‘We could easily get HIV infection here': the voice of incarcerated young people in Malawi's semi-urban prisons

Introduction: People incarcerated in Malawi's detention facilities face a lot of problems. The most common challenges are overcrowding, poor sanitation, and lack of access to basic needs such as adequate food, bedding, clothing, security, and health care. In addition, young people are vulnerable to sexual abuse. Methods: A qualitative approach using an exploratory study design was used to explore the experiences of incarcerated young people in semi-urban prisons. Ethical approval for the study was obtained from Malawi’s National Health Science Research Committee. Two focus group discussions (FGD) were conducted; involving six young incarcerated people aged 18 in each group. Focused groups followed a semi-structured interview guide; data was analyzed using thematic analysis. Results: The following four themes emerged from the data: prisoner-on-prisoner sexual violence; the need for communication regarding sexual violence; trauma associated with incarceration; and youth surviving prison life. The young incarcerated people reported being given incentives such as extra food and adequate sleeping space in exchange for sexual favours with adult incarcerated people or individuals with leadership roles. The sexually abused victims have had some difficulties in reporting the incidences due to a non-existent reporting system for such matters to prison authorities. Conclusions: This study reveals that the prison environment in Malawi is unsafe, particularly for young incarcerated people who are at an increased risk of being victims of sexual violence. The young people reported being more likely to be sexually abused when accommodated together with adult prisoners. Unfortunately, the perpetrators of sexual abuse are typically incarcerated adults in supervisory roles. Therefore, young people need special protection in prisons. We recommend that the youths should be separated from adults according to the United Nations Office on Drugs and Crime (UNODC) recommendations. The correction officers should prevent the young inmates from having sight or physical contact with adult incarcerated people while in housing units. We further recommend that prisons establish systems where abused inmates can report abuse without fear of retribution.