title: Sex, violence and HIV on the inside: cultures of violence, denial, gender inequality and homophobia negatively influence the health outcomes of those in closed settings.
abstract: To map the context of HIV in closed settings in Papua New Guinea (PNG), semi-structured interviews were undertaken with 56 prisoners and detainees and 60 key stakeholders. The nature of HIV-related risk differs for detained women and men, and reflects important gender-based issues present in PNG society more broadly. Women in detention are vulnerable to sexual violence and exploitation and at greatest risk of HIV while detained in police holding cells, where they are typically supervised by male officers, in contrast to prisons, where they have little contact with male staff. HIV risk for men in prison is associated with consensual and non-consensual sex; this risk is perpetuated by a pervasive culture of denial and institutionalised homophobia. The illegal nature of sodomy and male-to-male sex provides Correctional Services the legal grounds by which to refuse access to condoms for prisoners. Addressing HIV risk among detained men and women in PNG requires the reform of legislation, police and prison practices and an understanding of broader structural problems of gender-based violence and stigma and discrimination.
authors: a School of Public Health and Community Medicine, UNSW Australia , Sydney , Australia.
authors: Angela
authors: A
authors: Kelly-Hanku
authors: Thomas
authors: T
authors: Kawage
authors: Andrew
authors: A
authors: Vallely
authors: Agnes
authors: A
authors: Mek
authors: Bradley
authors: B
authors: Mathers
mesh_terms: D000328:Adult; D005260:Female; D063509:Homophobia / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D008875:Middle Aged; D010219:Papua New Guinea; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons / Q000706:statistics & numerical data; D011902:Rape / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012742:Sex Offenses / Q000706:statistics & numerical data*; D019529:Sexuality / Q000706:statistics & numerical data; D014754:Violence / Q000706:statistics & numerical data*; D035862:Vulnerable Populations / Q000706:statistics & numerical data*; D055815:Young Adult
keywords: HIV; Papua New Guinea; closed settings; condoms; prison; sexual violence