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PubMed2003

Female prisoners' preferences of collection methods for testing for Chlamydia trachomatis and Neisseria gonorrhoeae infection.

BACKGROUND: There is an increasing reliance on noninvasive techniques to collect specimens for the detection of sexually transmitted infections. The acceptability of these methods among the general population has been explored, but little is known about their acceptability among women confined in prison. GOAL: The goal was to compare female prisoners' preferences for collection of specimens (self-collected vaginal swab specimens, urine collection, or pelvic examination) for detection of Chlamydia trachomatis and Neisseria gonorrhoeae. STUDY DESIGN: A cross-section of inmates in a large federal prison provided urine samples and self-collected vaginal swab specimens. Women then completed a questionnaire regarding the ease of each method and their preferences for future specimen collection. RESULTS: A total of 535 women between the ages of 18 and 52 years (median = 33) participated in the study. More than half of the participants (57%) reported no difference between urine and swab in terms of ease of collection. Approximately 30% of participants said they would prefer to give a swab specimen in the future rather than collect urine (21%), but nearly half of the women expressed no preference for one method over the other. Most participants (60%) expressed a preference for providing a self-collected swab specimen rather than having a pelvic examination (23%), but nearly 17% expressed a preference for one over the other. CONCLUSION: The study population of female federal prisoners expressed no aversion to the self-collection of either vaginal swab or urine specimens for STD testing. A majority of participants expressed a preference for noninvasive techniques rather than a pelvic examination.

Adolescent↗
PubMed2005

Sexually transmitted infections and other health conditions of women entering prison in Georgia, 1998-1999.

OBJECTIVES: To assess health needs of women entering the Georgia prison system, prevalence of pregnancy and sexually transmitted infections was estimated. STUDY: Results of admission screening tests of women entering the Georgia prison system in 1998 to 1999 were abstracted retrospectively from prison records. RESULTS: Of 3636 women whose data were abstracted from prison records, 4.3% were pregnant and 8.2%, 4.0%, 5.9%, and 0.7%, respectively, had positive screening tests for trichomoniasis, HIV, chlamydia, and gonorrhea; 19.5% had at least 1 of those conditions. HIV prevalence was higher among inmates who were black or had a rapid plasma reagin test for syphilis reactive at > or =1:8 dilutions (6.0%, 15.8%, respectively) than others (1.3%, 3.7%; P < 0.001). CONCLUSION: Inmates in this study had high rates of sexually transmitted infections and many were pregnant. Black inmates were at higher risk for HIV and high rapid plasma reagin titers than white inmates or other routinely tested Georgia female populations.

Adolescent↗
PubMed2004

The self-reported health status of prisoners in New South Wales.

OBJECTIVE: To describe the physical health of the New South Wales prisoner population. DESIGN: Cross-sectional random sample of adult men and women prisoners. SETTING: 29 New South Wales correctional centres (27 male and two female). PARTICIPANTS: 747 men and 167 women. MAIN RESULTS: Despite the comparatively young population, 81% of women and 65% of men had at least one chronic health condition; 41% of men and 59% of women reported multiple health problems. The most common conditions were back problems, poor eyesight, arthritis, high blood pressure and asthma. Chronic conditions were more prevalent among women prisoners. Thirty-seven per cent of women and 28% of men rated their health as either 'poor' or 'fair' compared with 16% of women and 15% of men in the general NSW community. Psychiatric medication was more commonly prescribed to women than men (25% vs. 13%; p < 0.001). Similarly, methadone maintenance was more common among women than men (39% vs. 13%; p < 0.001). CONCLUSION: Men and women prisoners in NSW have multiple chronic health conditions. While not desirable, incarceration presents an opportunity to initiate treatment to improve the health of this disadvantaged group.

Adult↗
PubMedDate not supplied

A qualitative study of factors influencing psychiatric nursing practice in Australian prisons.

TOPIC: Factors influencing the practice of psychiatric nursing in Australian prisons. METHODS: A qualitative study of psychiatric nurses (N = 30) working in a prison. FINDINGS: The psychiatric nurses identified the following factors as influencing their work: challenging patients, threats to personal survival of patients, the technology and artifice of confinement, conflicting values of nurses and corrections staff, stigma by association, and prisoner identification of the nurses with prison administration. CONCLUSIONS: Psychiatric nurses who work in forensic settings must adapt to less than optimal practice conditions.

Australia↗
PubMed2005

[Predictive markers of HIV and HCV infection and co-infection among inmates in a Spanish prison].

OBJECTIVE: To study the prevalence and factors associated with HIV and HCV infection among inmates of a Spanish prison. METHOD: A cross-sectional study was carried out in July 2001. We determined HCV (ELISA and RIBA-3) and HIV (ELISA and Western-blot) serology in the prison population. Study variables included age, sex, nationality and previous intravenous drug use (IDU). In IDU inmates we analyzed the age when intravenous drug use was initiated, years of consumption, age at first admission in prison and syringe sharing with other inmates. The subpopulations of Arab and Romani (gypsy) inmates were studied differentially. RESULTS: A total of 800 inmates (mean age 34.2 6 6.2 years) were evaluated; 74.3% were Spanish and 33.6% IDU. HCV serology was obtained in 730 inmates and HIV serology in 773 with the following seroprevalence results: HCV 38.2%, HIV 19.1% and HCV-HIV co-infection 18.8%. The variables associated with HCV or HIV infection in the univariate analysis were Spanish nationality, previous IDU and coinfection by the other virus. In the multivariate analysis, only coinfection and, particularly, previous IDU (HCV infection: adjusted ORp 104.8 [95% CI: 49.4-222.2]) (HIV infection adjusted ORp 45.1 [95% CI: 14.0-144.9]) maintained an association with the two infections. CONCLUSIONS: The prevalence of HIV and HCV infection and coinfection is high in Spanish prisons. Infection by either of these viruses and previous IDU were independently associated with both infections. The percentage of non-Spanish inmates with these infections is low.

Adult↗
PubMed1997

A longitudinal study of transmission of tuberculosis in a large prison population.

The purpose of this study was to determine the extent of transmission of tuberculosis in a large prison population over an 18-mo period. Restriction-fragment-length polymorphism (RFLP) analysis of isolates of Mycobacterium tuberculosis was performed, using the insertion sequence IS6110 and the plasmid pTBN12. Patients infected with strains having the same fingerprint were grouped in clusters. Medical records were reviewed and movement of inmates among prisons was examined for selected patients. Tuberculosis was diagnosed in 216 inmates (case rate = 2,283 per 100,000 per year). Isolates from 210 (97%) patients were fingerprinted, 155 (74%) were grouped in 25 clusters, and 55 (26%) showed a unique fingerprint. Recent infection was inferred in 62% of these patients. Eighty-four percent (161 of 192) of patients tested were human immunodeficiency virus (HIV)-positive, of whom 121 were in clusters and 40 were not (p = 0.74). Patients in clusters were less adherent with tuberculosis treatment than those not in clusters (p < 0.05), and prison transmission of resistant strains was observed. It is crucial that infection control guidelines be fully implemented in the prison setting to prevent tuberculosis transmission.

Adult↗
PubMed1980

The violation of psychiatric standards of care in prisons.

The author evaluated psychiatric care in three U.S. prison systems. Major problems included limitations imposed by prison architecture, inadequate staff, medication prescription and distribution by unlicensed, untrained personnel, and a punitive rather than therapeutic attitude. Following the standards of care recommended by American Correctional Association would correct most of these problems. Psychiatrists should guard against prescribing unnecessary medications, particularly minor tranquilizers and sedatives, and should be concerned with prison conditions conductive to mental illness, particularly overcrowding, abuses of solitary confinement, and inadequate programs for inmates who are mentally disturbed but not overtly psychotic. The author recommends minimum staffing standards and suggests considering the transfer of mentally ill inmates to appropriate psychiatric hospitals outside the prison system.

Attitude of Health Personnel↗
PubMed1980

Improving psychiatric care for prisoners.

While psychiatry has been ambivalent about treating mentally ill offenders, recent mandates for better mental health care for prisoners will require the profession's intervention. The authors, whose study of mental health care needs of inmates in Oklahoma is reported in the article following this one, believe that because the prison is a community, a community-mental-health-like system offering a continuum of services is indicated. Some of the services they propose for prisons include outpatient and partial hospital services, an acute inpatient unit, a residential tertiary care unit, and an intermediate living unit. They also believe that mental health professionals should help improve the environment of prisons, and can do so by sharing lessons learned in their own institutional settings about the effects of a therapeutic community and a legitimate patient government.

Health Services Needs and Demand↗
PubMed1987

A survey of mental disability among state prison inmates.

To obtain a comprehensive picture of the levels of mental disability in the general state prison population in New York State, the authors gathered data on a random sample of inmates using a survey instrument adapted from the state's level-of-care surveys of the psychiatric population. The sample consisted of 3,332 inmates in the general prison population (9.4 percent) and 352 inmates in prison mental health units. The survey results showed that 8 percent of the state's prison inmates have severe psychiatric or functional disabilities that clearly warrant some type of mental health intervention, and another 16 percent have significant mental disabilities that require periodic services. The specific nature and extent of these disabilities need to be assessed before appropriate services can be developed.

Humans↗
PubMed1997

A survey of sentenced prisoners transferred to hospital for urgent psychiatric treatment over a three-year period in one region.

This study describes a survey of sentenced prisoners who were transferred to psychiatric hospitals in South Wales under 8.47 of the Mental Health Act of 1983 (England & Wales) over a three-year period. During this time there were 29 such transfers of 25 prisoners and all were male. Fifty per cent of these prisoners who became patients had a clinical diagnosis of schizophrenia, 13 per cent of recurrent depressive disorder, 4 per cent of a drug-induced psychosis, 4 per cent of hypomania and 6.6 per cent had some form of personality disorder. Forty-four per cent were returned to prison to complete their sentence once their mental disorder was treated.

Adult↗
PubMed2003

Prisoners' perception of informing to the authorities: an analysis in terms of functional moral judgment.

A series of functional measurement experiment show that prisoners modulate their moral judgments of violations of their in-group regulations. The participants were 67 women and 80 men, sentenced for at least three years for murder, robbery, drug-traffic or white collar offenses. Each was asked, individually, to imagine a series of incidents where incriminating information on in-group or out-group inmates is delivered to the prison authorities or to an ingroup source and to rate the deserved denigration of the informer, who was characterized as a leader or not and as a drug-addict or not who had a prison-leave or not. An assignment of approximately equal weight for social status, drug use and prison leave was found, beyond gender and type of offense. In line with the hypothesis of judgmental modularity, informing to an out-group source was judged much more severely than informing to in-group arbiter and than informing on an out-group inmate.

Adult↗
PubMed2005

An actuarial model for assessment of prison violence risk among maximum security inmates.

An experimental scale for the assessment of prison violence risk among maximum security inmates was developed from a logistic regression analysis involving inmates serving parole-eligible terms of varying length (n = 1,503), life-without-parole inmates (n = 960), and death-sentenced inmates who were mainstreamed into the general prison population (n = 132). Records of institutional violent misconduct of these 2,595 inmates were retrospectively examined for an 11-year period (1991 to 2002). Predictors affecting the likelihood of such misconduct included age, type and length of sentence, education, prior prison terms, prior probated sentences, and years served. The scale was modestly successful, as demonstrated by an overall omnibus area under the curve of .719. Double cross-validation demonstrated minimal shrinkage. The authors have termed this experimental scale the Risk Assessment Scale for Prison.

Adult↗
PubMed2006

Alcohol dependence: international policy implications for prison populations.

BACKGROUND: In light of the emphasis on drug abuse, this study explored the relative prevalence of substance use disorders among United Kingdom (UK) prison inmates in the context of findings from a general inmate population in the United States (US). The lead author of the report conducted a structured diagnostic interview with 155 new admissions to one of two prisons in the UK using the CAAPE (Comprehensive Addiction And Psychological Evaluation), a structured diagnostic interview, to ensure consistent assessments. The US sample consisted of 6,881 male inmates in a state prison system evaluated with an automated version of the SUDDS-IV (Substance Use Disorder Diagnostic Schedule-IV) interview. RESULTS: Alcohol dependence emerged as the most prevalent substance use disorder in both UK prisons and in the US sample. Relative frequencies of abuse and dependence for alcohol and other drugs revealed that dependence on a given substance was more prevalent than abuse ad defined by the current diagnostic criteria. CONCLUSION: Despite the emphasis on drugs in correctional populations, alcohol dependence appears to be the most prominent substance use disorder among the incarcerated in both the US and UK and must be considered in developing treatment programs and policy priorities.

Adolescent↗
PubMed1998

Managing terminally ill prisoners: reflection and action.

In 1997 a young remand prisoner was 'shackled' to his bed until shortly before his death. An outcry ensued. This paper discusses issues concerning care of terminally ill prisoners. In Cardiff, the Prison Service, local National Health Service trusts and the hospice have produced joint guidance on the escorting of ill prisoners and managing a bedwatch; these are outlined.

Delivery of Health Care↗
PubMed1994

Psychiatric disorder in women serving a prison sentence.

The paper describes a case-note and interview study of a cross-sectional sample comprising 25% of all women serving a prison sentence in England and Wales. A 5% sample of the male sentenced prison population was used for comparison. Diagnoses were assigned on clinical grounds and an assessment was made of the treatment needs of all 'cases'. The prevalence of psychosis, around 2%, was similar in the two groups but women had higher rates of mental handicap (6% v. 2%), personality disorder (18% v. 10%), neurosis (18% v. 10%) and substance abuse (26% v. 12%). There is a need for closer links between the NHS and prison health services. Women's prisons lack a therapeutic community of the Grendon type, which may be of benefit to a substantial minority of inmates.

Adolescent↗
PubMed2002

Ethnic differences in prisoners. 1: criminality and psychiatric morbidity.

BACKGROUND: In England and Wales, persons of African-Caribbean origin are more likely to be both imprisoned and admitted to secure hospitals. AIMS: To estimate population-based rates of imprisonment in different ethnic groups, and compare criminal behaviour and psychiatric morbidity. METHOD: We examined Home Office data on all persons in prison, and carried out a two-stage cross-sectional survey of 3142 remanded and sentenced, male and female, prisoners in all penal establishments in England and Wales in 1997. RESULTS: We confirmed high rates of imprisonment for Black people and lower rates for South Asians. Different patterns of offending and lower prevalence of psychiatric morbidity were observed in Black prisoners. CONCLUSIONS: Despite increased risks of imprisonment, African-Caribbeans show less psychiatric morbidity than White prisoners. This contrasts with the excess of African-Caribbeans in secure hospitals, an inconsistency possibly in part due to the effects of ethnic groups on admission procedures.

Adult↗
PubMed1984

Epilepsy in prison: elevated prevalence and no relationship to violence.

The epidemiologic, clinical, and social characteristics of epilepsy were investigated in men entering the Illinois prison system and compared with a matched control group of prisoners without epilepsy. The prevalence of epilepsy was 2.4%, four times higher than the prevalence among men aged 20 to 39 in Rochester, MN. Head trauma was the probable cause of epilepsy among 45% of the prisoners with epilepsy, a much higher percentage than that reported in studies of other populations. In comparison with an age- and race-matched group of prisoners without epilepsy, the epilepsy group was not convicted of more serious or more violent crimes.

Adolescent↗
PubMed2000

Herpes simplex virus type 2 in prisoners, New South Wales, Australia.

Our objectives were to determine the prevalence of, and risk factors for, herpes simplex virus type 2 (HSV-2) antibodies in male and female prisoners. A cross-sectional random sample was used consisting of 789 prisoners (657 males and 132 females) from 27 correctional centres across New South Wales (NSW), stratified by sex, age and Aboriginality. Participants were questioned about demographics and behavioural risk factors and were screened for serum antibody to HSV-2. The overall prevalence of HSV-2 antibodies was higher in females (58%) than males (21%), and in Aborigines (34%) compared with non-Aborigines (24%). HSV-2 prevalence increased with the number of sexual partners. Few prisoners (1%) reported a previous diagnosis of genital herpes. Independent risk factors for the presence of HSV-2 antibodies were increasing age and Aboriginality for men, and higher reported number of lifetime sexual partners and the presence of hepatitis C antibodies for women. HSV-2 infection is common in prison inmates. There is a need to incorporate information about STDs, including HSV-2, into education programmes for inmates.

Adult↗