Crowley, Desmond and Cullen, Walter and Lambert, John S and Van Hout, Marie Claire (2019) Competing priorities and second chances - a qualitative exploration of prisoners' journeys through the Hepatitis C continuum of care. PLoS ONE, 14, (9), e0222186. DOI: 10.1371/journal.pone.0222186.
External website: https://journals.plos.org/plosone/article?id=10.13...
High levels of undiagnosed and untreated HCV infection exist in prison populations globally. Prisons are a key location to identify, treat and prevent HCV infection among people who inject drugs (PWID). Understanding prisoners' lived experiences of the HCV continuum of care informs how HCV care can be effectively delivered to this marginalised and high-risk population. This study aimed to explore Irish prisoners' experience of prison and community-based HCV care. We conducted one-to-one interviews with 25 male prisoners with chronic HCV infection. Data collection and analysis was informed by grounded theory. The mean age of participants and first incarceration was 39.5 and 18.3 years respectively. The mean number of incarcerations was eight. The following themes were identified: medical and social factors influencing engagement (fear of treatment and lack of knowledge, HCV relevance and competing priorities), adverse impact of HCV on health and wellness, positive experience of prison life and health care and the transformative clinical and non-clinical changes associated with HCV treatment and cure. Findings suggest that prison release was associated with multiple stressors including homelessness and drug dependence which quickly eroded the health benefits gained during incarceration.
The study generated a substantive theory of the need to increase the importance of HCV care among the routine competing priorities associated with the lives of PWID. HCV infected prisoners often lead complex lives and understanding their journeys through the HCV continuum can inform the development of meaningful HCV care pathways. Many challenges exist to optimising HCV treatment uptake in this group and incarceration is an opportunity to successfully engage HCV infected prisoners who underutilise and are underserved by community-based medical services. Support and linkage to care on release is essential to optimising HCV management.
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See also,
G Health and disease > Disease by cause (Aetiology) > Communicable / infectious disease > Hepatitis C (HCV)
J Health care, prevention, harm reduction and treatment > Health care programme, service or facility > Prison-based health service
L Social psychology and related concepts > Interpersonal interaction and group dynamics > Social support
MA-ML Social science, culture and community > Social condition > Homelessness
MM-MO Crime and law > Justice system > Correctional system and facility > Prison
T Demographic characteristics > Person who injects drugs (Intravenous / injecting)
T Demographic characteristics > Person in prison (prisoner)
VA Geographic area > Europe > Ireland
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