Introduction Hepatitis C Virus (HCV) has been deemed by the Scottish Government to be ‘One of the most serious and significant public health risks of our generation’.1 Approximately 90% of those who are currently infected acquired the virus through drug injecting behaviour.2 A custodial sentence provides a unique opportunity to focus on hard to reach patients, providing the possibility of testing, diagnosis and treatment of the disease.
Methods An online questionnaire was made available to nursing staff currently working for the Scottish Prison Service (SPS). A questionnaire was also given to prisoners currently incarcerated in Scottish Prisons. The data gathered was compiled to evaluate the need for a standardised care pathway for HCV in the SPS.
Results Almost half of prisoners considered themselves to be at risk of HCV. Seventeen per cent of prisoners who did not consider themselves to be at risk had shared needles and/or other injecting paraphernalia. Eighty-eight per cent of blood borne virus nurses thought it would be of benefit if the prisoner did not move prison whilst receiving HCV treatment.
Forty seven per cent of prisoners considered themselves to be at risk of Hepatitis C and 2% were unsure of their potential risk. Twentyseven per cent of prisoners who do not consider themselves to be at risk have used intravenous drugs, 10.6% have shared needles and a further 6% have shared other injecting paraphernalia. Eightytwo per cent of the people who considered themselves to be at risk, or were unsure of their potential risk have been offered a test and 74% have been tested. Seventy per cent of the group that have been tested were tested in prison. Fifty seven per cent tested positive. Eightyeight per cent of blood borne virus nurses thought it would be of benefit to the treatment of Hepatitis C if the prisoner did not move prison whilst receiving treatment.
Conclusion A clear majority of the nurses thought that a standardised transfer form would be of benefit to patient care. As a result of this finding a standardised transfer form is in the process of being designed. The secondary outcome measures proved most interesting. Many prisoners claimed to have been vaccinated against Hepatitis C, indicating their lack of understanding of the virus. Further research is needed into improving education for the high risk population.
A lack of awareness of HCV amongst prisoners was identified, making further education crucial to achieving satisfactory health promotion and disease prevention. This study also concludes that a standardised transfer form would be of benefit to patient care. Further research is needed into improving education for the high risk population.
Disclosure of Interest None Declared.
Hepatitis C Action Plan for Scotland:Phase II:May 2008-March 2011
Scottish Prison Service. 11th Prisoner Survey 2007. SPS Edinburgh
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