The effectiveness of a peer-led HIV/AIDS and STI health education intervention for prison inmates in South Africa.

This article reports on the effectiveness of the first systematically developed health education intervention for the reduction of risky sexual behavior among soon-to-be-released prisoners in South Africa. Data from three out of four prisons are eligible for data analysis including 263 inmates. Using a nested experimental design, short-term evaluation while inmates were still in prison demonstrate that experimental groups showed higher knowledge of sexually transmitted infections and had a more positive intention to reduce risky behavior than the control group in two out of three prisons. Long-term assessment 3 to 6 months after release from prison indicates that experimental groups were more positive about sexual communication, self-efficacy, and intention. Groups educated by an HIV-negative educator perform marginally better than those in groups with an HIV-positive peer educator. It is argued that peer-led health education programs may be effective in reducing risky behavior amongst soon-to-be-released inmates.

Social construction and cultural meanings of STI/HIV-related terminology among Nguni-speaking inmates and warders in four South African correctional facilities.

Cultural sensitivity is increasingly recognized as a means to enhance the effectiveness of health promotion programmes all over the world. Sociocultural meanings and terminology of diseases are important in understanding how different groups perceive and interpret illness. This study was conducted as part of the process of developing and adapting a sexually transmitted infection (STI)/HIV peer led health education intervention for soon-to-be-released inmates who were predominantly Nguni speakers in South Africa. Two focus group discussions (FGDs) were conducted with prison inmates in each of four facilities. Additionally, one FGD was conducted in each prison with non-health trained (custodial) personnel who were Nguni speakers from the same community (n = 27). The data revealed unique terminology and meanings attached to several biomedically defined STIs. These sociocultural constructions were not limited to inmates as findings from warders' discussions showed a similar pattern. Moreover, we found the existence of a number of traditional 'folk' STIs and culture-specific prevention methods. These conceptualizations influence reported health-care-seeking behaviour, where dual consultation of traditional healers and biomedical remedies is widely practiced. The research has biopsychological as well as cultural implications for the development and adaptation of contextually relevant health promotion interventions.

Lifetime occurrence of sexually transmitted infection (STI) and substance use risk among prerelease South African prison inmates.

The current study examined self-reported history of STI and substance use risk behaviors in a sample of South African prison inmates. Participants were 344 inmates from four prisons in the provinces of KwaZulu-Natal and Mpumalanga. Significance tests were conducted using univariate logistic regressions to examine the independent associations of Lifetime occurrence of a Sexual Transmitted Infection and dichotomized correlates of substance use risk behavior. Findings showed that inmates in Mpumalanga (OR 1.43; 95% CI 0.90, 2.23) had a greater risk for STIs than inmates in KwaZulu-Natal (KZN) (OR 1.11; 95% CI 0.88, 1.37). Moreover, past experience using injection drugs (OR 2.34; 95% CI 0.62, 8.88), experience of needle sharing (OR 2.13; 95% CI 0.55, 8.27), and drug/alcohol use leading to problems at school or work were the strongest indicators for inmates having a lifetime STI.