Human Immunodeficiency Virus (HIV) and the Lived Experience of Male Inmates in Canadian Federal Penitentiaries: A Snapshot of the Ontario Region

Abstract

The HIV prevalence rate inside Canadian Federal Penitentiaries is estimated to be 7 times higher than the rate in the general Canadian population. Additionally, a survey of Correctional Service of Canada (CSC) HIV-positive inmates showed that over half were worried about HIV-related stigma while incarcerated. This study of HIV-positive current and former inmates, the first Canadian study of its kind, investigated participants’ lived experiences in and out of prison. Topics investigated include experiences of stigma and disclosure of HIV status during incarceration. This study consisted of semi-structured, in-person interviews. A total of 20 interviews were conducted with 10 currently incarcerated, 5 recently released HIV-positive males, 4 Peer Education Course (PEC) workers and 1 recently released HIV-negative male. Currently incarcerated participants were recruited through the health care departments of penitentiaries in the Ontario Region of CSC. Formerly incarcerated participants were recruited from social service organizations in Kingston, Ontario, that focus on working with PLWH and formerly incarcerated individuals. Participants reported experiencing or witnessing enacted, perceived and internalized stigma in and out of the prison environment. Experiences of enacted stigma ranged from verbal insults to being ostracized, threats of violence, and actual violent attacks. Variations in experiences of enacted stigma were explained by non- or limited disclosure based on fears of discrimination, as well as perceived standing in the prison hierarchy. Additionally, the majority of participants reported having experienced a variety of childhood traumas and feelings of poor self-worth and suicidal ideation. HIV-related stigma is a common experience of HIV-positive current and former inmates. Although there are HIV prevention programs including testing, bleach kits, condom distribution, and HIV treatment within CSC prisons, there are no reported programs that specifically target the reduction of HIV-related stigma. As a result, future research is needed to develop and evaluate possible avenues for intervention to prevent experiences of stigma for people living with HIV, both within and outside of the prison environment.