The Kirby Institute, University of New South Wales, Australia.
Justice Health and Forensic Mental Health Network (Justice Health NSW), Sydney, Australia.
Int J Drug Policy. 2024 Aug;130:104516. doi: 10.1016/j.drugpo.2024.104516. Epub 2024 Jul 11.
Hepatitis C virus (HCV) is a significant concern within prison populations. Provision of HCV testing and treatment for people in prison is expanding and a key component of global elimination efforts. Despite growing service availability, several challenges remain in HCV testing and treatment engagement during incarceration. The PIVOT study demonstrated that a 'one-stop-shop' intervention (point-of-care HCV RNA testing, Fibroscan®, nurse-led clinical assessment, and fast-tracked direct-acting antiviral prescription) enhanced HCV testing and treatment at a reception prison in Australia. Utilising Squier et al's Health Literacy Skills Framework, this analysis aimed to understand HCV health literacy and educational needs among people at a reception prison in Australia.
Semi-structured interviews were conducted with twenty-four male PIVOT study participants. Purposive sampling ensured comparable representation of those with: 1) prior HCV testing history (standard pathology / no prior testing), and 2) injecting drug use history (IDU; ever / never).
Varied HCV health literacy levels and educational needs were evident amongst people in prison. Whilst those with multiple incarceration episodes and IDU history (prior knowledge) appeared to have stronger HCV health literacy than those without, substantial gaps in HCV health literacy were evident. Knowledge of HCV transmission risks in prison was high, and most understood the importance of HCV testing and treatment in prison (comprehension), but ability to engage with HCV testing and treatment services, participation in safe injecting behaviours (health-related behaviours), and knowledge of re-infection and re-treatment, within the context of the prison environment, were suboptimal. There was a general desire for increased HCV education in prison.
Gaps in HCV health literacy among people in prison were evident, indicating opportunities for improvement. A targeted HCV education program for people in prison, addressing the gaps identified in this analysis, may enhance HCV testing, treatment, and prevention by fostering stronger HCV health literacy among people in prison.
丙型肝炎病毒（HCV）在监狱人群中是一个重大问题。为监狱中的人提供 HCV 检测和治疗正在扩大，并成为全球消除努力的关键组成部分。尽管服务的可及性不断提高，但在监禁期间进行 HCV 检测和治疗参与仍然存在一些挑战。PIVOT 研究表明，“一站式”干预措施（即时 HCV RNA 检测、Fibroscan®、护士主导的临床评估和快速直接作用抗病毒药物处方）增强了澳大利亚一所接收监狱的 HCV 检测和治疗。利用 Squier 等人的健康素养技能框架，本分析旨在了解澳大利亚一所接收监狱中 HCV 健康素养和教育需求。
对 24 名 PIVOT 研究参与者进行了半结构式访谈。采用目的抽样法，确保具有以下特征的参与者具有可比性：1）有 HCV 检测史（标准病理学/无既往检测），和 2）有注射吸毒史（有/无）。
在监狱中的人中，HCV 健康素养水平和教育需求存在差异。虽然那些有多次入狱经历和吸毒史（既往知识）的人似乎比没有的人有更强的 HCV 健康素养，但 HCV 健康素养方面存在明显差距。大多数人了解监狱中 HCV 传播风险较高，并且了解 HCV 检测和治疗的重要性（理解），但在监狱环境中，他们参与 HCV 检测和治疗服务的能力、参与安全注射行为（健康相关行为）以及对再感染和再治疗的认识都不太理想。人们普遍希望在监狱中增加 HCV 教育。
监狱中 HCV 健康素养方面的差距明显，表明有改进的空间。为监狱中的人提供一个针对 HCV 的教育计划，针对本分析中确定的差距进行改进，可能会通过提高监狱中 HCV 健康素养来增强 HCV 检测、治疗和预防。
