Willingness to be Treated for Hepatitis C among Prisoners: Results from the National Prison Entrants’ Bloodborne Virus and Risk Behaviour Survey (NPBBVS)

Author: Butler T, Yap L, and Simpson M

Theme: Epidemiology & Public Health Research Year: 2015

Background: Hepatitis C virus infection (HCV) has a significant global health burden with an estimated 2%–3% of the world’s population infected. Prisons potentially offer a relatively stable environment in which to commence treatment, providing good access to health care, and organised around routine and structure. Uptake of HCV treatment, however, remains low in the community and in prisons. In this study, we explored factors affecting willingness to uptake treatment inside prisons and how prisoner perspectives are an important factor in scaling up treatment in prison.

Methods: Between 2013 and 2014, the NPBBVS screened a cross-section of prison entrants over a two week period at 23 sites located in all Australian states and territories.

Results: A total of 620 prison entrants were surveyed, 540 (87%) men and 80 (13%) women. One Australian state did not complete questions on willingness to treat HCV and were excluded. Of those surveyed, 91 (81% men, 19% women) self-reported current HCV infection and 89 (97% men, 100% women) ever injected drugs. Among the 91 HCV infected, 81 (89%) never had HCV treatment. Of these, 50 (62%) had never sought treatment, 29 (37%) had sought treatment in the past, and 2 missing. Among those who never sought treatment, 11 (22%) preferred treatment inside prison, 14 (28%) outside prison, 20 (40%) were unsure, and 5 missing. Forty-eight (62%) planned to receive treatment in the next 12 months. These results included open responses on why prison entrants never sought treatment, why they were more willing to be treated in prison vs. outside prison, and why they did not want treatment in the next 12 months.

Conclusion: A proportion of prisoners did not want treatment inside prison while some prison jurisdictions were hesitant in offering HCV related treatment. These have implications for efforts to scale-up treatment in prison.

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