South Africa has acknowledged that it has a serious HIV/AIDS problem. The country has the largest number of HIV-positive people in the world, and the number will likely keep rising. After huge pressure from civil society, the government is beginning to tackle the problem with policies backed by science and common sense. Yet prisoners serving time and those awaiting trial remain incredibly vulnerable to the spread of HIV, with little being done to protect one of society’s most susceptible groups to disease.

Part of the problem is that the statistics regarding the number of HIV-positive inmates are unknown. The Department of Correctional Services (DCS) originally estimated the figure to be three percent. Yet, K.C. Goyer, a researcher with the Institute for Security Studies, currently places the figure at a little over 40 percent, while Inspecting Judge of Prisons Johannes Fagan suggested that the figure could be as high as 60 percent. The DCS has subsequently admitted that its initial estimate was too low.

There exists only one instance of independent research regarding HIV prevalence in South African prisons. The research was done in Midlands Medical B, a prison in the province of KwaZulu-Natal, an area with a very high HIV infection rate among the general population. The report has been withheld by the DCS because of fears that it might be used as an indicator of figures for the prison system as a whole. This basic lack of knowledge is a key problem facing those looking to fight the problem.

Whatever the actual rate of infection, it is undeniable that AIDS is having an impact on the prison population in South Africa. Goyer’s research revealed a 750 percent increase in the number of natural deaths in South African prisons since 1995. Of these, 90 percent to 95 percent are attributed to diseases often associated with the weakened immune system that AIDS produces; Goyer’s figure of the role of AIDS in prison deaths is further supported by a study of postmortem reports carried out in 1995 that placed the number of prison deaths from similar diseases also at 90 percent. Additionally, Fagan’s report showed a record number of natural deaths in prisons, with 1,169 in 2001, an increase over 600 percent from 186 in 1995.

The South African justice system releases and takes on approximately 25,000 prisoners every month. This emphasizes the fact that the problem of AIDS in South African prisons cannot be seen as an isolated problem but rather, as one that has a serious effect on South African society as a whole.

Another major area of concern is that not only prisoners serving time, but also those awaiting trial are dying of AIDS while in prison. Fagan points out that up to 40 percent of prisoners awaiting trial are in custody because of poverty and could not afford bail of as little as 50 rands (about US$7). He also mentions that, of the approximately 55,000 prisoners awaiting trial under the custody of the DCS, only 35 percent will be convicted and sentenced to serve time. Often this means that people will be released from prison and returned to their community having contracted HIV.

This situation is particularly problematic when one considers that while many prisoners enter the system already infected, many also become infected while in the system. Prisons are by their nature places that promote high-risk behavior, and this is where Goyer finds the DCS at fault for not doing enough to stop the spread of infection. High risk behavior includes assault, homosexual activity, sharing of needles, and use of contaminated objects for tattooing.

While the DCS has adopted policies that seek to address these main problems, it is impossible to follow through with them given the present condition of prisoners. Until general hygiene and security are increased and overcrowding is reduced, the effective implementation of any policy will be impossible. Nevertheless, there remain problems with current policy. Prisoners are only able to get HIV testing done at the request of a doctor, condoms are only available on request from prison officials after lectures on high-risk behavior, and there is no access to bleach to sterilize dirty needles used for tattooing.

The facts brought to light make it clear that the HIV/AIDS problem is very serious in South African prisons. It is also clear that it cannot be looked at as an isolated problem, since the nature of the prison system in South Africa makes it a problem that affects society in its entirety. However, the most significant issue at stake is not the development of proper AIDS policies but, in actuality, adressing the larger issues facing correctional services in South Africa.