HIV Seroprevalence and Associated Factors among Inmates in Bamenda Central Prison: A Cross-Sectional Study in the Northwest Region (NWR) Amidst the Socio-political Crisis

Introduction: People in prison have multiple vulnerabilities to Human immunodeficiency virus (HIV) and other infections. Although the number of HIV infections has decreased worldwide, this trend is high in closed settings like prisons, making the HIV pandemic a major global health problem.

Aims: The drive of this study is to determine the prevalence of HIV and related risk behaviours among inmates of the Bamenda Central Prisons.

Study Design: The study included inmates of all age groups, both male and female. Blood samples were used to determine the presence of HIV. Open-close, pre-tested questionnaires were administered to identify the risk factors associated with the infection.

Place and Duration of Study: The study was carried out in the Bamenda Central Prison located in the Bamenda I sub-division in the Northwest Region from April to July 2023.

Methodology: A total of 289 inmates of both sexes with an age range of 14-69 years took part in the study. Venous blood samples were collected to determine the prevalence of HIV, and pre-tested questionnaires were used to identify the risk factors. Data were analyzed using Statistical Product and Service Solutions. The Chi-square test was used for comparison of proportions and logistic regression were used to determine the risk factors. Variables with a p-value of <0.05 were considered statistically significant.

Results: HIV prevalence was 9.3% (27/289). A multivariate logistic regression analysis revealed that the risk factor associated with HIV status was age group > 20years (adjusted odds ratio (AOR) =0.14; 95% CI: 0.000- 0.589: p=0.025 for 20-30 years and AOR =0.16; 95% CI: 0.25- 0.589: p = 0.032 for inmates >30 years), married inmates (AOR = 0.014; 95% CI; 0.000- 0. 756: p= 0.033), inmates who were less than 5 in a room (AOR = 0.022; 95% CI: 0.002- 0.356: p= 0.003) and sexually active inmates (p<0.05). The risk of acquiring HIV was also common among inmates imprisoned because of sex-related crimes (AOR= 31.91; 95% CI: 1.751- 581.620: p=0.19) and in those who did their previous test > 6 months ago (AOR = 348; 95% CI; 45.7- 2714.28: p= 0.000 for 6-12months and AOR = 211.9 95% CI; 12.6-3567.466: p= 0.000 for > 1year.

Conclusions: A higher prevalence of 9.3% recommends urgent exposure-control measures such as routine screening at the time of entry, periodic screening of all inmates, and treatment of positive cases. The risk factors identified are areas of interventions for HIV prevention addressed not only in prisons but also in the community at large that the inmates will meet upon their release.