International Journal of Prisoner Health最新文献

Purpose: Sexually transmitted infections (STIs) can be transferred from one person to another through sexual contact. STIs lead to substantial morbidity and mortality and affect many different aspects of human life, including quality of life, sexual health, reproductive health and even the health of newborns and children. Despite of high rates of STIs in prisons, there are not sufficient screening, prevention and treatment programs to control STIs transmission among prisoners in Iran. This study aims to evaluate the prevalence of STIs among incarcerated women in Iran for the first time, using the active case finding strategy.

Design/methodology/approach: This is a cross-sectional study conducted on 438 incarcerated women in a prison in Tehran, Iran, from 2017 to 2018. A total of 438 prisoners were screened by active case findings for STI symptoms, then evaluated by complete genital and anal examination, followed by molecular testing.

Findings: A total of 189 (43.2%) prisoners announced vaginal discharge, while 194 (44.3%) individuals had vaginal discharge in the genital examination. In the cervical examination, 137 individuals (31.3%) had abnormal findings, of which 83 (18.9%) individuals had cervicitis, 40 (9.1%) individuals had cervical erosion, 38 (8.7%) individuals had cervical prolapse and 17 (3.9%) individuals had bleeding originated from the cervix.

Originality/value: This study showed that it is possible to set up a system in which the diagnosis, follow-up and treatment of prisoners with STIs can be actively performed. Educating prisoners about signs and symptoms, risk behaviors and prevention routes of STIs, as much as regular screening of prisoners, and adequate treatment can help control the STIs prevalence among prisoners and in the general population.

Purpose: Hepatitis C is one of the major health issues in both developed and developing countries. Hepatitis C virus (HCV) infection is more common in prisoners than in the general population. The purpose of this study was to determine the prevalence of HCV and its associated risk factors in Iranian male prisoners in Tehran.

Design/methodology/approach: In this cross-sectional study, the authors investigated the frequency and risk factors of hepatitis C infection among male prisoners in the Great Tehran Prison. Information on risk factors including the length of imprisonment, previous history of imprisonment, history of drug injection, history of tattooing, history of piercing, history of high-risk sex and family history of hepatitis C were extracted from patients' records. To evaluate HCV status, blood samples were collected and tested.

Findings: In this study, 179 participants were included. Nine participants (5.0%, 95% CI, 2.3-9.3) were positive for hepatitis C. HCV infection was not significantly associated with age, marital status, education, previous history of imprisonment, length of imprisonment, piercing and high-risk sex; however, there was a significant association between a history of tattooing and a history of injecting drug use and Hepatitis C.

Originality/value: The prevalence of hepatitis C among male prisoners in Great Tehran Prison was 5% in this study, similar to recent studies on prisoners in Tehran. A history of drug injections as well as tattooing were the most important risk factors for hepatitis C in male prisoners.

Purpose: This study aims to provide an overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among sentenced female prisoners.

Design/methodology/approach: A mixed-methods systematic literature review.

Findings: A total of 4 reviews and 39 single studies met the inclusion criteria for the review. Mental disorders were the main area of investigation in the majority of single studies, with substance abuse, particularly drug abuse, as the most consistently gender biased disorder, with higher prevalence among women than men in prison. The review identified a lack of updated systematic evidence on the presence of multi-morbidity.

Originality/value: This study provides an up-to-date overview and quality appraisal of the current scientific evidence concerning the prevalence and characteristics of mental and physical disorders among female prisoners.

Purpose: According to estimates, there are approximately 714,000 female prisoners in the world. A considerable proportion are pregnant, of childbearing age at the time of incarceration and may experience numerous reproductive health concerns. The purpose of this study is to examine the demographics and sexual and reproductive history of female prisoners in Iran.

Design/methodology/approach: Four hundred and thirty-four female prisoners (mean age: 39.0 ± 9.9) serving sentences at Qarchak prison, Iran, completed a questionnaire. The participants were recruited between October 2017 and September 2018 using a convenient sampling method. The questionnaire captured sociodemographic characteristics and sexual and reproductive history.

Findings: Most respondents had 7-12 years of formal education, were housewives (69.9%), were either married (41.6%) or divorced (41.8%) and were literate (91.3%). History of drug use among the respondents was 34.7%. Most respondents had regular menstruation (63.5%) and were pre-menopausal (86.1%). Natural birth control was preferred (39.7%) compared to other methods, such as condoms (18%) and oral contraceptive pills (8.4%). Spontaneous and induced abortions were reported by 17.8% and 16.4% of respondents, respectively. There was 5.9% of respondents that reported having a history of sexually transmitted infections (STIs) before incarceration, with HPV the most common (12.7%).

Research limitations/implications: This study has limitations, including the problem of following up with prisoners to shorten the average length of their imprisonment, which can leave many issues in the field of women's health and their follow-up incomplete. Prison health care workers should also follow up on women's health and pregnancy hygiene after their release because there is usually a high prevalence of STIs in prisoners.

Practical implications: The findings highlight the importance of improving the quality of women's health care and pregnancy-related care in prisons. Additionally, the importance of having a health protocol for incarcerated women in Iran. Other programs should also be implemented for women prisoners to eliminate the discrimination they may face in prison.

Originality/value: The international community has attempted to develop care guidelines for pregnant prisoners, particularly for prenatal and mental health services. However, currently in Iran no such guidelines have been developed. To date no research has explored the sexual health among female prisoners of this country. The aim of the present study was to examine the demographics and sexual and reproductive history of female prisoners in Iran. A secondary aim was to identify the health care needs of female prisoners in Iran.

Purpose: Looked after children (LAC) are criminalised at five times the rate of children in the general population. Children in contact with both child welfare and child justice systems have higher rates of neurodisability and substance use problems, and LAC in general have high rates of school exclusion, homelessness and unemployment. This study aims to understand whether these factors persist in LAC who are in prison as adults.

Design/methodology/approach: Administrative data collected by the Do-IT profiler screening tool in a prison in Wales, UK, were analysed to compare sentenced prisoners who were LAC (n = 631) to sentenced prisoners who were not LAC (n = 2,201). The sample comprised all prisoners who were screened on entry to prison in a two-year period.

Findings: Prisoners who were LAC scored more poorly on a functional screener for neurodisability (effect size = 0.24), and on four self-report measures capturing traits of dyslexia (0.22), attention-deficit hyperactivity disorder (0.40), autism spectrum disorders (0.34) and developmental co-ordination disorder (0.33). Prisoners who were LAC were more likely to have been to a pupil referral unit (0.24), have substance use problems (0.16), be homeless or marginally housed (0.18) and be unemployed or unable to work due to disability (0.13).

Originality/value: This study uniquely contributes to our understanding of prisoners who were LAC as a target group for intervention and support with re-integration into the community upon release. LAC in prison as adults may require additional interventions to help with employment, housing and substance use. Education programmes in prison should screen for neurodisability, to develop strategies to support engagement.

Purpose: Internationally, rates of suicide and lifetime self-harm are higher in prisoners compared to the general population. This study aims to identify specific characteristics of self-harming behaviour and to establish a profile of prisoners who engage in self-harm.

Design/methodology/approach: Data from the Self-Harm Assessment and Data Analysis Project (SADA) on self-harm episodes in prisons in the Republic of Ireland during 2017-2019 was used. Annual rates per 1,000 were calculated by age and gender.

Findings: The rate of self-harm between 2017 and 2019 was 31 per 1,000 prisoners for men and six times higher at 184 per 1,000 prisoners for women. The rate of self-harm was twice as high among prisoners on remand than sentenced prisoners (60.5 versus 31.3 per 1,000). The highest rates of self-harm among sentenced prisoners were observed among 18-29-year-old men (45 per 1,000) and women (125 per 1,000). The rate of self-harm was higher among women prisoners in all age groups. Contributory factors associated with self-harm were mainly related to mental health but also linked to a prisoner's environment and relationships.

Practical implications: There is a need to ensure access to timely and suitable mental health services, including both appropriate referral and provision of evidence-based mental health interventions to address the needs of these cohorts.

Originality/value: To the best of the authors' knowledge, this is the first national study to systematically examine incidence and patterns of self-harm among the prison population in Ireland. The recording of severity/intent of each episode is novel when assessing self-harm among the prison population.

Purpose: This intensified case finding study aimed to evaluate the prevalence of tuberculosis (TB) disease among people with HIV entering the largest prison in Malaysia.

Design/methodology/approach: The study was conducted in Kajang prison, starting in July 2013 in the men's prison and June 2015 in the women's prison. Individuals tested positive for HIV infection, during the mandatory HIV testing at the prison entry, were consecutively recruited over five months at each prison. Consented participants were interviewed using a structured questionnaire and asked to submit two sputum samples that were assessed using GeneXpert MTB/RIF (Xpert) and culture, irrespective of clinical presentation. Factors associated with active TB (defined as a positive result on either Xpert or culture) were assessed using regression analyses.

Findings: Overall, 214 incarcerated people with HIV were recruited. Most were men (84.6%), Malaysians (84.1%) and people who inject drugs (67.8%). The mean age was 37.5 (SD 8.2) years, and median CD4 lymphocyte count was 376 cells/mL (IQR 232-526). Overall, 27 (12.6%) TB cases were identified, which was independently associated with scores of five or more on the World Health Organization clinical scoring system for prisons (ARR 2.90 [95% CI 1.48-5.68]).

Originality/value: Limited data exists about the prevalence of TB disease at prison entry, globally and none from Malaysia. The reported high prevalence of TB disease in the study adds an important and highly needed information to design comprehensive TB control programmes in prisons.

Purpose: Women involved in the carceral system (CS) experience several conditions that increase their risk for HIV (e.g. high rates of substance use, psychiatric disorders, histories of victimization). The purpose of this study is to explore perspectives on potential strategies to connect women in the CS to pre-exposure prophylaxis (PrEP) services.

Design/methodology/approach: This study conducted in-depth interviews with 27 women involved in the CS eligible for PrEP. Using vignettes, interviews explored attitudes, barriers and facilitators toward PrEP screening, referral and linkage facilitated via a CS stakeholder, an mHealth application or providing PrEP service referrals during detention via a navigator.

Findings: Most women were, on average, 41.3 years, from racial and ethnic minority groups (56% black/African American; 19% Latinx). Inductive thematic analysis revealed CS involved women expressed mostly positive attitudes toward CS-based PrEP implementation. Younger women were more accepting of and interested in mHealth interventions. Implementation facilitators included leveraging relationships with trusted allies (e.g. "peers") and existing systems collaborations. Recommended implementation strategies included providing HIV and PrEP-specific education and training for system stakeholders and addressing issues related to privacy, system mistrust and stigma.

Originality/value: Results provide a critical foundation for the implementation of interventions to improve PrEP access for women involved in the CS and have important implications for implementation strategies for all adults involved in the CS. Improving access to PrEP among this population may also support progress toward addressing national disparities in PrEP uptake, where women, black and Latinx populations have substantial unmet need.

Purpose: This study aims to determine the association between prison circumstances, perceived family support and sleep quality among male inmates at the Ibara prison, Ogun State.

Design/methodology/approach: It was a cross-sectional study of 300 male inmates interviewed with socio-demographic proforma and Pittsburgh sleep quality index.

Findings: While all respondents described the prison as being overcrowded, half of them used inappropriate sleeping materials daily and 41.4% decried a very noisy environment at night. Twenty-seven percent of the respondents described poor family support while 47.3% experienced poor sleep quality. Though nature of sleeping material and self-awareness of sleep problem were associated with poor sleep quality, no predictor of the latter was identified.

Research limitations/implications: The study was conducted among males only because of the relative dominance of the male gender in the prison population. This makes analysis of gender difference impossible. Furthermore, sleep studies may be preferred over reports by some sleep experts.

Practical implications: Findings from this study may culminate in taking steps to improve the Nigerian prison conditions as well as the prisoner's welfare.

Social implications: Developing support group for relatives of inmates may be a focus of social intervention for these inmates. Also, inmates with good sleep quality are likely to partake effectively in the prison reformation programmes and may not self-medicate with sedatives.

Originality/value: This study provides a scholarly documentation of the state of Nigerian prisons; inmates' perception of family support; prevalence and correlates of poor sleep quality among a group of male inmates.