Testing and Treatment for Human Immunodeficiency Virus and Hepatitis C Virus Infections among Canadian Federal Inmates
Why we did this study
Correctional Service Canada (CSC) conducted a survey to obtain information about inmates’ health risk-behaviours, use of health programs, and knowledge of human immunodeficiency virus (HIV) and hepatitis C virus (HCV). Results reported here focus on the HIV and HCV testing and treatment experiences of Canadian federal inmates. This information will help CSC enhance its testing and treatment programs.
What we did
In collaboration with inmates and the Public Health Agency of Canada, CSC developed a self-administered questionnaire that asked inmates about their risk-behaviours, such as drug use and sexual activity, use of health programs offered by CSC, and knowledge of HIV and HCV. A random sample of men and all women were invited to complete the questionnaire. Inmate participation was voluntary. To ensure privacy and confidentiality, an external private company administered and retained the anonymous questionnaires, and provided CSC with an anonymous database for analysis. In total, 3,370 inmates across Canada completed the questionnaire in 2007.
What we found
More than 70% of men and 80% of women have been tested for HIV and/or HCV infections during their current sentence.
The rate of testing differed by gender and Aboriginal self-identification. Women were consistently more likely to be tested than men. Being Aboriginal was associated with more testing among men and less testing among women.
The most common reported reason for not being tested at CSC was not being offered the test. This is surprising given that inmates meet with a health professional shortly after admission. It may be that some inmates were unable to recall being offered tests in the distant past, particularly if they were overwhelmed with their circumstances during the admission process. Few cited fear of test result, lack of confidentiality at CSC, or discrimination at CSC as reasons for not being tested. More than half of inmates who have HIV, however, worry about discrimination in federal penitentiaries.
The self-reported rates of HIV (4.6%) and HCV (31.0%) infections among tested inmates were substantially greater than Canadian population rates, particularly among Aboriginal women inmates.
The proportion of HIV-positive inmates currently receiving anti-retrovirals (53%) may be less than that reported in the general community. Among HCV-positive inmates, however, treatment (33%) and efficacy (51%) rates compared favourably with those reported for the general community.
Inmates who have HIV may experience interruptions in their HIV medication due to practical operational issues, such as a temporary unavailability of medication at the institutional pharmacy or transfers between institutions. Inmates may also take themselves off treatment.
What it means
Overall, the majority of inmates are tested for HIV and/or HCV infections either before or during their current sentence at CSC. In addition, many who self-report HIV and/or HCV infections are receiving treatment at CSC. Additional work may be needed, however, to address testing and treatment challenges in the correctional environment.
For more information
Zakaria, D., Thompson, J., Jarvis, A., & Smith, J. (2010). Testing and Treatment for Human Immunodeficiency Virus and Hepatitis C Virus Infections Among Canadian Federal Inmates. Research Report R-223 Ottawa: Correctional Service Canada.
To obtain a PDF version of the full report, contact the following address: firstname.lastname@example.org
Prepared by: Dianne Zakaria
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