27, 2018 started off with a statement "One of the risk factors exposing people to HIV in Ugandan prisons is homosexuality between inmates and staff, the prisons boss has said." The commissioner of Uganda Prisons Services Byabashaija made this revelation last week, during a breakfast meeting on the Presidential Fast-Track Initiative (PFTI) on ending HIV/AIDS, as a public health threat in Uganda by 2030. It drew commentaries. 

A corrosive language was used by a side that maintains denigration, ridicule and attributions of negative association. This scares away those who have solutions as well as fuels contexts within which a small problem becomes bigger. 

We should not dismiss the following facts: 

• Dr James Kisambu the Assistant Commissioner for Health Services, Uganda Prisons Service said, about 4,700 inmates are HIV positive from all prisons within the country. Most of these prisoners come when they are HIV positive because they are arrested from high risk behaving areas, where they drink a lot, buy prostitutes, rob and when they involve in homosexuality, they spread the disease.

• Dr. James Kisambu also said HIV-associated infections like Hepatitis B are at 7 per cent for inmates and 6 per cent prisons staff. Malaria prevalence is at 4.6 percent and staff at 4 per cent. Syphilis prevalence amongst prisoners is at 4 percent, of which women are more infected, while the staff prisons are at 1.2 per cent.
• A total of 1,280 (14.4 per cent) prisoners were diagnosed with tuberculosis (TB) due to congestion in prisons.
• According to the Uganda Population-Based HIV Impact Assessment (UPHIA) report of 2016, about 1.3 million Ugandans are HIV positive and out of these at least one million are on ART.

For more read: Gay sex between prisons staff shocks Byabashaija

One camp maintains this as plain homosexuality and here most people freeze. We should not freeze. There are those in the public health arena who because they want an end to HIV break it down to events or phases of penile-anal sexual intercourse. To them, it is these events that should be interrogated further. Whether they happen among male-female, female-female (when they use dildos) and in male-male persons is what should be identified. Further questions should be around consent, use of protection, negotiated safer sex agreements, past history of STIs, comorbidity with other infections or diseases. Let us agree to join as one front not to allow HIV transmission among the incarcerated community. 

We ned to applaud the fact that the Uganda Prison Services has provided a report. We may fight over how the t's are crossed and i's are dotted, we may be aghast about homosexuality. That should not blind us from the fact that HIV transmission takes place when we do not provide prevention prophylactics. Further to that, we do not want to set the stage for drug resistant HIV. Let us play the fiddle but also mid the fire burning all of us! 


One side cries: Sodomy, homosexuality, abomination, power dynamics, no consent, oppression, must be prosecuted.

Other side rebuts: unprotected penile-anal sex event or phase, risk factor for HIV transmission, vulnerability to drug resistant HIV transmission, exposure to other STIs. Let us hear both sides with the goal of deciding to fight HIV.

There are lessons we can pick from both sides. Let us treat those with HIV with an understanding that we want to end HIV in Uganda.

Inmates during a public debate. Source: Observer Daily Uganda