Behind prison walls: HIV vulnerability of female Filipino prisoners

• Published date: 29 August 2019
• DOI: https://doi.org/10.1108/IJPH-12-2017-0060
• Pages: 232-243
• Date: 29 August 2019
• Author: Diana M. Palma,Jennifer Parr
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Behind prison walls: HIV vulnerability of

female Filipino prisoners

Diana M. Palma and Jennifer Parr

Abstract

Purpose –The imprisoned population is increasing worldwide and is overrepresented in the HIV epidemic.

The purpose of this paper is to explore the HIV vulnerability of female Filipinos who are pre-trial prisoners, as

the specific needs of imprisoned women are poorly understood and fewer resources are granted to pre-trial

detainees, especially in low and middle-income countries (LMICs).

Design/methodology/approach –This study was based on a Qualitative Descriptive Design. In total,

18 semi-structured interviews were conducted with prisoners and NGO directors. Data were analysed through

Framework Analysis, using the individual, social and community categories of the Modified Socio-Ecological Model.

Findings –Results from this study suggest that the prison environment and management practices

maximise the HIV vulnerability in the sample. This vulnerability is shaped by low HIV knowledge, combined

with the existence of multiple social vulnerabilities prior to incarceration.

Social implications –HIV care in Filipino prisons needs urgent attention from government and international

organisations, as it is a major public health and human rights concern. International goals of ending the

epidemic by 2030 cannot be reached if efforts are not translated into action within this setting.

Originality/value –In the Philippines, few studies have addressed this issue and little is known about the

conditions of Filipino prisons. This paper aims to fill a gap in literature regarding the vulnerability of imprisoned

women in LMICs, which is even more limited in examining pre-trial detention.

Keywords Women prisoners, Human rights, Prison, HIV/AIDS, Sexual health, Key populations

Paper type Research paper

Introduction

Around 10.2m people are incarcerated globally, of which 3.8m live with HIV (Dolan et al., 2016).

The prevalence of HIV in people living in closed settings is two to ten times higher than in the

general population. In total, 30m people move in and out of prison annually, which represents a

major public health concern (WHO, 2016).

In the Philippines, HIV prevalence among the general population is less than 1 per cent, but the

awareness, access to testing and availability of accurate epidemiological data are questionable

(Lucea et al., 2012, 2013). Between 2010 and 2015, there was a 52 per cent increase in new

infections(Human Rights Watch, HRW, 2016) that disproportionally affectedhigh-risk populations,

such as female sex workers (FSW), representing 62 per cent of all cases (Department of Health,

DOH, 2016). Despite sex work being illegal in the country, it is commonly practiced and only 30

per cent of theFSW have access to testing (UNWOMEN,2013). Whilst the countryseems to be at

the edge of a major epidemic (Farr and Wilson, 2010), HIV is understudied and interventions are

hindered by the insurgence of strong religious beliefs and low political engagement (HRW, 2016).

In 2017, 178,661 people were imprisoned in the Philippines, of which 74.4 per cent were in

pre-trial detention (Institute for Criminal Policy Research, ICPR, 2017). However, the figures of

HIV-positive prisoners are unreported and the government has stated that prisoners are not a

prioritised population for HIV prevention services (Philippines AIDS Council, 2014).

In South-East Asia, female prisoners have a higher rate of HIV than males (Dolan et al., 2016).

Between 2001 and 2012, the number of female prisoners increased by 200 per cent in the

Received 14 December 2017

Revised 27 May 2018

20 August 2018

6 October 2018

Accepted 11 October 2018

The authors thank every woman

who participated in this study for

sharing their stories, including the

NGO directors who were open to

tell about their work experience in

the Philippines. The authors want

to express wholehearted gratitude

to the leader of the host

organisation for believing in the

social and practical relevance of

this research and for providing a

welcoming environment for

conducting fieldwork. The authors

also acknowledge the amazing job

performed by the translator who

worked with the same enthusiasm

as the authors did to retrieve

the data.

Diana M. Palma and Jennifer

Parr are both based at the

Nuffield Centre for International

Health and Development,

Leeds Institute of Health

Sciences, University of Leeds,

Leeds, UK.

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INTERNATIONALJOURNAL OF PRISONER HEALTH

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VOL. 15 NO. 3 2019, pp. 232-243, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-12-2017-0060