As a setting, prisons offer a unique opportunity to invest in the health of disadvantaged and marginalised populations and address health inequalities and social exclusion - thereby achieving sustainable improvements in well-being for offenders and their families and in turn, helping to reduce rates of re-offending. This article draws on English and French experiences and doctoral research to advocate a shift from a pathogenic model towards a salutogenic model of health as a helpful way to address inequalities and thus, by promoting joined-up working across justice and wider systems, impact positively beyond 'health' for the effective resettlement of prisoners. The paper utilises examples from horticulture to further argue the powerful role of nature in the prison setting in mediating aspects of culture particularly relating to processes of socialisation. Critical success lies in bridging across systems and a commitment to joined-up working at all levels across and beyond prison.

http://ped.sagepub.com/content/23/1_suppl/66.full.pdf

Health-promoting prisons: theory to practice

Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age.

/pdf/disease-profiles-of-detainees-in-the-canton-of-vaud-in-14jzr3264d.pdf

Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions

Prior studies have reported higher HIV prevalence among prisoners than the general population in Brazil, but data have been derived from single prisons. The aim of this study was to evaluate HIV testing practices, prevalence and linkage to care among inmates in a network of 12 prisons. Methods
We administered a questionnaire to a population-based sample of inmates from 12 prisons
in Central-West Brazil and collected sera for HIV and syphilis testing from January to
December 2013. We evaluated factors associated with HIV testing and infection using multivariable
logistic regression models. Six months after HIV testing, we assessed whether
each HIV-infected prisoner was engaged in clinical care and whether they had started antiretroviral
therapy.
Results
We recruited 3,362 inmates, of whom 2,843 (85%) were men from 8 prisons, and 519 (15%)
were women from 4 prisons. Forty-five percent of participants reported never having been
tested for HIV previously. In multivariable analysis, the variables associated with previous
HIV testing were lack of a stable partner (adjusted odds ratio [AOR]: 1.38; 95% CI: 1.18–
1.60), completed more than four years of schooling (AOR 1.40; 95% CI: 1.20–1.64), history
of previous incarceration (AOR: 1.68; 95% CI: 1.43–1.98), history of mental illness (AOR
1.52; 95% CI: 1.31–1.78) and previous surgery (AOR 1.31; 95% CI: 1.12–1.52). Fifty-four
(1.6%) of all participants tested positive for HIV; this included 44 (1.54%) men and 10
(1.92%) women. Among male inmates, HIV infection was associated with homosexuality
(AOR 6.20, 95% CI: 1.73–22.22), self-report of mental illness (AOR 2.18, 95% CI: 1.13–
4.18), history of sexually transmitted infections (AOR 3.28, 95% CI: 1.64–6.56), and syphilis
sero-positivity (AOR 2.54, 95% CI: 1.20–5.39). Among HIV-infected individuals, 34 (63%)
were unaware of their HIV status; only 23 of these 34 (68%) newly diagnosed participants
could be reached at six month follow-up, and 21 of 23 (91%) were engaged in HIV care.
Conclusions
HIV testing rates among prison inmates are low, and the majority of HIV-infected inmates
were unaware of their HIV diagnosis. Incarceration can be an opportunity for diagnosis and
treatment of HIV among vulnerable populations who have poor access to health services,
but further work is needed on transitional HIV care for released inmates.

/pdf/a-cross-sectional-survey-of-hiv-testing-and-prevalence-in-3d2fjwv4to.pdf

A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities

Although a vaccine against hepatitis B virus (HBV) has been available since 1982, the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5–10% A high rate of chronic infections is also found in the Amazon and the southern parts of eastern and central Europe In the Middle East and the Indian subcontinent, the prevalence is 2–5% Less than 1% of the population of Western Europe and North America is chronically infected Given the high prevalence of infections (such as hepatitis) among inmates, prison is considered a reservoir for facilitating such infections Based on these premises, this current review examines and discusses emerging trends in the epidemiology of HBV infection, with particular attention to HBV infection in prison The hepatitis B surface antigen (HBsAg) prevalence in prisoners in west and central Africa is very high (235%) The Centers for Disease Control and Prevention has highlighted the importance of HBV blood screening and subsequent anti-HBV vaccination in the prison population The vaccination was recommended for all inmates, representing an opportunity to prevent HBV infection in a high-risk population In these subjects, an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term protection Therefore, it is necessary to seek collaboration among public health officials, clinicians and correctional authorities to implement a vaccination programme

/pdf/emerging-trends-in-epidemiology-of-hepatitis-b-virus-4u82nq3hsy.pdf

Emerging Trends in Epidemiology of Hepatitis B Virus Infection

Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. The aim of this study was to quantitatively evaluate the prevalence of HCV among Iranian prisoners conducting a systematic review and meta-analysis. We searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Sciences, the Cochrane library, Scopus, CINAHL, and PsycINFO as well as Iranian bibliographic thesauri (namely, Barakatns, MagIran, and SID) up to December 2017. The Newcastle Ottawa Scale (NOS) was used to assess the quality of the studies included. HCV prevalence rate with its 95% confidence interval (CI) was estimated using the DerSimonian-Laird random-effects model, with Freeman-Tukey double arcsine transformation. Egger’s regression test was used to evaluate publication bias. Finally, 17 articles were selected based on inclusion and exclusion criteria. Overall, 18,693 prisoners were tested. Based on the random-effects model, the prevalence of HCV among Iranian prisoners was 28% (CI 95% 21–36) with heterogeneity of I2 = 99.3% (p = 0.00). All studies used an ELISA test for the evaluation of HCV antibodies. The findings of this study showed that the highest prevalence rate (53%) was among prisoners who inject drugs. The findings of our study showed that the prevalence of HCV among Iranian prisoners is dramatically high. Managing this issue in Iran’s prisons requires careful attention to the availability of health facilities and instruments, such as screening, and harm reduction policies, such as giving sterile syringes and needles to prisoners. An integrated program of training for prisoners, prison personnel and medical staff is also needed to improve the level of health condition in prisons.

/pdf/prevalence-of-hepatitis-c-virus-infection-among-prisoners-in-g4d463qrjh.pdf

Prevalence of hepatitis C virus infection among prisoners in Iran: a systematic review and meta-analysis

We evaluated prevalence of human immunodeficiency virus (HIV) and hepatitis C virus (HCV) among prison inmates in France in 2010, in a cross-sectional single-day study based on a two-stage design. Sampling favoured larger establishments and included all types of prisons. Establishments were stratified by geographical region. Estimates were adjusted by post-stratification of the total population of inmates in France. From 60,975 inmates in all 188 prisons on the sampling day, 2,154 were selected from 27 prisons, and 1,876 questionnaires completed. HIV prevalence was estimated at 2.0% (95% confidence interval (CI): 0.9–4.2), 2.6% (95% CI: 0.7–8.8) in women and 2.0% (95% CI: 0.9–4.3) in men; 75% of inmates were receiving treatment for HIV. HCV prevalence was estimated at 4.8% (95% CI: 3.5–6.5) and was higher for women (11.8%; 95% CI: 8.5–16.1) than men (4.5%; 95% CI: 3.3–6.3). Almost half of HCV-infected inmates had chronic hepatitis C and 44% were receiving or had received treatment. HIV and HCV prevalence was six times higher than in the general population, and 2.5% of inmates had viraemic hepatitis C. The moment of incarceration provides an ideal opportunity for testing and treating, limiting spread of HCV and improving patients' prognosis.

/pdf/prevalence-of-human-immunodeficiency-virus-and-hepatitis-c-3y37j1xkjv.pdf

Prevalence of human immunodeficiency virus and hepatitis C virus among French prison inmates in 2010: a challenge for public health policy.

Surveillance and outbreak reports: Prevalence of human immunodeficiency virus and hepatitis c virus among French prison inmates in 2010: A challenge for public health policy

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Prevalence of human immunodeficiency virus and hepatitis C virus among French prison inmates in 2010: a challenge for public health policy.

Surveillance and outbreak reports: Prevalence of human immunodeficiency virus and hepatitis c virus among French prison inmates in 2010: A challenge for public health policy