title: Injecting drug use, sexual risk, HIV knowledge and harm reduction uptake in a large prison in Bali, Indonesia.
abstract: OBJECTIVE
  The purpose of this paper is to describe HIV-related risk behavior and knowledge of HIV among inmates of Kerobokan prison Bali, Indonesia.
  
  
  METHODS
  A cross-sectional survey of inmates of using a structured questionnaire and sample framework to reflect narcotic use among inmates and the prison gender mix.
  
  
  RESULTS
  Among 230 inmates recruited to the study self-reported prevalence of injecting drug use was 7.4 percent (95 percent CI 4.0-10.8 percent). Respondents who participated in a prison based methadone treatment program were all still injecting drugs, these made up 13/17 of the IDU. In total, 47 percent (95 percent CIs 45-55 percent) of respondents who reported injecting also reported sharing needles within the last week. Sexual intercourse while in prison was reported by 3.0 percent (95 percent CI 0.82-5.26 percent) of study respondents. One-third of non-injectors were unaware of the preventative role of condom use. This study suggests that despite harm reduction initiatives within Kerobokan prison HIV risk behavior continues and there is a considerable lack of awareness of the importance of condom use in preventing HIV.
  
  
  CONCLUSIONS
  The authors relied on self-reported risk behavior that may be subject to reporting bias. The sampling strategy may not reflect the true ratio inmates using or not using narcotics.
  
  
  CONCLUSIONS
  The current harm reduction approach, including methadone substitution treatment should be optimized within the Indonesian prison setting.
  
  
  CONCLUSIONS
  This is the first study reporting HIV-related risk behavior from an Indonesian prison with an established methadone substitution program.
authors.affiliation: Department of Community and Preventive Medicine, Udayana University Bali, Denpasar, Indonesia.
authors.forename: Anak Agung Sagung
authors.initials: AA
authors.lastname: Sawitri
authors.forename: Anak Agung Gede
authors.initials: AA
authors.lastname: Hartawan
authors.forename: Noel
authors.initials: N
authors.lastname: Craine
authors.forename: Ayu Kartika
authors.initials: AK
authors.lastname: Sari
authors.forename: Ni Wayan
authors.initials: NW
authors.lastname: Septarini
authors.forename: Dewa Nyoman
authors.initials: DN
authors.lastname: Wirawan
mesh_terms: D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D040261:Harm Reduction; D006801:Humans; D007214:Indonesia / Q000453:epidemiology; D007407:Interviews as Topic; D008297:Male; D016485:Needle Sharing; D011330:Prisons; D036301:Qualitative Research; D012309:Risk-Taking; D057566:Self Report; D012725:Sexual Behavior; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*
keywords: HIV; Harm reduction; Health in prison; Injecting drug use; Offender health; Public health