Lise Lafferty

Contextualising the social capital of Australian Aboriginal and non-Aboriginal men in prison.

Social capital is a valuable resource that has received little attention in the prison context. Differences in the construct and accessibility of bonding, bridging, and linking social capital exist for Aboriginal Australians in mainstream society, but were previously unexplored in prison. This study seeks to understand contextual differences of social capital for Australian Aboriginal and non-Aboriginal men in prison. Thirty male inmates participated in qualitative interviews across three New South Wales (NSW) correctional centres. Interviews were completed between November 2014 and March 2015. Experiences of bonding and linking social capital varied among Aboriginal and non-Aboriginal participants. Opportunities for bridging social capital were limited for all participants. There is greater scope for building bonding social capital among male inmates than either bridging or linking social capital. Bonding social capital, particularly among Aboriginal men in prison, should be utilised to promote health and other programs to inmates.

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.

Unlocking dimensions of social capital in the prison setting

BackgroundSocial capital has been shown to be a valuable resource for improving health outcomes. However, it has received little attention in the prison setting. Dimensions of social capital in mainstream society are likely to function differently among inmates in prison. This study seeks to identify and understand social capital dimensions among incarcerated men living with hepatitis C.MethodsIn-depth interviews were conducted across three correctional centres in New South Wales with 30 male inmates living with hepatitis C. Interviews were transcribed then thematically coded and analysed.ResultsThere were differences in the access and utility of social capital dimensions in prison focusing specifically on trust and safety, informal and formal networks, agency, and civic engagement.ConclusionsDimensions of social capital do not necessarily translate into prison. An inmate’s social capital may foster greater treatment uptake relating to health and rehabilitative programs during their incarceration.

Indicators of social capital in prison: a systematic review

BackgroundSocial capital theory encapsulates multidisciplinary principles and is measured across numerous social entities. However, there is a paucity of literature exploring the benefits of social capital for sentenced prisoners.MethodsA qualitative systematic review was conducted using the PRISMA Guidelines. Eight databases were searched; thirty-one articles met the inclusion criteria.ResultsSocial capital was found to exist across a number of themes/dimensions for sentenced prisoners. The benefits gained were sometimes gender-specific and differed between social capital available in prison and that provided externally.ConclusionSocial capital is a valuable resource among prisoners and has the capacity to improve quality of life outcomes. Further research exploring the causality of social capital and improved outcomes among prisoners is needed.

Understanding facilitators and barriers of direct-acting antiviral therapy for hepatitis C virus infection in prison

Hepatitis C virus (HCV) infection is a major public health concern. Globally, 15% of those incarcerated are HCV‐antibody positive (anti‐HCV). Even where HCV treatment is available within prisons, treatment uptake has remained low. This qualitative study was conducted to understand the barriers and facilitators for the delivery of HCV treatment in prisons from the perspectives of prisoners. This is important to inform health messaging for HCV treatment within correctional institutions. Thirty‐two prisoners (including eight women) with a history of injecting drug use participated in this qualitative study. Participants were equally recruited across four correctional centres (n = 8 per site). Overall, 16 participants (50%) had chronic HCV at their most recent test, and two participants were awaiting test results at time of interview. Structural (eg proximity of health clinic) and patient‐level (routine and motivation) factors were viewed as facilitators of HCV treatment within the prison setting. Structural (eg risk of reinfection) and social (eg lack of confidentiality and lack of social support) factors were perceived as barriers to prison‐based HCV care and treatment. In conclusion, to increase HCV treatment uptake, prison‐based programmes should implement (or advocate for) patient‐centred treatment approaches that protect privacy, provide social support, and promote access to clean needles and substitution therapy to protect prisoners from reinfection.

Measuring Social Capital in the Prison Setting: Lessons Learned From the Inmate Social Capital Questionnaire

Social capital has been associated with improved health outcomes. Measures of social capital have been developed specifically for different population groups, cultures, and contexts; however, there is no readily available measure for use among inmates in the prison setting. This study sought to translate a community concept into the prison setting through the development and piloting of the Inmate Social Capital Questionnaire (ISCQ). Thirty male inmates (living with hepatitis C) participated in the pilot phase of the ISCQ (n = 23 sentenced and n = 7 held on remand). Dimensions of social capital were influenced by length of incarceration (time already served as well as time to release), connections with family, and duration at current prison.

‘Fighting a losing battle’: prisoners’ perspectives of treatment as prevention for hepatitis C with inadequate primary prevention measures

Abstract Hepatitis C virus (HCV) is a global public health concern. Prisoners are particularly affected, with high prevalence and ongoing HCV transmission. The Surveillance and Treatment of Prisoners with hepatitis C (SToP-C) study is implementing the first trial of HCV treatment as prevention (TasP) in the prison setting, i.e., scaling up treatment at sufficient scale to achieve a preventive effect. This qualitative sub-study sought to explore prisoners’ perceptions of feasibility of TasP. Participants were recruited from four correctional centres in New South Wales, Australia, including one women’s prison. Thirty-two prisoners with a history of injecting drug use participated in interviews prior to prison-wide HCV treatment scale-up. All participants had been screened for HCV within the previous 6 months; half (n = 16) had chronic HCV; n = 2 were awaiting test results. Concerns regarding prisoner movements (e.g. transferred to another prison, or incarceration-release-incarceration) and perceived subsequent risks for HCV reinfection were consistently raised as a major challenge for TasP elimination efforts. Suggestions for harm reduction measures to assist TasP effectiveness (and reduce risk of re-infection) included education and prison needle syringe programmes. Prisoners remain concerned about long-term effectiveness of TasP efforts without access to effective prevention measures and subsequent risk of (re-)infection.

‘It's Fast, It's Quick, It Stops Me Being Sick’: How to influence preparation of opioid tablets for injection

INTRODUCTION AND AIMS Injection of pharmaceutical opioids (PO) among people who inject drugs has increased in many countries. The common method for preparing PO tablets for injection uses heat, resulting in greater particulate matter and therefore increased risk of local infection risk and damage to veins and organs. A cold preparation process has fewer risks, but this preparation method is not commonly used. This study seeks to explore how people who inject PO learn to prepare injections and how health promotion efforts could influence practice. DESIGN AND METHODS Between March and December 2013, qualitative interviews were undertaken with 33 clients of Sydneys Medically Supervised Injecting Centre who inject PO tablets regarding sources of knowledge and current preparation methods for injection of POs. RESULTS Overwhelmingly, the most commonly reported source of knowledge around injection of tablets was others who inject. Most participants reported heating the solution as the quickest way to administer the drug. Attitudes to the use of wheel filters varied, with some participants reporting that they would use the filters if they were shown how, while others reported a number of barriers to using filters, including complexity of use. DISCUSSION AND CONCLUSIONS Harnessing the power of social connections may provide avenues for education about safer injecting of tablets, including the use of wheel filters. Further work is required to debunk myths about the relative potencies of cold versus hot drug solution. Collaborations between harm reduction workers and peer workers would assist in knowledge dissemination regarding safer injecting practices.