Harm reduction behind bars
Prison worker perspectives
From SAGE Open
Hepatitis C virus (HCV) infection is one of the most commonly notified communicable diseases in Australia. While the risk is greatest in people with a history of injection drug use, history of imprisonment has long been independently associated with HCV. Transmission has proven to be difficult to study in prison populations, primarily due to rapid population turnover, but rates are thought to be high relative to the general community and direct evidence of transmission within Australian prisons has been reported.
This study aimed to identify how strategies to reduce the risk of hepatitis C virus (HCV) in prisons could be implemented in a way that is acceptable to those with the responsibility for implementing them. Attitudes toward a range of harm reduction interventions, including clean needle and bleach provision, were explored. It is clear there is widespread concern that needles and bleach could be used as weapons, and that their provision is tantamount to condoning drug use. Improving officer education around communicable diseases, providing assistance to achieve appropriate levels of vaccination coverage, and generally promoting a more integrated approach to the management of communicable diseases and infection control by correctional and health staff may help to foster a more collaborative approach to future harm reduction strategies.
We aimed to identify how strategies to reduce the risk of hepatitis C virus (HCV) in prisons could be implemented in a way that is acceptable to those with the responsibility for implementing them. Prison officer and nurse perceptions of HCV and attitudes toward a range of harm reduction interventions, including clean needle and bleach provision, were explored. In the context of highly prevalent feelings of resentment, most of the proposed strategies were perceived by all staff as a threat for officers and a privilege for prisoners. Addressing the underlying concerns of prison staff is essential in achieving a fully collaborative harm reduction effort. Ongoing resistance to proposed harm reduction strategies underscores the relevance of these findings for prison settings in Australia and elsewhere.
Emma R. Miller, Jan M. Moore, and Peng Bi
Harm Reduction Behind Bars: Prison Worker Perspectives
SAGE Open July-September 2013 3: 2158244013494209, first published on July 16, 2013doi:10.1177/2158244013494209