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Article

Stephanie Ellen Perrett, Mark Erricker and Marion Lyons

The purpose of this paper is to provide education on blood-borne viruses (BBVs) to prison staff to help reduce stigma within the prisons, improve the care prisoners…

Abstract

Purpose

The purpose of this paper is to provide education on blood-borne viruses (BBVs) to prison staff to help reduce stigma within the prisons, improve the care prisoners receive and reduce the risk of occupational transmission.

Design/methodology/approach

An e-module was used to improve staff understanding of hepatitis B (HBV), hepatitis C (HCV) and HIV at a prison in Wales, UK. An assessment was used to gather data on prison staff understanding of BBVs prior to undertaking the e-module.

Findings

In total, 530/697 (76 per cent) prison staff completed the BBV e-module. Average pre- and post-course assessment scores were 8.6/11 and 10.85/11, respectively. Most staff understood the modes of hepatitis transmission, however, gaps in understanding were highlighted. In total, 22 per cent of staff believed HBV and HCV were airborne, 9 per cent believed transmission occurred through sharing cutlery. In total, 31 per cent of staff believed prisoners with hepatitis should declare their status to the prison.

Practical implications

The e-module significantly improved staff understanding of BBVs and should be incorporated into future prison training packages. Future education should include how BBVs are not transmitted with an emphasis on casual contact. Medical confidentiality in prisons should also be addressed. Improving understanding will help reduce the stigma of BBVs within prison and improve the multidisciplinary care the prisoner receives.

Originality/value

To the authors knowledge this is the first published evaluation of a BBV learning package for custodial staff. Evaluation of this educational package demonstrates a unique and valuable insight into the general understanding of BBVs by prison staff in Wales, UK.

Details

International Journal of Prisoner Health, vol. 10 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

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Article

Stephanie E. Perrett, Noel Craine and Marion Lyons

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations…

Abstract

Purpose

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations for prisons within the Welsh Government's Blood Borne Viral Hepatitis Action Plan for Wales.

Design/methodology/approach

A task and finish group was established to ensure multidisciplinary engagement between healthcare and custody staff. A service improvement package was developed focusing on awareness raising and/or development of clinical services for prisoners, prison officers and prison healthcare staff.

Findings

Prison healthcare staff have undergone training in BBVs and are being supported to deliver clinical services to prisoners. Training has been delivered in pre/post test discussion and dried blood spot testing; care pathways have been established between prison and community specialists for treatment referrals. An e‐learning module is being rolled out to raise awareness amongst custody staff and encourage occupational hepatitis B vaccination. Literature on “liver health” has been produced to be given to every prisoner across Wales.

Social implications

It is envisaged that BBV services will become a routine part of prison care in Wales. Data on activity are being collected for evaluation and it is hoped that tackling BBVs in prisons will help reduce rates of infection both within prisons and in the wider community.

Originality/value

This paper describes new initiatives that have been established to tackle BBVs across Welsh prisons and will be relevant to any prison healthcare staff looking to develop similar services.

Details

International Journal of Prisoner Health, vol. 9 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

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Article

Mandie Wilkinson

When Mandie Wilkinson's patients ran a mile after tests for hepatitis and HIV, she had no idea her efforts would lead to a highly successful blood borne virus clinic…

Abstract

When Mandie Wilkinson's patients ran a mile after tests for hepatitis and HIV, she had no idea her efforts would lead to a highly successful blood borne virus clinic. There were many hurdles. Not only are patients reluctant to test for potentially fatal diseases such as hepatitis C, but the options for treatment are limited. Working with drug users is not everyone's cup of tea either and finding staff proved equally difficult. Now six years down the line, Mandie's nursing team has treated over 40 high‐risk patients, tests for liver cancer, provides community treatment programmes and is developing new screening methods for deep vein thrombosis and cervical cancer.

Details

Drugs and Alcohol Today, vol. 6 no. 2
Type: Research Article
ISSN: 1745-9265

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Article

Vellingiri Raja Badrakalimuthu, Andrew Tarbuck and Ajay Wagle

The aim of this study is to explore the characteristics of a group of patients over 50 years old who are entering a substitution treatment programme for opioid dependence…

Abstract

Purpose

The aim of this study is to explore the characteristics of a group of patients over 50 years old who are entering a substitution treatment programme for opioid dependence and to compare the characteristics of this group with those aged under 50 who are enrolled in the same substitution treatment programme.

Design/methodology/approach

This is a cross sectional survey involving 92 cases in the 50 and above age group and 194 cases in the under 50 age group from community drug and alcohol services. Data were collected on demographic details, substance misuse and treatment history and progress with treatment. All the data were analysed using the Statistical Package for the Social Sciences (SPSS), version 1.1. Statistical significance between fewer than 50 and 50+ groups were assessed using Fisher's exact test.

Findings

Amongst the 92 in the group 50 years and above, 67 (average dose=63.25 mg) were on methadone maintenance (average dose=63.25 mg) and 19 (average dose=10.37 mg) on buprenorphine. In total, 11 per cent started using opiates after the age of 50. Sixty per cent used other substances out of which 31 per cent used multiple substances. Benzodiazepines, cocaine and amphetamines were the common substances of misuse. Thirty seven were infected with HCV. Comorbid rates for physical and mental illnesses were 64 per cent and 62 per cent, respectively. Nearly 86 per cent achieved good compliance with the treatment programme. Statistically higher rates of being single, lacking stable accommodation, prescription of buprenorphine, high dose prescriptions and lower rates of bloodborne viruses, physical health and mental health, past forensic history were found in the under 50 age group compared with the 50+ age group.

Practical implications

There are a considerable number of patients above the age of 50 in maintenance treatment and they differ from the less than 50 age group. Old age and substance misuse psychiatrists should be aware of the prevalence of comorbid substance misuse, physical (including blood borne viruses) and psychiatric disorders in this population. Further research is required in this neglected area and a service provision should be based on such robust research.

Originality/value

This is the first study to the authors' knowledge that compares the demographic and treatment profiles of under 50 and over 50 years by age of patients in a methadone maintenance treatment programme. It clearly points to significant differences in the profiles based on age which will have implications for service provision which will have to take into account these age‐related differences in particular related to physical health and social needs.

Details

Drugs and Alcohol Today, vol. 12 no. 3
Type: Research Article
ISSN: 1745-9265

Keywords

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Article

Sarah Larney and Kate Dolan

Prison officers face multiple occupational hazards including needlestick injuries, which may result in the transmission of bloodborne viral infections. This study aimed…

Abstract

Prison officers face multiple occupational hazards including needlestick injuries, which may result in the transmission of bloodborne viral infections. This study aimed to assess the prevalence of needlestick injuries, the circumstances under which needlestick injuries occur and the responses of injured prison officers. Cross‐sectional data were collected from prison officers in two Australian jurisdictions between January and May 2006, using a self‐report questionnaire. Descriptive analyses were conducted. Of 246 prison officers who completed the survey, two‐thirds had found needles and syringes in the workplace. Seventeen officers (7%) reported having experienced a needlestick injury. Most injuries occurred during searches. Serological testing for bloodborne viral infections following injury was common, but less than half the injured officers accessed support services. Needlestick injuries appear to be a relatively rare occurrence, but may be further reduced by improving search techniques and equipment and regulating needles and syringes in prisons.

Details

International Journal of Prisoner Health, vol. 4 no. 3
Type: Research Article
ISSN: 1744-9200

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Article

Emanuele Pontali, Nicoletta Bobbio, Marilena Zaccardi and Renato Urciuoli

– The purpose of this paper is to evaluate the prevalence of HBV and/or HCV co-infection among HIV-infected inmates entering the correctional facility.

Abstract

Purpose

The purpose of this paper is to evaluate the prevalence of HBV and/or HCV co-infection among HIV-infected inmates entering the correctional facility.

Design/methodology/approach

Prospective collection of data of HIV-infected inmates entered the institution over a ten-year period.

Findings

During study period 365 consecutive different inmates were evaluated. HCV co-infection was observed in more than 80 per cent of the tested HIV-infected inmates, past HBV infection in 71.6 per cent and active HBV co-infection was detected in 7.1 per cent; triple coinfection (HIV, HCV and HBs-Ag positivity) was present in 6 per cent of the total.

Originality/value

This study confirms high prevalence of co-infections among HIV-infected inmates. Testing for HBV and HCV in all HIV-infected inmates at entry in any correctional system is recommended to identify those in need of specific care and/or preventing interventions.

Details

International Journal of Prisoner Health, vol. 12 no. 2
Type: Research Article
ISSN: 1744-9200

Keywords

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Article

Charlotte N.E. Tompkins

This paper aims to explore the cessation of injecting amongst male drug users when in prison in England and uncovers what influenced this behaviour and why.

Abstract

Purpose

This paper aims to explore the cessation of injecting amongst male drug users when in prison in England and uncovers what influenced this behaviour and why.

Design/methodology/approach

Qualitative interviews were conducted with 30 male drug users on release from prison to explore what happened to their injecting drug use in prison. The research was conducted from a pragmatic harm reduction approach using grounded theory.

Findings

Not injecting in prison was identified as a pertinent finding and nine overarching themes accounted for this decline. The themes often overlapped with one another, highlighting how the decision not to inject when last in prison was multi‐factorial. Running throughout the themes were participants' concerns regarding the health and social risks attributed to injecting in prison, alongside an appreciation of some of the rehabilitative measures and opportunities offered to injecting drug users when in prison.

Originality/value

This qualitative research offers an updated perspective on illicit drug injecting in prison in England from the view of drug users since health and prison policy changes in prescribing and practice. It contributes to evidence suggesting that prisons can be used as a time of reprieve and recovery from injecting drug use.

Details

International Journal of Prisoner Health, vol. 9 no. 2
Type: Research Article
ISSN: 1744-9200

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Article

Stephanie E. Perrett and Thomas D. Waite

Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were…

Abstract

Purpose

Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were diagnosed across two male vulnerable prisoner (VP) custodial units in Wales, UK. Cases were identified through routine BBV testing. The paper aims to discuss these issues.

Design/methodology/approach

As a result of identifying four new HIV cases, targeted BBV testing across the VP units using dried blood spot testing for HIV, Hepatitis C (HCV) and Hepatitis B was undertaken.

Findings

A total of 617 men were offered testing, 256 (41 per cent) were tested. No further cases of HIV were identified. Eight men were identified as HCV antibody positive. There was no evidence to suggest the four original cases of HIV were linked.

Practical implications

Embedding universal BBV screening within prison health provision will ensure timely identification of cases. Further research is needed to better understand BBV transmission risks within subsets of the prison population such as the VP and sex offending groups.

Originality/value

Little is known about the prevalence of BBVs in vulnerable prison populations. The findings add to the knowledge available for practitioners in the field.

Details

International Journal of Prisoner Health, vol. 15 no. 3
Type: Research Article
ISSN: 1744-9200

Keywords

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Article

Lynn A. Stewart, Amanda Nolan, Jennie Thompson and Jenelle Power

International studies indicate that offenders have higher rates of infectious diseases, chronic diseases, and physical disorders relative to the general population…

Abstract

Purpose

International studies indicate that offenders have higher rates of infectious diseases, chronic diseases, and physical disorders relative to the general population. Although social determinants of health have been found to affect the mental health of a population, less information is available regarding the impact of social determinants on physical health, especially among offenders. The purpose of this paper is to examine the relationship between social determinants and the physical health status of federal Canadian offenders.

Design/methodology/approach

The study included all men admitted to federal institutions between 1 April 2012 and 30 September 2012 (n=2,273) who consented to the intake health assessment. Logistic regression analyses were used to explore whether age group, Aboriginal ancestry, and each of the individual social determinants significantly predicted a variety of health conditions.

Findings

The majority of men reported having a physical health condition and had experienced social determinants associated with adverse health outcomes, especially men of Aboriginal ancestry. Two social determinants factors in particular were consistently related to the health of offenders, a history of childhood abuse, and the use of social assistance.

Research limitations/implications

The study is limited to the use of self-report data. Additionally, the measures of social determinants of health were indicators taken from assessments that provided only rough estimates of the constructs rather than from established measures.

Originality/value

A better understanding of how these factors affect offenders can inform strategies to address correctional health issues and reduce the impact of chronic conditions through targeted correctional education and intervention programmes.

Details

International Journal of Prisoner Health, vol. 14 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

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Article

Angelo Augusto, Orvalho Augusto, Atija Taquibo, Carina Nhachigule, Narcisa Siyawadya and Eduardo Samo Gudo

The purpose of this paper is to determine the prevalence of hepatitis B virus (HBV) among 448 HIV-infected prisoners from 32 prisons in Mozambique.

Abstract

Purpose

The purpose of this paper is to determine the prevalence of hepatitis B virus (HBV) among 448 HIV-infected prisoners from 32 prisons in Mozambique.

Design/methodology/approach

All HIV seropositive prisoners were screened for HBV.

Findings

Of the 448 HIV seropositive prisoners, 51 (11.4 percent, 95%CI: 9.3–13.9 percent) were HBsAg-positive and was significantly higher in prisoners aged<25 years.

Originality/value

Data from this study show for the first time that the frequency of HBV among HIV-infected prisoners is high, suggesting that immediate interventions are needed during incarceration.

Details

International Journal of Prisoner Health, vol. 15 no. 1
Type: Research Article
ISSN: 1744-9200

Keywords

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