A cross-sectional study was carried out among 1284 male and 54 female prisoners to assess the prevalence of and risk factors for sexually transmitted diseases (STD) in 4 correctional institutions of Maputo, Mozambique. Among the men, 32% reported a history of prostitute contact and 41% reported a history of STD. Only 9% reported having ever used condoms. Seventy (5.5%) men reported having had sexual intercourse while in prison, in all but one instance this involved sex with another man. There was no reported intravenous drug use. One hundred and four (7.8%) inmates had positive serological tests for syphilis and 8 (0.6%) had antibodies to HIV. Among men, syphilis was associated with a history of genital ulcer [odds ratio (OR) = 3.1, 95% confidence interval (CI) = 1.4, 6.4] and uncircumcised status (OR = 1.5, 95% CI = 1.0, 2.5). This study demonstrates that syphilis is common among inmates in Maputo and that risk behaviours for STD transmission exist within Maputo prisons. There is a need for STD screening and treatment programmes within prisons in Mozambique and the introduction of educational interventions, including condom promotion.
PIP: Syphilis is a major public health problem in Mozambique, with 603 of 14,036 blood donations made at the central hospital in Maputo during 1990 being positive on VDRL testing. There were approximately 2340 prisoners held at Machava, Mutatele, and Hanhane prisons, and Cadeia civil jail between September 1990 and February 1991, the period during which a cross-sectional study was conducted to determine the prevalence of and risk factors for sexually transmitted diseases (STDs) among inmates in the 4 facilities. 1284 male and 54 female inmates voluntarily agreed to participate in the study. The men were of mean age 26.2 years (range, 15-70 years) and had been in jail an average of 5.5 months. 36% of the men reported having been imprisoned on at least one previous occasion. The men and women reported having a mean 1.6 and 1.2 sex partners per week, respectively, before their detention. 32% of men reported having a history of sexual relations with prostitutes; 41% and 17% of men and women, respectively, reported a history of STDs; and 9% of men and no woman reported ever having used condoms. 7.9% of men and 3.7% of women had syphilis. 70 men reported having sexual intercourse in jail, 69 of whom reported such intercourse as being with other men. 0.6% of men and no woman had antibodies to HIV. There was no reported IV drug use among respondents. Among men, syphilis infection was significantly associated with a history of genital ulcers and being uncircumcised. 64% of the men were uncircumcised. STD screening and treatment programs, educational interventions, and condom promotion are needed in Mozambique's prisons.