Provincial Prison Research Articles

Perceived patient navigator services and characteristics to address barriers to linkage to hepatitis C care among people released from provincial prison in Quebec, Canada

BackgroundPatient navigation increases linkage to hepatitis C virus (HCV) care following release from prison; however, little is known about the services patient navigators should provide to maximize linkage to care. We aimed to identify perceived barriers and facilitators to linkage to HCV care post-release, and to determine patient navigator services and characteristics best suited to address barriers to linkage to care among people released from prison. MethodsTen semi-structured interviews were conducted with adult (age ≥18 years) men living with chronic HCV, released from the largest Quebec provincial prison, and linked to HCV care by a patient navigator. Interviews were guided by the Socio-Ecological Model (SEM) and aimed to explore the multi-level barriers and facilitators to linkage to HCV care post-release. Interviews were audio-recorded, transcribed, and analyzed using a deductive, thematic approach. ResultsThe median age of participants was 54 years. Barriers to linkage to HCV care included competing priorities post-release (e.g., substance use, mental health issues, unstable housing), stigma (related to HCV, injection drug use, and incarceration), and lack of transportation. Facilitators included social support, established relationships with existing healthcare providers, prior cure with direct-acting antivirals, and HCV-related health literacy and knowledge. Perceived essential patient navigator services to enhance linkage included pre-release discharge appointments, housing assistance, and facilitated transportation to HCV appointments. Ensuring a consistent, non-judgemental, and empathetic patient navigator were considered important characteristics; lived experiences of incarceration and/or HCV were not felt to be essential for a patient navigator. ConclusionsInterventions that seek to improve linkage to HCV care for people following release from prison should address many levels (individual, interpersonal, and policy) of the SEM. While people experience several competing priorities post-release, having an empathetic and consistent patient navigator, regardless of their lived experiences of HCV and/or incarceration, may improve linkage to HCV care post-release.

Дамское отделение Нижегородского попечительного о тюрьмах комитета (конец 1911–1912 гг.): причины создания, функции, историческое значение

The article is devoted to the charitable activities of the «Ladies’ branch of the Nizhny Novgorod prison board», which in late 1911–1912 was headed by Ekaterina Aleksandrovna Khvostova, the wife of Nizhny Novgorod governor Alexei Nikolaevich Khvostov. During the entire existence of the Nizhny Novgorod prison committee (1846–1917) this was the first and only experience of the functioning of the Ladies’ department created under it. The novelty of this article lies in the formulation of the problem, the involvement of new historical sources. The chronological framework is determined by the time of operation of this charity. The main historical source was the Case of the Nizhny Novgorod provincial prison inspectorate “I” Office work. About the correspondence of the Nizhny Novgorod Ladies’ branch of the Society for the care of prisons in 1911. It is stored in the fund 386 Nizhny Novgorod prison inspectorate (1908–1918) of the Central archive of the Nizhny Novgorod region. Unpublished epistolary and clerical materials, reference materials, pre–revolutionary periodical press — the journal Prison bulletin were used. The author came to the conclusion that the main reason for the creation of the Ladies’ department of the Nizhny Novgorod prison committee was the fight against child crime, the need to open special educational and correctional institutions for detained children and juvenile delinquents, who were held mainly together with adult prisoners in prisons of the Russian empire at the beginning of the XX century. E. A. Khvostova was engaged in collecting charitable funds for the opening of a shelter located at the Second Nizhny Novgorod provincial prison, providing assistance to unhappy children. An important result of her work was the appearance of such a shelter with an elementary school, a children’s library, and craft workshops.

Impact of the COVID-19 pandemic on hepatitis C virus screening in provincial prisons in Montreal, Quebec, Canada.

Little is known about the impact of the COVID-19 pandemic on hepatitis C (HCV) screening efforts in carceral settings. We explored the impact of the pandemic on HCV screening in two of Quebec's largest provincial prisons. Retrospective data of HCV-related laboratory tests between July 2018 and February 2022 at l'Établissement de détention de Montréal (EDM) and l'Établissement de détention de Rivière-des-Prairies (EDRDP) were obtained. To examine the association between the pandemic and the number of HCV-antibody (HCV-Ab) tests, a three-level time period variable was created: pre-outbreak, outbreak, and post-outbreak. Negative binomial regression (with monthly admissions as an offset) was used to assess the change in HCV-Ab tests across time periods and by prisons. Adjusted odds ratios (aOR) with 95% confidence intervals (95% CI) were calculated. A total of 1,790 HCV-Ab tests were performed; 56 (3%) were positive. Among these, 44 (79%) HCV RNA tests were performed; 23 (52%) were positive. There was a significant decrease in HCV-Ab screening at EDM during the outbreak (aOR 0.29; 95% CI 0.17-0.48) and post-outbreak (aOR 0.49; 95% CI 0.35-0.69) periods, compared to the pre-outbreak period. There was no significant change in HCV-Ab screening at EDRDP during the outbreak (aOR 0.98; 95% CI 0.49-2.11) but a significant increase in HCV-Ab screening post-outbreak (aOR 1.66; 95% CI 1.04-2.72). The COVID-19 pandemic negatively affected HCV screening at EDM but had minimal impact at EDRDP. To eliminate HCV from carceral settings, minimizing screening interruptions during future outbreaks and combined HCV/SARS-CoV-2 screening should be prioritized.

An Investigation of Ciprofloxacin-resistant Neisseria Meningitidis Serogroup B Infection Outbreak in a Provincial Prison, Nan Province, Thailand, October 2023

Meningococcal infection is a severe illness that can result in organ damage or death. On 23 Oct 2023, a joint investigation team was notified about two inmates diagnosed with meningococcal infection in a provincial prison. The investigation aimed to confirm the outbreak, describe epidemiological characteristics, determine possible source and risks of infection, and provide recommendations and control measures. This study reviewed the situation using surveillance databases. Active case finding was conducted among inmates and prison staff. Close contacts were identified and assessed. Drug sensitivity and serogroup identification were done in the cultured-growth specimens. Surveying inmate rooms, observing inmates' behaviors, and interviewing inmates and prison staff were performed. There were 7 laboratory-confirmed cases identified (attack rate 0.5%). All cases were male inmates with a median age of 46 years (interquartile range 38.5–49.5 years). Common symptoms were fever (100%) and headache (71%). Eight cases required hospital admission and one dead case was found (CFR 14%). Among 609 close contacts, 99% were inmates. All cultured-growth specimens were Neisseria meningitidis serogroup B with ciprofloxacin resistance. Crowded inmates and sharing water cups were risk factors for intra-room spreading. Daily activities and the previous influenza outbreak promoted inmates' inter-room contact. This is the ciprofloxacin-resistant serogroup B meningococcal disease outbreak in a provincial prison revealing multiple factors, including environmental, behaviors and daily activities, that promoted the disease's spread. Rifampicin chemoprophylaxis, active surveillance, and limited inmate activities could help reduce disease spread.

Sleep quality and mental disorder symptoms among correctional workers in Ontario, Canada

Correctional workers (CWs) report high levels of work stressors, frequent exposures to potentially psychologically traumatic events (PPTEs), and substantial mental health challenges. There is evidence of associations between sleep disturbances and diverse mental health challenges, including preliminary evidence from public safety personnel; however, replications and extensions would better inform interventions to support mental health. The current study was designed to examine associations between quality of sleep, work stress, and mental health disorders in a sample of diverse CWs employed in a provincial correctional service in Ontario, Canada. Data were analyzed from 943 CWs who participated in the cross-sectional, web-based Ontario Provincial Correctional Worker Mental Health and Well-Being Study conducted from December 2017 to June 2018. Sleep quality indicators included symptoms of insomnia, total hours of sleep per night on work nights and off-shift nights, number of days feeling rested per week, and overall sleep quality. Descriptive statistics, analyses of variance, correlational analyses, and logistic regression were used to examine relationships among sleep quality, stress of shift work, and mental health disorder symptoms. CWs slept an average of 6.0 h per night when working and 7.2 h during off-shift nights. CWs reported waking up feeling rested an average of 2.6 days per week and rated their overall quality of sleep in the fair to poor range. Many CWs (64.9%) screened positive for clinically significant symptoms of insomnia. There were also differences across occupational groups such that CWs working as correctional officers reported the most sleep problems. There were statistically significant relationships between insomnia and mental health disorder symptoms. Higher levels of stress from shift work were associated with worse sleep quality. CWs, especially those working as correctional officers in a provincial prison, reported many indicators consistent with poorer quality of sleep. Poor quality of sleep was also associated with work stress and mental health disorders.

The Moral Impacts of Organizational Stress on Correctional Officers

Organizational stress (i.e., structural aspects of the organization such as excessive workload, shiftwork, gossip) has long been found by public safety personnel to be more impactful on their health and wellness than operational stress (i.e., inherent stresses of the job such as altercations, intervention in suicide behaviors). In the current study, which engages semi-structured interviews conducted with 28 correctional officers employed at one provincial prison in Atlantic Canada, we unpack through a lens of moral distress four prevalent sources of organizational stress among correctional officers that emerged in the data without categories precogitated, with a focus on participant experiences and expressed similarities across accounts: (1) management, (2) staff retention, (3) training needs, (4) lack of mental health support. Findings indicate organizational stress has a significant impact on correctional officers and these sources of organizational stress are exacerbated by officers’ moral and ethical vulnerabilities emergent from their conditions of employment. We recommend several practical changes to ease the strains and moral harms felt by correctional officers and better support their mental health and well-being, such as increasing staffing levels, providing more education and training opportunities for frontline officers and senior leaders, and providing more adequate mental health support for correctional officers.

“We wish we had the option”: a qualitative study of women’s perspectives and experiences with contraception in a provincial prison in Ontario, Canada

BackgroundEvidence suggests that women who are incarcerated desire access to contraception while incarcerated, and that this need is not currently being met. Our objective in this study was to explore the perspectives and experiences of women in prisons regarding contraception and contraception access using data from focus groups with women in a provincial prison. We analyzed focus group data collected in a provincial prison in Ontario, Canada using content analysis and a constructivist epistemology.ResultsWe conducted three focus groups, each approximately one hour in length. Discussions revolved around (1) knowledge and decision making about contraception, (2) accessing contraception, and (3) ideas for increasing access to contraception in the prison setting. Decision making about contraception was mainly related to concerns about side effects, consistent access to care, impacts on future fertility, and autonomy around decision-making. Participants discussed a wide range of experiences with contraception. Ideas for increasing access to contraception included information sessions, inclusion of discussions about contraception as a component of admission and release planning, and time spent in prison as a crucial juncture for decision-making about contraception.ConclusionsMore qualitative research is needed to better understand the needs of women in prisons related to contraception. The findings of this study suggest that programs should focus on consistency and continuity of access to care, education opportunities, and integration of discussions about contraception into official admission and release procedures.

Perceived anxiety and depression and associated factors among women inmates with a long-term sentence in Thailand.

In Thailand, the growing prevalence of mental health problems among the increasing number of adult female prisoners has emerged as a significant public health concern. However, studies on the health of women prisoners are primarily conducted in Western societies, and studies in other countries are rare. Thailand, a non-western country, is no exception to this. The objectives of this study were to assess the current levels of anxiety and depression among women drug offenders in Thailand and to identify possible associated factors. Data were collected from a sample consisting of 554 women drug offenders serving sentences of eight years or more. Stratified random sampling with proportionate stratification was employed during the data collection. The female inmates were being held in three categories of prisons: correctional institutions, central prisons, and provincial prisons. A single question was used to measure self-perceived levels of anxiety and depression: none, moderate, or substantial. Ordered logit regression was employed in the data analysis. One out of five (21.1%) of the inmates in the sample reported no perceived current anxiety and depression, 61.7% reported moderate anxiety and depression, and 17.1% reported having substantial perceived levels of anxiety and depression. It was found that chronic health conditions or disease, concerns about economic status, and feelings of shame were associated with the perceived anxiety and depression reported by the inmates. The study's findings suggest that integrated mental health services that emphasize a holistic approach that acknowledges the intersectionality of women's mental health and societal gender roles should be provided in prisons. Regular mental health screening and accessible mental health services are essential for all incarcerated women. Empowerment programs during confinement can boost self-esteem and thus lead to better post-release outcomes. The government should also implement programs to alleviate the financial burden on prisoners' households.

THE ROLE OF COMMUNITY INSTITUTIONS IN THE FRAMEWORK OF RESIDIVITY DEVELOPMENT FOR INFORMED CITIZENS IN CILEGON CLASS II A COMMUNITY INSTITUTIONS

The role of social institutions in the context of developing prisoners in prisons, especially Cilegon prisons, needs to be increased so that the Binaa residents, after they have finished serving as prisoners, when they are released, have truly become good human beings in the community. Both from a religious and moral perspective and obeying legal regulations. The aim of this research is to determine the role of Cilegon Prison in the context of developing citizens in Class II Cilegon Correctional Institutions. The research method uses a quantitative descriptive approach with data analysis using descriptive statistics. The instrument used in this research is the researcher, who acts as a "human instrument" to obtain the required data. The researchers used observation guidelines, interview guidelines, and questionnaires aimed at each data source, Head of Cilegon Prison, Residents of Cilegon Province Prison. Banten. From the results of research and discussions, it is clear that in the last 3 years the pattern of training inmates in Cilegon prisons has been successful with a significant reduction in criminal cases, especially general criminal cases, and a reduction in recidivists re-entering Cilegon Provincial prisons. Banten, where the consistent application of criminal law for repeat criminals with increased punishment and the provision of special treatment for recidivist prisoners, is expected to reduce the number of recidivist prisoners. In general, there is no difference in the mechanism for training ordinary prisoners and recidivist prisoners. The form of guidance for recidivist prisoners is more focused on independent activities, so that it is hoped that recidivists who have already committed crimes will no longer commit crimes and after leaving their sentence will be well received by the outside community

Започаткування та розвиток тюремного піклування в Херсонській губернії (1828-1857 рр.)

The purpose is to study the specifics of prison care in the Kherson province in the second quarter of the nineteenth century. The research methodology is based on the principles of a specific historical approach or historicism. The study uses historical and genetic, historical and comparative, periodisation, and descriptive methods. The scientific novelty of the study is that it is the first attempt to form a holistic view of the origins of prison care in the Kherson province, in particular in such cities as Kherson and Alexandria. The study analyses for the first time the formation and activities of the Kherson Prison Care Committee, and examines its work in modernising the prison system. At the same time, the first attempts to establish trusteeship committees in the county towns of the province are studied. In turn, the activities of the Kherson Committee of Trustees were examined in the context of the formation of prison care in the Ukrainian provinces of the Russian Empire. Conclusions. It has been established that the Kherson Prison Trusteeship Committee emerged after the construction of the Kherson prison castle, which was a typical phenomenon in the Ukrainian provinces of the empire. The development of its activities, like most regional committees, can be divided into two stages. From its foundation in 1835 to the 1840s, the committee introduced significant changes to the prison regime and prisoners' living conditions, trying to organise the functioning of the provincial prison on the basis of the Prison Instruction of 1831. During the 1840s, until the reform of prison care in 1851 and the provincial audit, the committee's activity declined and it performed exclusively economic functions. The reason for the passivity of local elites in promoting prison reform is associated with the lack of educational and ecumenical ideals inherent in the organisers of prison reforms in Western Europe and the capital of the Russian Empire..

Тюремные инспекторы Западной Сибири и организация пенитенциарного ведомства в конце XIX – начале XX в.

The purpose of the article consists in studying of a position of provincial prison inspector in the regional administrative apparatus and in researching of local prison inspection’s activity. Using microhistorical approach, structural-functional method and methods of retrospective and discourse analysis, the authors made an attempt to analyze the stages of the creation of the prison institution in Western Siberia and the scenarios of its transformation. The historical sources involved in the research including periodicals, sources of personal origin, documents of governmental agencies, archive materials and works of historians and publicists allow us to provide an overall pattern of provincial prison inspections’ functioning. A logical consequence of the creation of a central prison institute was the gradual formation of provincial prison departments. Due to a number of favorable factors, the prison inspection bodies (as part of the provincial governments) were formed in 1892 in the Tomsk Governorate. In other regions of Siberia, including the Tobolsk Governorate, these regulations became effective only in 1895. The prison departments were headed by provincial prison inspectors, who held a much higher position than another heads of departments. In this regard, they were almost on the same level as the vice-governor. The authors conclude that the inspection of prisons was sufficiently extensive, ranging from inspection of penitentiaries, detention houses and transit points, control of their sanitary conditions and technical equipment, to the staffing of prison schools, churches and libraries. The West Siberian prison inspections played an important role in the production and organization of convict labor, which served as an integral part of the penitentiary process of criminal forces. The philanthropic feelings were also not alien to prison officials – a lot of work was invested by the inspectors in the development of trusteeship and charitable institutions, maintaining corporate identity within the prison department, expanding official relations at the all-Russian and international level. These prison officers played a significant role in the systematization of penitentiary regulations. Despite the fact that the thesis of the need for the existence of the prison inspections was questioned in official circles, it still survived the onslaught of criticism, proving the expediency and effectiveness of its activities, developed its own scenarios for functioning during the period of revolutionary unrest and social transformations.

Acceptance of the COVID-19 Vaccine by Prisoners and Staff in Spanish Prisons.

The COVID-19 vaccination of prisoners and prison staff represents a public health intervention to reduce the impact of the pandemic in conglomerate settings. In Spanish prisons, the road map of the Ministry of Health was followed to protect the population at risk. We conducted a cross-sectional study to assess the acceptance of COVID-19 vaccination by prisoners and prison staff in a prison in Alicante, Spain. We analyzed data obtained through a standardized, self-administered, and anonymous questionnaire; 1016 prisoners and 288 prison staff responded to the survey. The majority of inmates and staff reported no history of symptomatic COVID-19, 90.15% and 91.66%, respectively. Respondents reported that 88.72% agreed to be vaccinated and 89.64% would recommend the vaccine to others. Approximately 89% believe that the benefit of getting vaccinated against COVID-19 is greater than the risk, and 70.55% reported that vaccination should be mandatory for inmates and staff to participate in some activities. The acceptance of COVID-19 vaccination among prisoners and prison staff is high in a Provincial Prison in Spain. Elevated acceptance of COVID-19 vaccination in prisons is a major factor in public health intervention and vaccine equity.

«Его императорскому высочеству государю наследнику цесаревичу и великому князю Алексею Николаевичу…» (подарок от арестантов Первой нижегородской губернской тюрьмы в 1913 г.)

The article is devoted to little-known facts from the life of the family of Emperor Nicholas II. The main historical source was “The case of the Nizhny Novgorod Provincial Prison Inspection. About the products of the workshops of the First Nizhny Novgorod prison in 1913”, preserved in the fund 386 of the Central Archive of the Nizhny Novgorod region. It testifies that the prisoners of the First Nizhny Novgorod Provincial Prison prepared a unique gift for the son of Emperor Nicholas II — Tsarevich and Grand Duke Alexei Nikolaevich. The gift was timed to celebrate the 300th anniversary of the Romanov dynasty. The article also used other types of historical sources: “Diaries of Emperor Nicholas II”, memoirs of P. Gilyar, a teacher of French, mentor of Tsarevich Alexei Nikolaevich, materials of the pre—revolutionary periodical press — the magazine “Prison Bulletin”, as well as unique photographic documents of M. P. Dmitriev, who recorded the ceremonial reception of the imperial family in Nizhny Novgorod on May 17, 1913. The historiographical basis was the works of modern historians: N. F. Filatov, A. V. Morokhin, R. V. Golubin, S. Yu. Varentsov, L. Abrosimova. The author came to the conclusion that at the beginning of the XX century in Nizhny Novgorod penitentiary institutions, convict labor was fairly well organized, prison workshops developed. In the First Nizhny Novgorod provincial prison, an exclusive gift was prepared for Tsarevich Alexei Nikolaevich — a printing machine with the name “American”. It was made of expensive materials, taking into account the age and interests of the heir to the imperial throne.

Factors associated with changes in illicit opioid use during the COVID-19 pandemic among incarcerated people who use drugs in Quebec, Canada

PurposePeople who use drugs (PWUD) have been disproportionately affected by the COVID-19 pandemic. This study aims to examine changes in illicit opioid use and related factors among incarcerated PWUD in Quebec, Canada, during the pandemic.Design/methodology/approachThe authors conducted an observational, cross-sectional study in three Quebec provincial prisons. Participants completed self-administered questionnaires. The primary outcome, “changes in illicit opioid consumption,” was measured using the question “Has your consumption of opioid drugs that were not prescribed to you by a medical professional changed since March 2020?” The association of independent variables and recent changes (past six months) in opioid consumption were examined using mixed-effects Poisson regression models with robust standard errors. Crude and adjusted risk ratios with 95% confidence intervals (95% CIs) were calculated.FindingsA total of 123 participants (median age 37, 76% White) were included from January 19 to September 15, 2021. The majority (72; 59%) reported decreased illicit opioid consumption since March 2020. Individuals over 40 were 11% less likely (95% CI 14–8 vs 18–39) to report a decrease, while those living with others and with a history of opioid overdose were 30% (95% CI 9–55 vs living alone) and 9% (95% CI 0–18 vs not) more likely to report decreased illicit opioid consumption since March 2020, respectively.Originality/valueThe authors identified possible factors associated with changes in illicit opioid consumption among incarcerated PWUD in Quebec. Irrespective of opioid consumption patterns, increased access to opioid agonist therapy and enhanced discharge planning for incarcerated PWUD are recommended to mitigate the harms from opioids and other drugs.

Association of Mental Health Services Access and Reincarceration Among Adults Released From Prison in British Columbia, Canada

Diagnosis of mental disorder is prevalent among people who have been incarcerated. Nevertheless, community mental health services are often limited following release from prison, and reincarceration rates are high. The prevalence of mental disorders is growing among people who are incarcerated in British Columbia (BC), Canada, increasing the urgency of timely and accessible mental health services after release. To examine the association of mental health services access and timeliness of services access with reincarceration risk among people released from prison. In this cohort study, mental disorder diagnoses were derived from International Classification of Diseases, Ninth Revision or International Statistical Classification of Diseases and Related Health Problems, Tenth Revision codes in administrative health records. Data on prison release and reincarceration were retrieved from corrections records. Population-based health and corrections data were retrieved from the BC Provincial Overdose Cohort, which contains a 20% general population random sample of 1 089 677 BC residents. This study examined releases from provincial prisons between January 1, 2015, and December 31, 2018, among people in the 20% random sample who had a mental disorder diagnosis in the year before their release. Analyses were performed from January to June 2022. Mental health services access (primary care, emergency department visits, or hospitalization) and sociodemographic, health, and incarceration characteristics. A multistate modeling approach was taken. Cox proportional hazards models were stratified by transition, from release to reincarceration, with and without mental health services access. A state arrival extended model examined the influence of timeliness of mental health services access on subsequent hazard of reincarceration. A total of 4171 releases among 1664 people (3565 releases among male individuals [84.6%]; 2948 releases [70.7%] among people <40 years old; 2939 releases [70.5%] among people with concurrent substance use disorder diagnosis) were identified. The total study follow-up time was 2834.53 person-years, with a mean (SD) of 0.68 (0.93) years and median (IQR) of 0.25 (0.07-0.84) years per release. Mental health services access was associated with a reduction in the hazard of reincarceration (hazard ratio, 0.61; 95% CI, 0.39-0.94). For each additional month between release and mental health services access, the hazard of reincarceration was increased by 4% (hazard ratio, 1.04; 95% CI, 1.01-1.07). In this cohort study of people with mental disorder diagnoses released from prison in BC, mental health services access was associated with reduced reincarceration risk. These findings suggest that these services may have the greatest impact on reducing reincarceration risk when they are available in a timely manner in the days and weeks immediately following release.

1435. Incidence of Tuberculosis Infection Among New Prisoners in Southern Thailand

Abstract Background Tuberculosis in prisons was reported to be 100 times higher than the normal population. Late diagnosis, overcrowding, and poor ventilation encourage the transmission of tuberculosis. Five percent of new tuberculosis infections turn into active disease within two years. This study was conducted to determine the incidence of tuberculosis infection among new prisoners in southern Thailand. Methods A prospective cohort study was planned for January 2020‒December 2021 at Songkhla Provincial Prison. However, due to the emerging COVID-19 pandemic, the study was terminated early in February 2021. All new prisoners aged ≥15 years were included. Subjects were excluded if they had any history of a previous diagnosis of tuberculosis, household contact with a tuberculosis patient, or a history of repeated imprisonment. Chest radiography together with a 2-step tuberculin skin test (TST) was done within 2 weeks after imprisonment and at 6 months using the one-step TST. A positive TST was defined by a skin reaction ≥1.5 cm. Prisoners with negative TST had a repeat TST at 6 months. New tuberculosis infection was defined by conversion of TST to positive after 6 months of imprisonment without evidence of active tuberculosis from chest radiography. Results The number of new prisoners during the study period was 602. All prisoners were men with an average age of 31.11 (range 18‒75) years Fifty-one prisoners were excluded. Three hundred and eighty-five prisoners completed the 2-step TST. A total of 11.07% (61/551) of subjects had initially tested positive. Three hundred and seventy prisoners were followed. The COVID-19 pandemic caused a total shutdown of the study because access to the prison was blocked. Therefore, only 53 (9.6%) prisoners completed the study protocol at 6 months. Five prisoners (9.4%) were tuberculin converters with no evidence of active tuberculosis from chest radiography Conclusion The incidence of tuberculosis infection in new prisoners was 9.4%. This study has limitations. Due to the emerging COVID-19 pandemic, 90.4% of subjects were lost to follow-up and some prisoners were released before 6 months, which caused low power of the study. Further studies are needed to identify the incidence of new tuberculosis infection in new prisoners. Disclosures All Authors: No reported disclosures.

Stimulant use disorder diagnosis and opioid agonist treatment dispensation following release from prison: a cohort study

BackgroundConcurrent opioid and stimulant use is on the rise in North America. This increasing trend of use has been observed in the general population, and among people released from prison in British Columbia (BC), who face an elevated risk of overdose post-release. Opioid agonist treatment is an effective treatment for opioid use disorder and reduces risk of overdose mortality. In the context of rising concurrent stimulant use among people with opioid use disorder, this study aims to investigate the impact of stimulant use disorder on opioid agonist treatment dispensation following release from prison in BC.MethodsLinked health and corrections records were retrieved for releases between January 1st 2015 and December 29th 2018 (N = 13,380). Hospital and primary-care administrative health records were used to identify opioid and stimulant use disorder and mental illness. Age, sex, and health region were derived from BC’s Client Roster. Incarceration data were retrieved from provincial prison records. Opioid agonist treatment data was retrieved from BC’s provincial drug dispensation database. A generalized estimating equation produced estimates for the relationship of stimulant use disorder and opioid agonist treatment dispensation within two days post-release.ResultsCases of release among people with an opioid use disorder were identified (N = 13,380). Approximately 25% (N = 3,328) of releases ended in opioid agonist treatment dispensation within two days post-release. A statistically significant interaction of stimulant use disorder and mental illness was identified. Stratified odds ratios (ORs) found that in the presence of mental illness, stimulant use disorder was associated with lower odds of obtaining OAT [(OR) = 0.73, 95% confidence interval (CI) = 0.64–0.84)] while in the absence of mental illness, this relationship did not hold [OR = 0.89, 95% CI = 0.70–1.13].ConclusionsPeople with mental illness and stimulant use disorder diagnoses have a lower odds of being dispensed agonist treatment post-release compared to people with mental illness alone. There is a critical need to scale up and adapt opioid agonist treatment and ancillary harm reduction, and treatment services to reach people released from prison who have concurrent stimulant use disorder and mental illness diagnoses.

Importance of occupation for SARS-CoV-2 seroprevalence and COVID-19 vaccination among correctional workers in Quebec, Canada: A cross-sectional study.

Correctional workers are at increased risk of SARS-CoV-2 infection. We examined the seroprevalence of SARS-CoV-2, determined the effects of carceral and occupational exposures on seropositivity, and explored predictors of COVID-19 vaccine uptake among correctional workers in Quebec, Canada. We conducted a cross-sectional seroprevalence study in three provincial prisons. The primary and secondary outcomes were SARS-CoV-2 antibody seropositivity (Roche Elecsys® serology test) and self-reported COVID-19 vaccination status ("fully vaccinated" defined as two doses or prior infection plus one dose), respectively. Poisson regression models with robust standard error were used to examine the effect of occupational variables with SARS-CoV-2 seropositivity and predictors of COVID-19 vaccine uptake. Estimates are presented as crude and adjusted prevalence ratios (aPR) with 95% confidence intervals (95% CI). From 14 July to 15 November 2021, 105/600 (18%) correctional workers tested positive across three prisons (range 11-21%); 76% were fully vaccinated. Seropositivity was affected by prison occupation (aPR 1.59, 95% CI 1.11-2.27 for correctional officers vs. all other occupations) and low perceived concern of SARS-CoV-2 acquisition (aPR 1.62, 95% CI 1.11-2.38 for not/hardly worried vs. somewhat/extremely worried). Predictors of being fully vaccinated included race/ethnicity (aPR 0.86, 95% CI 0.76-0.99 for visible minority vs. White), presence of comorbidities (aPR 1.14, 95% CI 1.02-1.28 for > 2 vs. none), and prison occupation (aPR 0.82, 95% CI 0.73-0.92 for correctional officers vs. all other occupations). Correctional officers were most likely to have acquired SARS-CoV-2, but least likely to be vaccinated, underscoring the importance of addressing both occupational risks and COVID-19 vaccine hesitancy to mitigate future outbreaks.

Identifying barriers and enablers to opt-out hepatitis C virus screening in provincial prisons in Quebec, Canada: A multilevel, multi-theory informed qualitative study with correctional and healthcare professional stakeholders.

Diffuse implementation of hepatitis C virus (HCV) treatment is dependent on universal screening for HCV, but screening strategies are heterogenous across prisons in the province of Quebec (Canada). We sought to identify barriers and enablers to universal opt-out HCV screening and to describe the multisectoral decision-making processes related to HCV screening in Quebec provincial prisons. A multilevel, multi-theory informed qualitative descriptive approach was used to conduct semi-structured interviews. Interview guides and analyses with correctional stakeholders were informed by the Consolidated Framework for Implementation Research (CFIR) and those with healthcare professionals (HCPs) were based on the Theoretical Domains Framework (TDF). Directed content analysis was used to identify domains within CFIR and TDF reflecting barriers and enablers to opt-out HCV screening. Sixteen interviews (correctional stakeholders: n=8; HCPs: n=8) were conducted in April-May 2021. Twelve CFIR constructs were identified as barriers, seven as enablers, and two as neutral factors for the implementation of opt-out HCV screening. Correctional stakeholders underscored the need for political will (construct: external policy and incentives), highlighted limited resources (construct: available resources), and expressed concerns for the lack of consideration of implementation issues (constructs: trialability, planning). Six TDF domains were identified among HCPs as relevant to the implementation of opt-out HCV screening: beliefs about consequences (mixed=enablers and barriers), environmental context and resources (barrier), social influences (barrier), optimism (mixed), emotions (mixed), and behavioural regulation (barrier). The decision-making processes vis-à-vis HCV care in Quebec correctional settings were found to be hierarchical and complex. The use of CFIR and TDF was helpful in identifying barriers and enablers to HCV screening at multiple levels for people incarcerated in Quebec provincial prisons. Going forward, several political, structural, and organizational factors should be addressed through the engagement of stakeholders and people with lived experience of incarceration.

Identifying barriers and enablers to opt-out hepatitis C virus screening in provincial prisons in Quebec, Canada: A multilevel, multi-theory informed qualitative study with correctional and healthcare professional stakeholders&amp;nbsp;&amp;nbsp;

Identifying barriers and enablers to opt-out hepatitis C virus screening in provincial prisons in Quebec, Canada: A multilevel, multi-theory informed qualitative study with correctional and healthcare professional stakeholders&amp;nbsp;&amp;nbsp;