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At least 469 records · Page 26Linked to original sources
PubMed1998

A survey of bloodborne viruses and associated risk behaviours in Greek prisons.

AIMS: To determine HIV and hepatitis infection prevalence and correlates with risk behaviour. DESIGN: Cross-sectional study: voluntary, anonymous HIV, hepatitis (HCV, HBV and HDV) surveillance and questionnaire on risk factors. SETTING: Korydallos Prison, Athens and Ag. Stefanos Prison, Patra, Greece. PARTICIPANTS: Of 544 drug users imprisoned for drug related offences, all completed the questionnaire and 533 blood samples were collected. MEASUREMENTS: HIV (by anti-HIV-1), HCV (by anti-HCV), HBV (by anti-HBc, HBsAg) and HDV (by anti-HDV) prevalence. Data on demography, legal status, drug use, sharing of injecting equipment. FINDINGS: Of the 544 drug users, 375 (68.9%) had injected drugs (IDUs) at some time, 35% of whom had injected whilst in that prison. Of the 533 blood samples tested, one was positive for anti-HIV-1 (0.19%), 310 for anti-HCV (58.2%), 306/531 (57.6%) for anti-HBc, 34/527 (6.5%) for HBsAg and 12/527 (2.3%) for anti-HDV. Prevalence rates for IDUs only were 0.27% for HIV-1, 80.6% for hepatitis C, 62.7% for hepatitis B and 3.3% for hepatitis D. Ninety-two per cent of IDUs injecting in prison shared needles, indicating that IDUs inject less but share more during incarceration. Multiple logistic regression revealed needle-sharing as the most important risk factor for HCV infection in IDUs. Prior knowledge of a positive hepatitis result did not appear to inhibit IDUs from practising risky behaviours in prison. CONCLUSIONS: The epidemic of hepatitis B and C among imprisoned IDUs identified by this study constitutes a major public health problem. Prevention programmes, such as counselling, HBV vaccination, community-based methadone maintenance treatment and syringe exchange schemes, are necessary in order to prevent a further spread.

Adult↗
PubMedDate not supplied

The ethics of organ transplantation for prisoners.

Organ transplantation for prisoners raises numerous ethical issues. Questions immediately emerge about how to justify the use of scarce organs for prisoners when law-abiding citizens are waiting. The answer to whether and why we ought to perform organ transplants for prisoners lies in how we understand society's commitments to prisoners' health and health care, and whether being incarcerated changes the priority of a patient waiting for a transplant. While prisoners forfeit many freedoms, access to and the provision of adequate health care are guaranteed to them, and ought to include access to organ transplants.

Humans↗
PubMedDate not supplied

[Psychotherapy within the prison system after the change of law].

The amendment of the law limiting the professional secrecy of physicians and psychologists toward the prison authorities has triggered a discussion on the consequences involved for treatment practice in the prison system. To reduce the lack of empirically based arguments in this discussion, our study deals with the question of whether and to what extent psychotherapy in conjunction with prison health care offers also contributions to preventing recidivism. A quasi-experimental control group study showed that especially for serious violent offenses delinquents of the Tegel detention center who underwent at least 20 hours of therapy at the psychotherapeutic consultation and treatment service had a markedly lower recidivism rate a mean of four years after release from prison than an untreated group. If changes in the penal code jeopardize a regular therapeutic setting with professional secrecy, they carry the risk of excluding prisoners primarily requiring psychotherapy who have thus far apparently also derived benefit especially from prevention-oriented therapy.

Adult↗
PubMed2002

The role of prisons in the HIV epidemic among female injecting drug users.

The objective of this study was to describe factors associated with imprisonment of female injecting drug users (IDUs) and to assess if female IDUs who have been in prison have different HIV risk behaviours when compared to females IDUs who have never been incarcerated. A seroepidemiological survey was conducted of 304 female IDUs recruited in outreach and treatment programmes in Madrid, Spain. Data on sociodemographic characteristics and recent and lifetime risk factors, sexual and reproductive history and history of imprisonment were collected. Bivariate analysis and a logistic regression model were used to identify factors associated with imprisonment. Risk factors for imprisonment were having illegal sources of income, not having a fixed address, leaving education before finishing primary school and starting injection of drugs early in adolescence. HIV risk behaviours were highly prevalent among this population of female IDUs and drug injection in prison was reported by more than one-third of those who had ever been imprisoned. In addition, recent HIV risk behaviour indicators were not associated with imprisonment, suggesting that incarceration did not lead to risk reduction after release from prison. Female IDUs who have been in prison have substantial reproductive health problems that require gynaecological care. These results point to the urgent need for prevention programmes which address HIV and other blood-borne infections using gender specific approaches for women IDUs incarcerated in Spanish prisons.

Adult↗
PubMed2001

Federal prison residential drug treatment reduces substance use and arrests after release.

OBJECTIVE: The effectiveness of federal prison-based residential drug and alcohol treatment programs was evaluated using event history procedures that addressed the problem of selection bias and included a wide range of control variables. METHODS: The sample comprised 760 treatment subjects and 809 comparison subjects. Treatment subjects were from 20 different prisons of medium, low, and minimum security levels. Comparison subjects were drawn from over 30 prisons. RESULTS: The results indicated that individuals who entered and completed in-prison residential treatment were less likely to experience the critical postrelease outcomes of new arrests and substance use during the first 6 months following release. CONCLUSIONS: Without controlling for selection bias, the effects of treatment would most likely have been attenuated. The results have greater generalizability than other studies of prison-based treatment. This study occurred within a multisite context of 20 programs serving both male and female inmates and operating within different security levels and different geographic regions.

Adult↗
PubMed2001

Working toward a portable tele-ophthalmic system for use in maximum-security prisons: a pilot study.

The medical care of prisoners is a difficult and often costly process. Basic medical needs are serviced by prison medical officers. However, specialized care often means transport to specialist centers with the attendant cost and safety. We examined portable ophthalmic equipment in a prison environment to screen 11 prisoners who were scheduled for specialist ophthalmic assessment. Medical and ophthalmic histories were documented, visual acuity was tested, digital images were taken of the external eye and retina, and intraocular pressures taken. The data were sent via modem to a specialist ophthalmologist, and the reports were dictated via e-mail at the end of each session. Of the 11 patients who were scheduled to travel for ophthalmic assessment, only 2 were still required to travel to a specialist ophthalmic center. This pilot study showed that there were considerable cost savings to be made by this screening process with the attendant increase in community safety. The prototype equipment requires refinement by further experimentation, but showed the potential as an adjunct to current examination and assessment techniques when applied to a prison population.

Adult↗
PubMed2005

Adherence to antiretroviral treatment in prisons.

The effectiveness of antiretroviral drugs is closely linked to the degree of adherence. The prison environment has specific characteristics that may affect adherence in HIV-positive patients, so that it may not be possible to extrapolate factors associated with nonadherence in HIV+ patients outside prison. The objective was to analyze the prevalence of nonadherence to antiretroviral treatment in three Spanish prisons, and to examine the relation between a large group of factors and nonadherence to the medication. A cross-sectional study of all patients receiving antiretroviral treatment was done. Adherence was evaluated using a validated questionnaire (SMAQ). The prevalence of nonadherence was 54.8%, and the factors independently associated with nonadherence were having difficulties in taking the medication, feeling completely or largely unable to follow the medication, classifying the food as "bad", mentioning not having anyone concerned for them outside prison, suffering anxiety or depression in the last week, and having the flexibility of the prison staff opening their cell in the event of them forgetting their medication.

Adult↗
PubMed2004

Unmet treatment needs of older prisoners: a primary care survey.

BACKGROUND: little is known about the treatment needs of older prisoners and to what extent they are being met. SUBJECTS: representative sample of 203 sentenced prisoners aged 60 and over in 15 prisons in England and Wales. DESIGN: case notes were surveyed using a standardised proforma and information on current medication was collected. RESULTS: three-quarters of older prisoners were prescribed medication. Those with cardiovascular, respiratory and endocrine health problems were prescribed medication that was mostly appropriately targeted. In contrast, only 18% of inmates with recorded psychiatric morbidity were prescribed psychotropic medication. CONCLUSIONS: reviewing the medical records of older prisoners and considering the appropriateness of their current medication regime would be a primary care intervention that could significantly improve the health of this marginalized group.

Aged↗
PubMed2005

Violent offenders in a deaf prison population.

Previous research suggested an unexplained difference in the patterns of offending behaviors among deaf people when compared to hearing people. This study, conducted in Texas, compares the incidence and types of violent offenses of a deaf prison population in comparison to the hearing prison population. Sixty-four percent of deaf prisoners were incarcerated for violent offenses in comparison to 49% of the overall state prison offender population. This finding is consistent with previous research. The most significant difference between the populations was found in the category of sexual assault, which represented 32.3% of deaf offenders in contrast to 12.3% of hearing state prison inmates overall. Factors potentially impacting violent offending by deaf persons are their vulnerability to child sexual abuse, use of chemicals, educational histories, and development of language and communication skills. Additionally, there is a widespread lack of accessible intervention and treatment services available to deaf sex offenders across the nation.

Achievement↗
PubMed2005

The mortality of young offenders sentenced to prison and its association with psychiatric disorders: a register study.

BACKGROUND: We studied the nationwide mortality in Finland of young offenders sentenced to prison, with the advantage of a long-term follow-up in an unselected population. In addition, we aimed to clarify the relationship between psychiatric disorders requiring hospital treatment and early death in young offenders sentenced to prison. METHODS: All offenders sentenced to prison between 1984 and 2000 in Finland and aged 15-21 years when the crime was committed were selected for this study. The mortality of the young offenders was compared with the age- and sex-matched mortality data of the general population, obtained from Statistics Finland. Information on hospital treatment periods for psychiatric diagnoses was collected from the Finnish Health Care Register and linked to the mortality data. RESULTS: The study population consisted of 3,743 young male and 89 young female offenders. Of these, 435 (11.4%) had died by the end of the follow-up period, including 3 girls. The standardized mortality ratio for young male prisoners was 7.4 (95% confidence interval 6.7-8.1). There was a higher mortality rate among young offenders convicted in the later years of the study period. The causes of death were mostly unnatural and often violent. Hospitalization for a psychiatric disorder or substance abuse was significantly associated with the risk of death. However, hospitalization for emotional disorders with an onset specific to childhood and adolescence were associated with a lower death risk. CONCLUSION: The mortality rate in the population of young offenders sentenced to prison is alarmingly high. The high mortality in this group is associated with substance abuse and psychiatric disorders, but not with emotional disorders with an onset specific to childhood and adolescence.

Adolescent↗
PubMed1984

Seroepidemiology of hepatitis B in Tennessee prisoners.

A prevalence serosurvey was performed on an 11.7% sample of the 6,503 adult male inmates in Tennessee prisons. On the basis of the sample, 0.9% of the prisoners possessed hepatitis B surface antigen, and 29.5% had one or more serum markers for hepatitis B virus (HBV). Thirty-two possible risk factors were analyzed for association with possession of HBV serum markers. The significant risk factors for possession of HBV markers in this population were found to be age, intravenous drug use while not incarcerated, intravenous drug use while incarcerated, race, education, military service history, and duration of prior and current imprisonments, in that order of importance. Given the modest contribution of incarceration to overall risk, mass immunization of prisoners against HBV seems unwarranted. Prisoners with unusually long sentences or who use intravenous drugs in prison are subgroups at particularly high risk. The logistic model can be used to target a serological screening and immunization program.

Adolescent↗
PubMed1998

Study size and documentation to detect injection-related hepatitis C in prison.

We used existing data on hepatitis C prevalence, injection-related hepatitis C transmission and needle use in prisons and new data on infectiousness, to estimate the size of study required to detect injection-related hepatitis C in UK prisons. A pilot study of 500 prisoners followed for 10 weeks would have a 65% chance of detecting a hepatitis C seroconversion, conservatively assuming one injection per prisoner per week, and a 3% transmission rate per injection, but uncertainty might persist as to whether transmission had occurred during a short incarceration or before it. If the actual transmission rate was 10%, as recently documented, then such a study would have more adequate statistical power. A definitive study of 3000 prisoners for 10 weeks would expect to detect about six seroconversions, even with conservative estimates of injection frequency and transmission rate. Adequate design and power of these studies is important because of the complacency that could result from false-negative findings. We suggest six risk-factor themes that studies should document.

Adult↗
PubMed1999

Prevalence of hepatitis C in prisons: WASH-C surveillance linked to self-reported risk behaviours.

We used cross-sectional willing anonymous salivary hepatitis C (WASH-C) surveillance linked to self-completed risk-factor questionnaires to estimate the prevalence of salivary hepatitis C antibodies (HepCAbS) in five Scottish prisons from 1994 to 1996. Of 2121 available inmates, 1864 (88%) participated and 1532/1864 (82%) stored samples were suitable for testing. Overall 311/1532 (20.3%, prevalence 95% CI 18.3-22.3%) were HepCAbS-positive: 265/536 (49%, 95% CI 45-54%) injector-inmates but only 27/899 (3%, 95% CI 2-4%) non-injector-inmates. Among injectors, HepCAbS positivity was only slightly higher (p = 0.03) in those who had injected inside prison (53%, 162/305) than in those who had not (44%, 98/224). Those who began injecting in 1992-96 were much less likely to be HepCAbS-positive than those who started pre-1992 (31%, 35/114 vs. 55%, 230/422; p < 0.001). Even with injectors who began in 1992-96 but had never injected inside prison, the prevalence of hepatitis C carriage was 17/63 (95% CI 16-38%). The prevalence and potential transmissibility of hepatitis C in injector-inmates are both high. Promoting 'off injecting' before 'off drugs' (both inside and outside prison), methadone prescription during short incarcerations, alternatives to prison, and support of HepCAbS-positive inmates in becoming eligible for treatment, all warrant urgent consideration.

Adult↗
PubMed1979

Prison health and medical education.

Prison health has long been neglected as an area of serivice by organized medicine and a site for clinical education by health science centers. The University of New Mexico Health Science Center offers an elective, weekly clinical experience for preclinical medical students, senior nursing students, and senior pharmacy students at a prison facility in need of medical services. Students' reaction to the prison experience was strongly positive. Most developed empathy toward the inmates and a greater understanding of prison health problems. Inmates rated the student service highly and requested its continuation. This community health education experience has provided a noncontractual model of a university-prison health alliance.

Ambulatory Care Facilities↗
PubMed1988

Transmission of HIV-1 within a statewide prison system.

To assess the incidence of infection with HIV-1 in the Maryland state prison system, inmates with excess sera stored from specified intake periods between April and June 1985 and 1986 were approached in May 1987 to volunteer for venipuncture. Of the 2286 inmates for whom intake specimens were stored, 1038 (45.4%) no longer incarcerated as of April 1987 were excluded from the study; another 319 missed the survey. Of the 929 eligible inmates approached for the study, 446 (48%) consented and 422 (94.6%) provided a specimen. Twenty-nine (6.6%) were confirmed seropositive at time of entry into prison, indicating that infection had occurred prior to incarceration. Baseline seropositives were more likely (P less than 0.05) to be non-violent offenders, committed in Baltimore City, and black. The 393 participants seronegative at baseline provided a total of 482 prison-years of potential exposure to infection. Two inmates seroconverted with baseline specimens seronegative on Western blot and follow-up sera confirmed positive; their duration of pre-incarceration detention was 69 and 146 days, respectively. No interruption of incarceration was recorded for these two inmates. The rate of infection in this prison sample, which does not include an average of 2 months of pre-incarceration detention for the study sample, was 0.41% per prison-year.

Acquired Immunodeficiency Syndrome↗
PubMed1977

Health status of the New York City prison population.

During a two-week period in June 1975, all 1,420 prisoners admitted to New York City Correctional Facilities were studied to determine the prevalence of current and past health conditions. Information was obtained from a standard admission health examination. Almost three-quarters of the male and female prisoners were 30 years or less. Of the study population, 57 per cent were black, 24 per cent were Hispanic and 17 per cent were white. Forty-one per cent reported a history of illicit drug use. More than one-quarter of the prisoners reported a present illness and three-fifths received at least one diagnosis. Commonly diagnosed conditions included drug abuse, psychiatric disorder, trauma, and alcohol abuse. Seven per cent of male prisoners had a previous psychiatric hospitalization. On examination, new trauma was noted in 10 per cent of the male population. In addition to these findings, a history of seizure disorder was reported in 4 per cent of the male population. Health services within prisons must be able to manage the most pressing problems in this population-substance abuse and psychiatric disorder and provide care for the range of conditions that is similar to that found in the general population for this age group.

Adult↗
PubMedDate not supplied

Age, testosterone, and behavior among female prison inmates.

OBJECTIVE: The objective of the study was to determine how testosterone levels, both alone and interacting with age, were associated with criminal behavior and institutional behavior among female prison inmates. METHOD: Subjects were 87 female inmates in a maximum security state prison. Criminal behavior was scored from court records. Institutional behavior was scored from prison records and interviews with staff members. Testoster-one levels were scored from radioimmunoassay of saliva samples. RESULTS: Product-moment correlations revealed first-order relationships among age, testosterone, criminal behavior, and institutional behavior. Structural equation analysis suggested a causal model in which age leads to lower testosterone, which in turn leads to less violent crime and less aggressive dominance in prison. CONCLUSION: Testosterone is related to criminal violence and aggressive dominance in prison among women, as has been reported among men. Changes in these behaviors with age are in part explained by a decline in testosterone levels.

Adolescent↗
PubMed1991

Treatment of opiate withdrawal on entry to prison.

Forty-nine opiate-dependent persons entering remand prison were treated with methadone over 5-10 days in decreasing doses according to standard practice of the prison medical service. The prisoners were mainly young, unmarried men with an average of 5 years regular opiate use and an average of four previous imprisonments; 45% were known to be HIV infected, although routine testing was not carried out. Ten were on methadone maintenance prior to imprisonment. Urine analysis on entry detected an average of three psychoactive substances, principally opiates, benzodiazepines and cannabis. Prescribed starting doses of methadone were not correlated to independently assessed withdrawal severity. Starting doses were related to prisoners' requests and to their age. Withdrawal severity decreased after 4 days treatment but symptom relief was incomplete. Treating withdrawal symptoms on entry to prison poses unsolved ethical and practical problems.

Adult↗