Jillian Guthrie

Social capital strategies to enhance hepatitis C treatment awareness and uptake among men in prison

Prisoner populations are characterized by high rates of hepatitis C (HCV), up to thirty times that of the general population in Australia. Within Australian prisons, less than 1% of eligible inmates access treatment. Public health strategies informed by social capital could be important in addressing this inequality in access to HCV treatment. Twenty‐eight male inmates participated in qualitative interviews across three correctional centres in New South Wales, Australia. All participants had recently tested as HCV RNA positive or were receiving HCV treatment. Analysis was conducted with participants including men with experiences of HCV treatment (n=10) (including those currently accessing treatment and those with a history of treatment) and those who were treatment naïve (n=18). Social capital was a resourceful commodity for inmates considering and undergoing treatment while in custody. Inmates were a valuable resource for information regarding HCV treatment, including personal accounts and reassurance (bonding social capital), while nurses a resource for the provision of information and care (linking social capital). Although linking social capital between inmates and nurses appeared influential in HCV treatment access, there remained opportunities for increasing linking social capital within the prison setting (such as nurse‐led engagement within the prisons). Bonding and linking social capital can be valuable resources in promoting HCV treatment awareness, uptake and adherence. Peer‐based programmes are likely to be influential in promoting HCV outcomes in the prison setting. Engagement in prisons, outside of the clinics, would enhance opportunities for linking social capital to influence HCV treatment outcomes.

Measuring health service satisfaction: female inmates

This study examines female inmates’ utilisation of and satisfaction with provision of health services, based on data from the 1996 New South Wales (Australia) Inmate Health Survey. Particular variables – indigenous status, mean age, age range, and education level – were analysed for factors associated with satisfaction with provision of health services. Further analysis indicated that for nine outcomes, correctional centre location was the only statistically significant indicator of satisfaction with various aspects of health‐care provision. Three factors – correctional centre location, indigenous status, and age group – were associated with being satisfied with health care received during a woman’s last prison doctor consultation. This study’s most important finding – that correctional centre location was associated with inmates’ satisfaction with health care services in gaol – has implications for governments regarding physical access to health services, and for ensuring services meet inmates’ needs at each correctional centre location.