Health Outcomes for Clients of Needle and Syringe Programs in Prisons

Lazarus, Jeffrey V.; Safreed-Harmon, Kelly; Hetherington, Kristina L.; Bromberg, Daniel J.; Ocampo, Denise; Graf, Niels; Dichtl, Anna; Stöver, Heino; Wolff, Hans

doi:10.1093/epirev/mxx019

Cited by 38 publications

(29 citation statements)

References 27 publications

(33 reference statements)

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“…Although some people stop injecting while in custody, others continue, and even though they typically do so at a lower frequency, each injection episode is high risk ( 16 ) because of the lack of access to clean injecting equipment in most prisons ( 17 , 18 ). Lazarus et al ( 19 ) reviewed what is known about the impacts of prison needle and syringe programs (PNSPs) on health outcomes for clients of these programs. Despite sustained and widespread advocacy for PNSPs ( 20 , 21 ), they identified only 5 eligible studies and rated the strength of evidence as low, although suggestive of benefits for the prevention of HIV and HCV.…”

Section: Infectious Diseases In Prisonmentioning

confidence: 99%

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

Kinner

Young

2018

Epidemiologic Reviews

113

105

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The world prison population is growing at a rate that exceeds the rate of population growth. This issue of Epidemiologic Reviews comprises articles in which researchers summarize what is known about some of the key health issues facing people in prison, particularly in relation to human immunodeficiency virus and other blood-borne viral infections. A key recurring theme is that addressing the health needs of people in prison is important to reducing health inequalities at the population level—that prisoner health is public health. The reviews also highlight some critical evidence gaps, notably the lack of evidence from low- and middle-income countries, and the limited number of longitudinal studies in which health behaviors, health outcomes, or health service experiences after release from prison are documented. Despite growing evidence of the poor health of detained adolescents, none of the included reviews considered this population. Further research on the health of young people who cycle through juvenile detention should be a priority. Despite a rapidly growing literature on the health of people who experience incarceration, some critical health issues remain poorly understood, and there has been insufficient attention devoted to co-occurring health conditions and the consequent need for coordinated care. Key populations in custodial settings remain understudied, limiting capacity to develop targeted, evidence-based responses to their health needs. The quality of many studies is suboptimal, and although rigorous, independent research in correctional settings can be challenging, it is not impossible and is critical to laying the groundwork for evidence-based reform.

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Section: Infectious Diseases In Prisonmentioning

confidence: 99%

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

Kinner

Young

2018

Epidemiologic Reviews

113

105

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“…This requires new technologies such as RDOT or ‘Point of Care’ tests, which allow a serological diagnosis, and especially detection of positive viraemia within 20‐30 minutes, for a ‘test and treat’ policy . All these measures can help meet the challenge by improving ‘diagnostic burn‐out’, with five times more viral C infections than diagnosed in 2016 and five times fewer cures than new infections …”

Section: Improving Screening Of Hcv Infectionmentioning

confidence: 99%

“…Thus, this population could benefit from rapid diagnosis and treatment procedures, which take 8‐12 weeks to reduce both individual medical risks and contamination in prisons. Harm reduction services, such as prison‐based needle and syringe programs and treatment for opioid use disorders, are crucial for reducing the incidence of HCV in prisons and improving overall health outcomes . Historically, many prisoners were not screened for HCV infection because there was limited knowledge about new treatment options and concerns that this population would not have access to treatment .…”

Section: Improving Access To Care By Delocalizationmentioning

confidence: 99%

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Micro‐elimination of hepatitis C virus

Hollande

Parlati

Pol

2020

Liver International

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Background & Aims HCV affects about 71 million people worldwide with 1.75 million new infections a year, mainly associated with healthcare, blood transfusion before screening of donors and drug use. Hepatitis C is a systemic disease with hepatic and extrahepatic manifestations resulting in increased morbidity and mortality in HCV‐infected patients compared to cured or uninfected individuals. Results The goal of eliminating hepatitis C by 2030 is based on the following three main actions: strengthening and increasing outreach screening; increasing access to treatment; and improving prevention. Although the tools and the targets of HCV elimination have now been well established, micro‐elimination, a cure in high‐risk populations, is possible, but has not been achieved. These populations are mainly migrants, prisoners, drug users, HIV co‐infected patients and psychiatric patients. New tools must be developed to achieve micro‐elimination, in particular, rapid diagnostic orientation tests for better screening, delocalization of healthcare services to improve access to care, and training physicians to raise awareness of the disease, increase understanding of its pathogenesis and provide information on the availability of safe and effective treatment to cure chronic infection and reverse hepatic and extrahepatic manifestations. Conclusion Thus, while the goal of complete elimination of hepatitis C virus was feasible in Western countries, it was more difficult in high‐prevalence countries where improvement in the detection of chronic infection (with rapid serological and virological diagnostic tests), outsourcing of diagnostic and therapeutic care and access to direct oral antivirals are urgently needed.

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“…Prisoners report much higher prevalence rates of drug use and more harmful patterns of use than the general population [1]. Lifetime prevalence among prisoners in the European Union for using any illicit drug before imprisonment is estimated between 16% (Romania) and 79% (England, Wales and the Netherlands), and between 15% (Finland) and 39% (Spain) for using heroin [6].…”

Section: Introductionmentioning

confidence: 99%

“My first 48 hours out”: Drug users’ perspectives on challenges and strategies upon release from prison

Jamin

Stöver

Vanderplasschen

et al. 2020

Preprint

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Background Prisoners report much higher prevalence rates of drug use and more harmful patterns of use than the general population [1]. People who use drugs have also an above-average experience with the criminal justice system in general, the prison system and the subsequent release situation in particular. Release from prison is associated with increased mortality rates among drug users due to the risk of overdose [2–5]. The EU-funded project ‘My first 48h out’ aimed to address the gaps in the continuity of care for long-term drug users in prison and upon release and had a special focus on drug user’s perspectives on challenges upon release.Methods A multi-country (Belgium, France, Germany and Portugal) qualitative study was set up to explore drug users’ perceptions of drug use and risk behaviour upon prison release, experiences of incarceration, knowledge of risks and overdose prevention, individual risk reduction mechanisms and strategies to avoid risks when being released. Therefore, interviews and focus groups based on a semi-structured interview with (ex-) prisoners in four countries were implemented.Results 104 (Ex-) prisoners pointed out that there are a lot of challenges for people who use drugs at release from prison. Mainly named are a lack of housing and employment support and also a complex administrative procedure regarding services, health insurance and welfare benefits. Beside these structural challenges there are individual challenges like old habits, drug use (overdose) and the situation outside prison. As a result of a lack of support (ex-) prisoners use individual strategies to cope with the risks and challenges at release.Conclusion There are measures to prepare prisoners for release, but mostly they do not focus on individual and specific challanges of poeple who use drugs. Mainly psychosocial and medical support need to be improved and adjusted inside and outside prison. To implement measures the individual needs and strategies of people who use drugs should be utilized, as they show the specific needs of drug users at release.

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Health Outcomes for Clients of Needle and Syringe Programs in Prisons

Cited by 38 publications

References 27 publications

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis

Micro‐elimination of hepatitis C virus

“My first 48 hours out”: Drug users’ perspectives on challenges and strategies upon release from prison

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