A sentence to a prison term to Lima's Lurigancho Penitentiary
represents many risks - including the possibility of contracting HIV
/ AIDS. In this particular prison, inmates are seven times more
likely to acquire an infection of HIV / AIDS than on the street.
In Peru there are places, such as prison, where the HIV virus is all
but walking freely. Since 2000, the aim of Médecins Sans Frontières
(MSF) in Lurigancho Penitentiary has been to combat the spread of all
sexually transmitted diseases (STDs), while treating other
However, in one of the most overpopulated prisons in Latin America,
where overpopulation has reached a staggering 7,016 men occupying a
space allotted for only 1,800, MSF activities would fail if not
adapted to the prison's unique infrastructure.
Nothing is easy in the prison, as the distribution of the limited
number of condoms to the prison population can be extremely
"In jail you pay for everything and a condom has an economical value
that can be scalped", explained Katelijn Deknoper, MSF's Project
Coordinator for Lurigancho Penitentiary since 2001.
On the third floor of the hospital, where the MSF doctors work with
Lurigancho Penitentiary's Health Department staff, pills are no
longer distributed in the cells. Instead the inmates are asked to
visit the consultation clinic. Unless directly monitored, the pills
are quickly converted into currency.
Even in the worst medical scenarios, inmates will continue to sell
their required medications for actual currency. Gonzalo Chavez, the
MSF epidemiologist of four months, said: "What is good is to be
close to the inmates and listen to them; We learn to understand them
and try to prevent these types of abuses within their population".
However this is easier said than done. MSF's long term objective of
complete intervention with the prison population often seems
"It is almost impossible to change the prison environment," said
Ketelijn Deknoper. "When security is the main priority for the
prison authorities, health is not one of the daily concerns of the
prisoners and risk situations like drugs, alcohol or lack of condoms
The majority of prisoners go for an MSF consultation only when they
are suffering from dire health conditions.
In Lurigancho Penitentiary's medical facilities, MSF treats 65 cases
of HIV/AIDS. However, the prison's seroprevalence index of 2.6
indicates that there are at least 180 possible carriers of the
HIV/AIDS in the facility.
"The problem is that in most of the cases the inmates are not
conscious of the high risk they are confronted with," said Deknoper.
"We are talking about people without medical coverage - even outside
the prison - so they are more susceptible to illnesses and they are
not thinking about taking care of themselves".
In addition, there is the social stigma related to both STDs and HIV.
MSF hosts information sessions to both inmates and prison officers
that raises awareness of sexually related issues. However the
challenge is the negative connotations within the prison population
associated with a simple visit to an MSF informational session.
An inmate's fear of visiting the clinic is the possibility of being
ostracized and shunned within the penitentiary's social structure.
"Inmates who act as liasons between MSF and the prison population can
visit the community clinic without fear of being labelled as having
an illness," explained Dr. Chavez. "We support them and they inform
us what is going on inside the cell blocks".
In addition, there is the social stigma related to both STDs and HIV. MSF hosts information sessions to both inmates and prison officers that raises awareness of sexually related issues. However the challenge is the negative connotations within the prison population associated with a simple visit to an MSF informational session. An inmate's fear of visiting the clinic is the possibility of being ostracized and shunned within the penitentiary's social structure.