Human immunodeficiency virus care and management in incarcerated populations in Sub-Saharan Africa between 2010 and 2022: A narrative review

BACKGROUND: Different countries in sub-Saharan Africa (SSA) have established guidelines to reduce HIV transmission and improve its management in prisons. This narrative review aimed to examine established literature on HIV care and management among incarcerated persons in SSA to identify successful interventions that could inform improved guidelines, policies, and practices related to the clinical care of this population. METHODS: We searched PubMed, Scopus, Web of Science, Embase, and TRIP Medical Databases in August 2022 for articles published between 1st January 2010 and 30th June 2022. We identified 27 eligible articles based on the Population/Concept/Context framework. RESULTS: HIV screening primarily involved mass campaigns rather than formal prison programmes, with limited implementation of universal testing and treatment. Although a few studies reported on access to antiretrovirals (ARVs), prisoners in urban areas and females had disproportionate access. Barriers identified include poor living conditions, high levels of stigma, and resource constraints. Inter-prison transfers, release from prison, and lack of established programmes hindered follow-up and linkage to care. CONCLUSIONS: The implementation of strategies such as universal testing and treatment, human resource strengthening, financing plans for testing, ARV care, and frequent assessment of risk could improve HIV care and management in prisons in SSA.

• Epidemiology and Determinants of Health
  • Determinants of Health
• Determinants of Health
  • Stigma/discrimination
• Population(s)
  • Prisoners
  • General HIV+ population
• Prevention, Engagement and Care Cascade
  • Engagement and Care Cascade
• Engagement and Care Cascade
  • Treatment
• Testing
  • Testing
• Health Systems
  • Financial arrangements
  • Delivery arrangements