The frequencies of antigen-specific memory cells are often low in chronic disease states related to infection and autoimmunity, making detection of such populations difficult, even with high sensitivity assays such as the cytokine enzyme-linked immunospot (ELISPOT). The spectrum and function of antigen presenting cells (APC) in the peripheral compartment can differ considerably from the inflamed target organ. In order to approximate the costimulatory environment of the target organ, we measured T cell responses with and without the addition of agonistic anti-CD28 antibody in the ELISPOT assay. CD4 and CD8 IFN-gamma responses to viral (hepatitis C) and autoimmune antigens (islet cell) were tested in 10 hepatitis C and 8 type 1 diabetic as well as healthy control subjects. IFN-gamma responses to tetanus toxoid, mumps and cytomegalovirus (CMV) protein antigen, as well as Epstein-Barr virus and CMV peptides were also measured in healthy control subjects. We found higher frequencies of T cells reactive to protein and peptide antigens when anti-CD28 antibody was present, often detecting responses only in the presence of anti-CD28 antibody. These results demonstrate that anti-CD28 antibody signal enhanced ELISPOT assays can facilitate the identification of low precursor frequency T cells in chronic infectious and autoimmune disease states where suboptimal costimulatory environment may exist in the periphery. The use of such costimulation may also enable a more quantitative assessment of circulating memory effector T cell frequency.
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- 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 The purpose of this study was to systematically review literature to investigate trends in compassionate release policies, facility implementation, barriers at both the incarcerated individual and institutional levels, as well as gaps in the literature. The absence of uniform and appropriate policies to address suitable interventions at the end-of-life has aggravated the challenges and issues facing health-care systems within a correctional facility. A response to address and alleviate these barriers is policies related to compassionate release, a complex route that grants eligible inmates the opportunity to die in their community. Despite the existence of compassionate release policies, only 4% of requests to the Federal Bureau of Prisons are granted, with evidence demonstrating similarly low rates among numerous state prison systems, signifying the underuse of these procedures as a vital approach to decarceration. Design/methodology/approach A systematic review was completed using preferred reporting items for systematic reviews and meta-analyses guidelines. Centre for Agriculture and Biosciences International Abstracts, Cumulative Index to Nursing and Allied Health Literature, Cochrane Library, Education Resources Information Center, Google Scholar, MEDLINE, PsycINFO, PubMed, Social Services Abstracts and Social Work Abstracts were searched from inception to March 2021. Inclusion criteria included: the compassionate release policy (or related policy) is implemented in the USA; reported qualitative and/or quantitative outcomes; and reported original data. Findings Twenty studies formed the final data set. Data analysis revealed four main themes: language barriers, complexities of eligibility criteria, over-reliance on prognostication and social stigma. Barriers to inmates' access to compassionate release policies include unclear or technical language used in policy documents. Eligibility criteria appear to vary across the country, including disease prognoses and the ability to predict terminal declines in health, creating confusion amongst inmates, lawyers and review boards. Stigmas surrounding the rights of incarcerated individuals frequently influence policymakers who experience pressure to maintain a punitive stance to appease constituents, thus discouraging policies and interventions that promote the release of incarcerated individuals. Research limitations/implications Further research is vital to strengthen the understanding of compassionate release policies and related barriers associated with accessing various types of early parole. To promote social justice for this marginalized population, end-of-life interventions in corrections need to be consistently evaluated with outcomes that improve care for dying inmates. Practical implications Within correctional facilities, correctional health-care workers should play an integral role in influencing prison and medical staff attitudes toward dying inmates by providing an understanding of how to effectively support this vulnerable population. Social workers should participate in research that focuses on effective guidelines for correctional facilities to provide compassionate end-of-life care for inmates. Social implications Racial disparities in the US criminal justice system are prevalent and well documented, as individuals of color are arrested far out of proportion to their share of all individuals in the USA. This particular population is thus challenged with poor access to and quality of health care in corrections. Correctional health-care workers can play an integral role in influencing policymakers, as well as prison and medical staff attitudes toward dying inmates by providing an understanding of how to effectively support this vulnerable population. Originality/value Currently, there are no published research articles that provide a systematic review of compassionate release policies in the USA.
Purpose The rate of female committals to prison has grown rapidly in recent years. Women in prison are likely to have trauma histories and difficulties with their mental health. This paper aims to synthesise the findings of qualitative literature to gain a deeper understanding of the experiences of women in the context of prison-based mental health care. Design/methodology/approach A systematic search of five academic databases, Cumulative Index to Nursing and Allied Health Literature, Applied Social Sciences Index and Abstracts, Psychological Information Database (PsycINFO), Excerpta Medica DataBASE (EMBASE) and Medline, was completed in December 2020. This study’s search strategy identified 4,615 citations, and seven studies were included for review. Thomas and Harden’s (2008) framework for thematic synthesis was used to analyse data. Quality appraisal was conducted using the Joanna Briggs Institute Checklist for Qualitative Research (Lockwood et al. , 2015). Findings Four analytic themes were identified that detail women’s experiences of prison-based mental health care: the type of services accessed and challenges encountered; a reduction in capacity to self-manage mental well-being; the erosion of privacy and dignity; and strained relationships with prison staff. There is a paucity of research conducted with women in the context of prison-based mental health care. The findings suggest there is a need for greater mental health support, including the need to enhance relationships between women and prison staff to promote positive mental health. Originality/value To the best of the authors’ knowledge, this is the first systematic review conducted on the experiences of women in the context of prison-based mental health care.
PURPOSE:This study aims to analyze the pattern of deaths in detention in Northern Tunisia as well as the causes of death.DESIGN/METHODOLOGY/APPROACH:The authors conducted a cross-sectional retrospective study including all the casualties of death in detention examined in the legal medicine Department in the main teaching hospital from 2005 to 2019. The department covers 10 out of the 11 governorates of Northern Tunisia and 13 prisons.FINDINGS:Of a total of 197 casualties, only 2 were females. The mean age was 45.39 ± 14.43 years. A known medical history was reported in 63.5%, mainly cardiovascular disease, mental health disorders and diabetes. Half of the deaths occurred at the hospital. A total of 53 victims spent less than one year in custody before their death. Most deaths occurred due to disease-related causes (78.7%; n = 155); among these, 69 victims died from cardiovascular disease. Suicide accounted for 3.6% of the casualties and homicides for four cases.RESEARCH LIMITATIONS/IMPLICATIONS:Several missing data regarding the details of the detention circumstances as well as the absence in some cases of the toxicological and histopathology analysis results, which could bias the study findings.PRACTICAL IMPLICATIONS:Death in detention in Northern Tunisia involved mainly males between their 30s and their 50s who died mainly from cardiovascular or pulmonary disease. These results underscore the importance of empowering the penitentiary health system.ORIGINALITY/VALUE:To the best of the authors' knowledge, this study is one of largest studies with regard to the number of decedents and the number of prisons from the Arab countries allowing to draw a pattern of casualties of death in prison.
PurposeThis paper aims to report findings about how prisoners experience and cope with COVID-19 restrictions, which can contribute to an understanding of how pandemic responses, and specifically the COVID-19 response, affect prisoners. Design/methodology/approachData was collected through ethnographic fieldwork involving days of observations (N = 24) and the conduction of semi-structured interviews with prisoners (N = 30) in closed prisons and detentions in Denmark between May and December 2021. The transcribed interviews and field notes were processed and coded by using the software programme NVivo. FindingsThe data analysis reveals that the pains of imprisonment have been exacerbated to people incarcerated during the COVID-19 pandemic. To relieve pains of imprisonment, prisoners turn to censoriousness as an informal coping strategy, where they complain about inconsistency and injustice in the prison's COVID-19 prevention strategy to reveal the prison system itself as a rule-breaking institution. The prisoners criticise the prison management for using COVID-19 as an excuse, treating prisoners unjustly or not upholding the COVID-19 rules and human rights. Furthermore, principles of justice and equality are also alleged by some prisoners who contemplate the difficulty in treating all prisoners the same. Research limitations/implicationsMore research will be needed to create a full picture of how prisoners cope with pandemic responses. Further research could include interviews with people working inside prisons. Originality/valueIn a Scandinavian context, to the best of the author's knowledge, this study is the first of its kind to apply an ethnographic approach in exploring prison life during the COVID-19 pandemic.
Purpose Prisoners’ oral health is an often overseen, yet important aspect of the general health of prisoners. To develop effective measures to improve the situation, it is important to get an overview of existing research. The purpose of this study is to examine and analyse existing research on oral health of prisoners and provide a thorough understanding of prisoners’ oral health and related factors. Design/methodology/approach Due to relatively few scientific papers on prisoners’ oral health, an integrative review was chosen. Integrative reviews allow for the inclusion of diverse methodologies. A literature search was conducted, followed by an assessment of the quality of the studies by using the Mixed Methods Appraisal Tool. Thematic analysis was used to analyse the studies. Findings The few studies addressing European prisoners’ oral health in the last 21 years differ in design and methodology. The results from this review indicate that prisoners’ oral health is a complex phenomenon and should be understood from both individual and organisational perspectives. More research is needed to bridge the gap in the literature on prisoners’ oral health. Originality/value To the best of the authors’ knowledge, this is the first literature review on European prisoners’ oral health.
Purpose The menstrual health and menstrual hygiene management (MHM) of incarcerated women remains relatively low on the agenda of public health interventions globally, widening the inequitable access of incarcerated women to safe and readily available menstrual health products (MHP). The COVID-19 pandemic has adversely impacted on the MHM gains made in various development sectors in the global North and South, through its amplification of vulnerability for already at-risk populations. This is especially significant to developing countries such as South Africa where the incarcerated female population are an often-forgotten minority. Design/methodology/approach This viewpoint highlights the ignominious silence of research and policy attention within the South African carceral context in addressing MHM. The ethical and political implications of such silences are unpacked by reviewing international and local literature that confront issues of inequality and equitable access to MHP and MHM resources within incarcerated contexts. Findings Structural inequalities in various contexts around the world have exacerbated COVID-19 and MHM. Within the prison context in South Africa, women face multiple layers of discrimination and punishment that draw attention to the historical discourses of correctional facilities as a site of surveillance and discipline. Research limitations/implications This study acknowledges that while this viewpoint is essential in rising awareness about gaps in literature, it is not empirical in nature. Practical implications The authors believe that this viewpoint is essential in raising critical awareness on MHM in carceral facilities in South Africa. The authors hope to use this publication as the theoretical argument to pursue empirical research on MHM within carceral facilities in South Africa. The authors hope that this publication would provide the context for international and local funders, to assist in the empirical research, which aims to roll out sustainable MHP to incarcerated women in South Africa. Social implications The authors believe that this viewpoint is the starting point in accelerating the roll out of sustainable MHP to incarcerated females in South Africa. These are females who are on the periphery of society that are in need of practical interventions. Publishing this viewpoint would provide the team with the credibility to apply for international and national funding to roll out sustainable solutions. Originality/value It is hoped that the gaps in literature and nodes for social and human rights activism highlighted within this viewpoint establish the need for further participatory research, human rights advocacy and informed civic engagement to ensure the voices of these women and their basic human rights are upheld.
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.
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.
PurposeThis study aims to estimate the overall SARS-CoV-2 seroprevalence and evaluate the accuracy of an antibody rapid test compared to a reference serological assay during a COVID-19 outbreak in a prison complex housing over 13,000 prisoners in Brasília.Design/methodology/approachThe authors obtained a randomized, stratified representative sample of each prison unit and conducted a repeated serosurvey among prisoners between June and July 2020, using a lateral-flow immunochromatographic assay (LFIA). Samples were also retested using a chemiluminescence enzyme immunoassay (CLIA) to compare SARS-CoV-2 seroprevalence and 21-days incidence, as well as to estimate the overall infection fatality rate (IFR) and determine the diagnostic accuracy of the LFIA test.FindingsThis study identified 485 eligible individuals and enrolled 460 participants. Baseline and 21-days follow-up seroprevalence were estimated at 52.0% (95% CI 44.9–59.0) and 56.7% (95% CI 48.2–65.3) with LFIA; and 80.7% (95% CI 74.1–87.3) and 81.1% (95% CI 74.4–87.8) with CLIA, with an overall IFR of 0.02%. There were 78.2% (95% CI 66.7–89.7) symptomatic individuals among the positive cases. Sensitivity and specificity of LFIA were estimated at 43.4% and 83.3% for IgM; 46.5% and 91.5% for IgG; and 59.1% and 77.3% for combined tests.Originality/valueThe authors found high seroprevalence of anti-SARS-CoV-2 antibodies within the prison complex. The occurrence of asymptomatic infection highlights the importance of periodic mass testing in addition to case-finding of symptomatic individuals; however, the field performance of LFIA tests should be validated. This study recommends that vaccination strategies consider the inclusion of prisoners and prison staff in priority groups.
PURPOSEPrisons can be epicentres of infectious diseases. However, empirical evidence on the impact of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic in prison is still scarce. This study aims to estimate the seroprevalence rates of anti-SARS-CoV-2 in the largest and most crowded Swiss prison and compare them with the seroprevalence rate in the general population.DESIGN/METHODOLOGY/APPROACHA cross-sectional study was conducted in June 2020, one month after the first wave of SARS-CoV-2 in Switzerland. Groups included: people living in detention (PLDs) detained before the beginning of the pandemic (n = 116), PLDs incarcerated after the beginning of the pandemic (n = 61), prison staff and prison healthcare workers (n = 227) and a sample from the general population in the same time period (n = 3,404). The authors assessed anti-SARS-CoV-2 IgG antibodies.FINDINGSPLDs who were incarcerated before the beginning of the pandemic had a significantly lower seroprevalence rate [0.9%, confidence interval (CI)95%: 0.1%-5.9%] compared to the general population (6.3%, CI 95%: 5.6-7.3%) (p = 0.041). The differences between PLDs who were incarcerated before and other groups were marginally significant (PLDs incarcerated after the beginning of the pandemic: 6.6%, CI 95%: 2.5%-16.6%, p = 0.063; prison staff CI 95%: 4.8%, 2.7%-8.6%, p = 0.093). The seroprevalence of prison staff was only slightly and non-significantly lower than that of the general population.ORIGINALITY/VALUEDuring the first wave, despite overcrowding and interaction with the community, the prison was not a hotspot of SARS-CoV-2 infection. Preventive measures probably helped avoiding clusters of infection. The authors suggest that preventive measures that impact social welfare could be relaxed when overall circulation in the community is low to prevent the negative impact of isolation.
PurposeWomen 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/approachThis 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. FindingsMost 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/valueResults 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 People who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic. Design/methodology/approach The authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated. Findings A total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively. Originality/value The authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.
PurposeRates of self-harm are elevated in prison, and there is limited evidence to support the efficacy of brief risk screening at reception to predict and prevent self-harm. This study aims to examine the predictive validity of the self-harm/suicide screening items embedded in a prison mental health screening tool from two key domains strongly associated with risk: previous suicidal/self-harm behaviour, and recent ideation. Design/methodology/approachA sample of men and women were screened on entry to prison, with eight screening items covering the two key domains of risk. Follow-up data on self-harm incidents were collected for 12 months post-screening. The predictive validity of individual screening items, item combinations and cumulative screening score was examined for the overall sample and for men and women separately. FindingsIndividual screening items across the two domains were all strongly associated with self-harm in the follow-up period, with odds ratios varying from 2.34 to 9.24. The predictive validity of both individual items, item scores and item combinations demonstrated high specificity but low to moderate sensitivity, and modest area under the curves (AUCs). Predictive validity was generally better for men than women; however, differences were not statistically significant. Practical implicationsIdentifying those at risk of self-harm in prisons remains challenging and brief universal screening at prison entry should be only one component of a broader prison risk assessment and management strategy. Originality/valueTo the best of the authors' knowledge, this study is one of very few to prospectively examine self-harm behaviour following risk screening. Predictive validity was examined in a representative sample of individuals in custody, and for men and women separately.
PurposeContinuity of care and access to primary care have been identified as important contributors to improved health outcomes and reduced reincarceration among people who are justice-involved. While the disproportionate burden of health concerns among incarcerated populations is well documented, less is known about their health service utilization, limiting the potential for effective improvements to current policy and practice. This study aims to examine health status and health care utilization among men recently released from a superjail in a large metropolitan area to better understand patterns of use, risk factors and facilitators.Design/methodology/approachParticipants included adult men (n = 106) matched to a general population group (n = 530) in Ontario, Canada, linked to medical records (88.5% linkage) to examine baseline health status and health utilization three-months post-release. The authors compared differences between the groups in baseline health conditions and estimated the risk of emergency department, primary care, inpatient hospitalization and specialist ambulatory care visits.FindingsSuperjail participants had a significantly higher prevalence of respiratory conditions, mental illness, substance use and injuries. Substance use was a significant risk factor for all types of visits and emergency department visits were over three times higher among superjail participants.Originality/valueThis empirical case is illustrative of an emerging phenomenon in some regions of the world where emergency departments serve as de facto "walk-in clinics" for those with criminal justice involvement. Strategic approaches to health services are required to meet the complex social and health needs and disparities in access to care experienced by men released from custody.
Purpose This study aims to characterize the June 2020 COVID-19 outbreak at San Quentin California State Prison and to describe what made San Quentin so vulnerable to uncontrolled transmission. Design/methodology/approach Since its onset, the COVID-19 pandemic has exposed and exacerbated the profound health harms of carceral settings, such that nearly half of state prisons reported COVID-19 infection rates that were four or more times (and up to 15 times) the rate found in the state's general population. Thus, addressing the public health crises and inequities of carceral settings during a respiratory pandemic requires analyzing the myriad factors shaping them. In this study, we reported observations and findings from environmental risk assessments during visits to San Quentin California State Prison. We complemented our assessments with analyses of administrative data. Findings For future respiratory pathogens that cannot be prevented with effective vaccines, this study argues that outbreaks will no doubt occur again without robust implementation of additional levels of preparedness - improved ventilation, air filtration, decarceration with emergency evacuation planning - alongside addressing the vulnerabilities of carceral settings themselves. Originality/value This study addresses two critical aspects that are insufficiently covered in the literature: how to prepare processes to safely implement emergency epidemic measures when needed, such as potential evacuation, and how to address unique challenges throughout an evolving pandemic for each carceral setting.
PurposePrisoners are at a higher risk of HIV infection compared to the general population. The purpose of this study is to estimate the prevalence of HIV and related risk behaviours among inmates of the Central Prisons in four states of North India. Design/methodology/approachThe HIV sentinel surveillance was conducted in seven Central Prisons in four states of North India from February to April 2019. Four hundred inmates were included from each prison. The interviews were conducted at the Integrated Counselling and Testing Centre located within the prison premises. The Ethics Committee of the National AIDS Control Organization, New Delhi, granted ethical approval before the start of the surveillance. FindingsOverall, 2,721 inmates were enrolled in this study. The mean (SD) age was 38.9 (13.9) years. One-third of prison inmates had comprehensive knowledge about HIV/AIDS. The proportion of convict (54%) and undertrial (46%) inmates was almost equal. The overall prevalence of HIV infection among inmates was 0.96% (95% CI 0.65-1.40). The odds of being HIV positive were significantly higher in never married inmates, undertrials, inmates who were in the prison for more than three months to one year, inmates incarcerated for multiple times, inmates with history of injecting drug use and inmates with history of intercourse with a commercial sex worker. Originality/valueThe findings from the very first HIV sentinel surveillance in central prisons in North India have been presented in this paper. This has huge implications for future policy decisions.
