Knowledge, attitudes and beliefs in inmates toward AIDS and HIV infection:a survey in the prions of Marseille

Background: The objectives of our study were to evaluate knowledge, attitud es and beliefs of inmates toward HIV infection, and to compare them with th ose reported in the general population and according to injecting drug use. Methods: Three hundred and seventy persons incarcerated in the prison of Ma rseille were invited between December 1995 and March 1997, to answer a volu ntary questionnaire offered by an independent staff. Odds ratios were estim ated by logistic regression models adjusting for age, sex and type of quest ionnaire (self-administered for literate, face-to-face for illiterate inmat es). The average scores among injecting and non injecting drug users (IDUs) were compared by analysis of variance adjusting for age, sex and type of q uestionnaire. These scores were also compared with those reported in a nati onal survey (ACSF 1994), after adjustment for age, sex and educational leve l. Results: The participation lute was 55%. Among the 202 participants, 152 an swered a self-administered and 50 a face-to-face questionnaire; 45/202 (22% ) were IDUs. The average scores of knowledge and tolerance towards HIV infe cted people were lower among inmates than in the general population. Furthe rmore, the scores of uncertainty towards HIV risk and unfavorable opinions about condom were higher than in the general population. While the average scores of knowledge, uncertainty towards HIV risk and unfavorable opinions did not differ between IDUs and non-IDUs, the score of tolerance towards HI V infected people wets lower among non-IDUs than IDUs. Conclusion: That study shows that in spite of the high prevalence of at ris k behaviors among people who are incarcerated that population is not target ed enough by HIV prevention programs. Furthermore, the low level of toleran ce towards HIV infected people among inmates, especially non-IDUs, is very likely an obstacle to health care management in that population with a high HIV prevalence. It is urgent to enhance the equality of access to care and prevention policy inside and outside prison.