High prevalence of sexually transmitted and blood-borne infections amongst the inmates of a district jail in Northern India

Abstract

Two hundred and forty male and 9 female jail inmates confined for various crimes in a district jail near Delhi were screened for sexually transmitted and blood-borne diseases including HIV, syphilis and hepatitis B and C viral infections, skin diseases etc. The inmates were aged 15-50 years with a mean of 24.8+/-0.11. Their alleged criminal background, period of stay in the jail, drug addiction, education, birth place, marital status, sexual activity, and clinical complaints were recorded by an anonymous questionnaire. Serum samples were tested for antibodies against HIV (1+2), hepatitis C (HCV), Treponema pallidum and for hepatitis B surface antigen (HBsAg). Sputum examination was done for acid-fast bacilli. Out of the 240 men, 115 were married and 125 unmarried. One hundred and eighty-four (76.6%) men gave history of penetrative sex. Of the 184, 53 (28.8%) were homosexuals or bisexuals and 131 (71.2%) had sex with women only. Sixty of the 131 (45.8%) were faithful to their partners while 124 gave a history of having multiple sexual partners and 100 of them (80.6%) had unprotected sex. Eighty-three of these 100 also had had sex with commercial sex workers (CSWs). One hundred and twenty-six were addicted for alcohol, 44 for smack/charas and 8 had a history of intravenous drug abuse. One hundred and seventy-four were not aware of AIDS. On examination 28 of the 240 (11.6%) had active hepatitis with or without a history of jaundice in the last 2 years, 25 (10.4%) active pulmonary tuberculosis (TB) and 11 (4.6%) had syphilitic ulcers on the penis. Four-fifths of the teenagers confined to a particular barrack had moderate to severe scabies. Three males (1.3%) were found to be Western blot confirmed HIV-1 positive while 28 (11.1%) men and 2 (22.2%) women were positive for HBsAg. Twelve (5.0%) men but no women, were found to be positive for anti-HCV antibodies. Out of the 3 HIV-positive persons, one was an intravenous drug user (IVDU), second was a drug addict and frequent CSW visitor while the third was a homosexual. This pilot study gives an indication that sexually transmitted and blood-borne infections are highly prevalent in jail premises and pose a threat of rapid spread of these infections through IVDU and homosexuality.

PIP: This is a study conducted to establish the seroprevalence rate of sexually transmitted and blood-borne infections among district jail inmates in Northern India. The subjects (240 males and 9 female inmates), aged 15-50 years, were asked to answer a questionnaire comprising their background characteristics, alleged criminal background, period of confinement in jail, sexual activity, and sexual partners. Any history of blood transfusion, injury, injecting drug use and drug addiction were also noted together with the level of AIDS awareness . Out of the 240 men, 115 were married and 125 were unmarried. Serum samples were obtained from these inmates and were tested for antibodies against HIV (1+2), hepatitis C virus (HCV), Treponema pallidum, and hepatitis B surface antigen (HBsAg). The results indicated that 76.6% gave a history of penetrative sex with their wives or other females including casual sex partners and commercial sex workers (CSWs). 71.2% had had sex only with women, while 28.8% were homosexual or bisexual. Out of 131, 60 (45.8%) had been faithful to their partners, while 124 had experienced multiple sexual partners and 80.6% had had unprotected sex. Of the 100 who had had unprotected sex, 83 did so with CSWs. 126 inmates (52.75%) were addicted to alcohol, 44 (18.33%) to smack/charas, and 8 (3.33%) used intravenous drugs. On examination, 11.6% had active hepatitis, 10.4% with active pulmonary tuberculosis, 4.6% had syphilitic ulcers on the penis, and four-fifths of the teenagers had moderate to severe scabies. 1.3% of the subjects were HIV-1 positive, while 11.1% men and 22.2% women were positive for HBsAg. These results indicate a high prevalence of sexually transmitted and blood-borne infections in the studied area.