Title: Promoting sexual health and accessible HIV Prevention, Treatment, Care and Support services for women prisoners in Zimbabwe and Malawi.
Funder: Medical Research Council

Abstract: The Sub Saharan African region remains at the epicentre of the HIV epidemic, with a continuing disproportionate level of HIV infected women and girls, and concentration of HIV among inmates in prisons. HIV prevalence among women prisoners is higher due to sub-standards in hygiene, limited access to sexual and reproductive (SRH) services, and interruption of the necessary services during incarceration. Adequate health services in prisons are mandated under the Sustainable Development Goals (SDG 3, 5, and 16), as well as under the United Nations Standard Minimum Rules for the Treatment of Prisoners (Nelson Mandela Rules), the Bangkok Rules for Female Prisoners and in the SSA region, where the partnership will take place, the Southern African Development Community Minimum Standards for HIV in Prisons. The rationale for this new partnership is grounded in the recent United Nations evaluation, which reported that current provisions for women in Zimbabwean and Malawian prison systems currently fall far short of mandated equivalence care standards. This unique partnership will challenge and address the SRH inequalities of women prisoners, who are a vulnerable HIV/AIDS population in Zimbabwe and Malawi. Both countries are compromised by a lack of robust gender sensitive monitoring systems for HIV/AIDs in prisons, and little strategic information available around women prisoner's experiences and needs. It will set the scene for a strong international collaborative effort to monitor, investigate, understand and promote women prisoner's human rights and SRH needs in Zimbabwe and Malawi. The issue of HIV/AIDS in prisons is both a human rights and public health issue, which requires a strategic approach to prevent HIV transmission and improve health for all, whilst at the same time ensuring the respect of human rights and dignity of those infected and requiring treatment. The partnership is interdisciplinary and inter sectoral, and brings together key partners from development, law, gender and human rights, and the performing arts, in conjunction with public health and clinical disciplines. Its research, communication and policy reform activities sit within the global aim of leveraging the end of AIDS through working and collaborating in an interdisciplinary and multi-sectoral partnership (sustainable development goal, SDG 17). Understanding prison environmental cultures which shape prison staff and wardens' understanding and responsiveness to female prisoners' SRH needs in both countries is vital to inform policy change and improved standards for women prisoners and their children. In partnership with CSOs, the project activities will support expert and local knowledge sharing and build national and international collaboration to generate research interest, research capacity and expertise, and develop participatory theatre programmes used to disseminated HIV/AIDS and SRH messages. Local cultures are central to design and piloting in prisons. Participatory HIV communication using forum and image theatre have never been applied to women in the prison setting. Using theatre, women prisoners are both creators and spectators. This is central to communication of HIV and SRH messages to prisoners and staff, both within the public health and human rights domains. The partnership through its activities will foster health citizenship and a sense of belonging to a community of people whose citizenship has been devalued at two levels, namely that of gender, and that of incarceration. The partnership represents a form of international sustainable development work which will create a first step in both countries towards addressing female prisoner SRH disparity, and ensure that their views are utilized to contribute to reframing of gender sensitive and human rights based prison responses and prison health policies, and enhance their access to high-quality and stigma-free SRH and HIV prison services when needed.


Research activity codes: 3.1 PRIMARY PREVENTION INTERVENTIONS TO MODIFY BEHAVIOURS OR PROMOTE WELL-BEING;3.2 INTERVENTIONS TO ALTER PHYSICAL AND BIOLOGICAL ENVIRONMENTAL RISKS
Health categories: INFECTION