Abstract
BackgroundPrison populations are known to be at high risk of sexually transmitted infections (STIs) and blood borne viruses (BBVs). In accordance with State health guidelines, the Western Australian Department of Correctional Services' policy is to offer testing for STIs and BBVs to all new prison entrants. This audit was undertaken to assess the completeness and timeliness of STI and BBV testing among recent prison entrants in Western Australia, and estimate the prevalence of STIs and BBVs on admission to prison.MethodsA retrospective audit of prison medical records was conducted among 946 individuals admitted to prison in Western Australia after the 1st January 2005, and discharged between the 1st January and 31st December 2007 inclusive. Quota sampling was used to ensure adequate sampling of females, juveniles, and individuals from regional prisons. Main outcomes of interest were the proportion of prisoners undergoing STI and BBV testing, and the prevalence of STIs and BBVs.ResultsApproximately half the sample underwent testing for the STIs chlamydia and gonorrhoea, and almost 40% underwent testing for at least one BBV. Completeness of chlamydia and gonorrhoea testing was significantly higher among juveniles (84.1%) compared with adults (39.8%; p < 0.001), and Aboriginal prisoners (58.3%) compared with non-Aboriginal prisoners (40.4%; p < 0.001). Completeness of BBV testing was significantly higher among adults (46.5%) compared with juveniles (15.8%; p < 0.001) and males (43.3%) compared with females (33.1%; p = 0.001). Among prisoners who underwent testing, 7.3% had a positive chlamydia test result and 24.8% had a positive hepatitis C test result.ConclusionThe documented coverage of STI and BBV testing among prisoners in Western Australia is not comprehensive, and varies significantly by age, gender and Aboriginality. Given the high prevalence of STIs and BBVs among prisoners, increased test coverage is required to ensure optimal use of the opportunity that prison admission presents for the treatment and control of STIs and BBVs among this high risk group.
Highlights
Prison populations are known to be at high risk of sexually transmitted infections (STIs) and blood borne viruses (BBVs)
Among adult prisoners who had a documented initial health assessment form on their electronic medical record (97.1%, 919/946), the health assessment was performed at the prison of admission for all prisoners apart from 3 prisoners, 2 of whom were admitted to regional prisons
This study is unique compared with previous studies of prisoner health in Western Australia [1,3] in that we studied prisoners from both metropolitan and regional prisons, and sampled a large number of females, allowing comparisons of test coverage and disease prevalence by sex and Aboriginality
Summary
Prison populations are known to be at high risk of sexually transmitted infections (STIs) and blood borne viruses (BBVs). In accordance with State health guidelines, the Western Australian Department of Correctional Services' policy is to offer testing for STIs and BBVs to all new prison entrants. This audit was undertaken to assess the completeness and timeliness of STI and BBV testing among recent prison entrants in Western Australia, and estimate the prevalence of STIs and BBVs on admission to prison. Prison populations frequently engage in behaviours which put them at high risk for the transmission of sexually transmitted infections (STIs) and blood borne viruses (BBVs) [1,2]. To determine whether documented prisoner health assessment practices are consistent with STI and BBV testing policy, an audit was conducted to assess the completeness and timeliness of STI and BBV testing among prisoners in Western Australia, and estimate the prevalence of STIs and BBVs on admission to prison
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