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Healthcare challenges and interventions in pre-trial detention centers in Venezuela
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BACKGROUND: In Venezuela, pre-trial detention centers, originally intended for brief holding periods, often detain individuals far beyond the normative 48 hours, with some awaiting trial for up to 10 years. This prolonged detention, in facilities not designed for long-term occupancy, leads to severe overcrowding and deteriorating physical conditions for detainees. From January 2021 to October 2023, healthcare was provided to 3975 detainees in 60 such centers, focused on providing healthcare to detainees, who were the primary population of interest, without considering other high-risk groups.
METHODS: This was a cross-sectional, observational study conducted in 60 pre-trial detention centers across 9 Venezuelan states (Miranda, Vargas, Zulia, Bolívar, Nueva Esparta, Carabobo, Aragua, Anzoátegui, Distrito Capital) from January 2021 to October 2023. The study involved 3975 detainees, with the age distribution as follows: <19 (0.69%), 19-25 (24.31%), 26-35 (36.81%), 36-45 (19.1%), and >46 (19.1%), with an average age of 34 years, where 422 women (10.6%), 3550 men (89.3%), and 10 transgender women. HIV screening involved initial 3rd generation rapid tests, followed by confirmatory 4th generation rapid tests. Confirmed HIV-positive individuals underwent viral load testing. The study also assessed the prevalence of tuberculosis using GeneXpert, along with other common health conditions like scabies, musculoskeletal pain, and skin diseases. Interventions included medical treatment and linkage to local healthcare services for those requiring ongoing care, particularly for HIV and tuberculosis.
RESULTS: Out of 3975 detainees, 53 (1.33%) tested HIV positive. The distribution was 3 women (0.71% of the female population), 49 men (1.38% of the male population), and 1 transgender woman. There were 118 TB cases identified, with no HIV-TB. Health issues included scabies (27.5%, 1093 cases), musculoskeletal pain (25.2%), skin diseases (14%, 556 cases), and other STIs (7%). Comprehensive healthcare was provided for respiratory symptoms, dermatological conditions, and musculoskeletal pain, along with preventive measures like deworming.
CONCLUSIONS: This intervention in Venezuelan pre-trial detention centers highlighted significant health challenges, including the prevalence of HIV and TB, under conditions of severe overcrowding and prolonged detention. The study emphasizes the necessity of continuous healthcare provision and highlights the unique healthcare needs of detainees as a key population in HIV epidemiology.
METHODS: This was a cross-sectional, observational study conducted in 60 pre-trial detention centers across 9 Venezuelan states (Miranda, Vargas, Zulia, Bolívar, Nueva Esparta, Carabobo, Aragua, Anzoátegui, Distrito Capital) from January 2021 to October 2023. The study involved 3975 detainees, with the age distribution as follows: <19 (0.69%), 19-25 (24.31%), 26-35 (36.81%), 36-45 (19.1%), and >46 (19.1%), with an average age of 34 years, where 422 women (10.6%), 3550 men (89.3%), and 10 transgender women. HIV screening involved initial 3rd generation rapid tests, followed by confirmatory 4th generation rapid tests. Confirmed HIV-positive individuals underwent viral load testing. The study also assessed the prevalence of tuberculosis using GeneXpert, along with other common health conditions like scabies, musculoskeletal pain, and skin diseases. Interventions included medical treatment and linkage to local healthcare services for those requiring ongoing care, particularly for HIV and tuberculosis.
RESULTS: Out of 3975 detainees, 53 (1.33%) tested HIV positive. The distribution was 3 women (0.71% of the female population), 49 men (1.38% of the male population), and 1 transgender woman. There were 118 TB cases identified, with no HIV-TB. Health issues included scabies (27.5%, 1093 cases), musculoskeletal pain (25.2%), skin diseases (14%, 556 cases), and other STIs (7%). Comprehensive healthcare was provided for respiratory symptoms, dermatological conditions, and musculoskeletal pain, along with preventive measures like deworming.
CONCLUSIONS: This intervention in Venezuelan pre-trial detention centers highlighted significant health challenges, including the prevalence of HIV and TB, under conditions of severe overcrowding and prolonged detention. The study emphasizes the necessity of continuous healthcare provision and highlights the unique healthcare needs of detainees as a key population in HIV epidemiology.