Provincial Prison Research Articles

Quality of Antenatal Care for Women Who Experience Imprisonment in Ontario, Canada

Women who experience imprisonment have high morbidity and an increased risk of adverse pregnancy outcomes. Antenatal care could modify pregnancy-related risks, but there is a lack of evidence regarding antenatal care in this population. To examine antenatal care quality indicators for women who experience imprisonment and to compare these data with data for the general population. This population-based, retrospective cohort study used linked correctional and health administrative data from women released from provincial prison in Ontario, Canada, in 2010 and women in the general population with deliveries at 20 weeks' gestation or greater from January 1, 2005, to December 31, 2015. Data analysis was performed from January 1, 2017, to May 4, 2020. Pregnancies in women with time in prison during pregnancy (prison pregnancies), pregnancies in women with time in prison but not while pregnant (prison control pregnancies), and pregnancies in women in the general population (general population pregnancies). Antenatal care quality indicators: first-trimester visit, first-trimester ultrasonography, and 8 or more antenatal care visits. A total of 626 prison pregnancies in 529 women (mean [SD] age, 26.6 [5.4] years), 2327 prison control pregnancies in 1570 women (mean [SD] age, 26.2 [5.4] years), and 1 308 879 general population pregnancies in 884 063 women (mean [SD] age, 30.3 [5.3] years) were studied. Of 626 prison pregnancies, 193 women (30.8%; 95% CI, 27.1%-34.6%) had a first-trimester visit, 272 (48.4%; 95% CI, 44.4%-52.4%) had at least 8 antenatal care visits, and 209 (34.6%; 95% CI, 31.0%-38.4%) received first-trimester ultrasonography. In 2327 prison control pregnancies, 1106 women (47.5%; 95% CI, 45.3%-49.8%) had a first-trimester visit, 1356 (59.2%; 95% CI, 56.9%-61.4%) had 8 or more antenatal care visits, and 893 (38.5%; 95% CI, 36.4%-40.6%) received first-trimester ultrasonography. Compared with 1 308 879 general population pregnancies, the odds of antenatal care were lower for the first-trimester visit (odds ratios [ORs], 0.11 [95% CI, 0.09-0.13] in prison pregnancies and 0.23 [95% CI, 0.21-0.25] in prison control pregnancies), 8 or more antenatal care visits (ORs, 0.16 [95% CI, 0.14-0.19] in prison pregnancies and 0.25 [95% CI, 0.23-0.28] in prison control pregnancies), and first-trimester ultrasonography (ORs, 0.43 [95% CI, 0.36-0.50] in prison pregnancies and 0.51 [95% CI, 0.46-0.55] in prison control pregnancies). This study found that women who experienced imprisonment were substantially less likely to receive adequate antenatal care than were women in the general population whether or not they were in prison during pregnancy. Efforts are needed to improve antenatal care for this population both in prison and in the community.

The prevalence and health status of people with developmental disabilities in provincial prisons in Ontario, Canada: A retrospective cohort study.

Data on the prevalence of developmental disabilities in people who experience imprisonment and on their characteristics are lacking. The present authors identified adults with developmental disabilities who were released from Ontario provincial prisons in 2010 and a general population comparator group using administrative data. The present authors examined demographic characteristics, morbidity and healthcare use. The prevalence of developmental disabilities was 2.2% in the prison group (N=52,302) and 0.7% in the general population (N=10,466,847). The prevalence of psychotic illness, substance-related disorder and self-harm was higher among people in the prison group with developmental disabilities. People with developmental disabilities were more likely to have emergency department visits and hospitalizations in prison and in the year after release. People with developmental disabilities are overrepresented in provincial prisons and have a high burden of disease. Strategies are indicated to prevent incarceration and to improve health.

Care, custody, control, and the preservation of life: the complexity of correctional officer work

ABSTRACT Correctional officers are tasked with and committed to preserving life, yet deaths do occur in custody. Moreover, it is said deaths that receive public attention and media coverage. In the current article, we examine the complexities around the preservation of life as experienced during correctional work. We focus on the discrepancies between public and media interpretations of correctional work and the occupational experiences of correctional officers, including the relationships that develop between staff and prisoners. Drawing from semi-structured interviews with 43 Canadian correctional officers with experience working in provincial or territorial prisons, we thematically analyze their narratives of responding to prisoner death by suicide, either attempted, completed, or both, as well as self-harming behaviours. Results highlight the discrepancies between the role and responsibilities of correctional officers versus how the public perceives their occupational work. We evidence that most staff do care about those in custody, thus balancing preservation of life, care, custody, and control, while keeping themselves, their colleagues, and the public safe creates a complex space for officers.

The role of prison-based interventions for hepatitis C virus (HCV) micro-elimination among people who inject drugs in Montréal, Canada

BackgroundIn Canada, hepatitis C virus (HCV) transmission primarily occurs among people who inject drugs (PWID) and people with experience in the prison system bare a disproportionate disease burden. These overlapping groups of individuals have been identified as priority populations for HCV micro-elimination in Canada, which is currently not on track to achieve its elimination targets. Considering the missed opportunities to intervene in provincial prisons, this study aims to estimate the population-level impact of prison-based interventions and post-release risk reduction strategies on HCV transmission among PWID in Montréal, a Canadian city with high HCV burden. MethodsA dynamic HCV transmission model among PWID was developed and calibrated to community and prison bio-behavioural surveys in Montréal. Then, the relative impact of prison-based testing and treatment or post-release linkage to care (both 90% testing and 75% treatment coverage), alone or in combination with strategies that reduce the heightened post-release transmission risk by 50%, was estimated from 2018 to 2030, and compared to counterfactual scenarios. ResultsPrison-based test-and-treat strategies could lead to the greatest declines in incidence (48%; 95%CrI: 38–57%) over 2018–2030 and prevent the most new first chronic infections (22%; 95%CrI: 16−28%) among people never exposed to HCV. Prison testing and post-release linkage to care lead to a slightly lower decrease in incidence and prevented fraction of new chronic infections. Combining test-and-treat with risk reduction measures could further its epidemiological impact, preventing 35% (95%CrI: 29−40%) of new first chronic infections. When implemented concomitantly with community-based treatment scale-up, prison-based interventions had synergistic effects, averting a higher fraction of new first chronic infections. ConclusionOffering HCV testing and treatment in provincial prisons, where incarcerations are frequent and sentences short, could change the course of the HCV epidemic in Montréal. Prison-based interventions with potential integration of post-release risk reduction measures should be considered as an integral part of HCV micro-elimination strategies in this setting.

Infant and Maternal Outcomes for Women Who Experience Imprisonment in Ontario, Canada: A Retrospective Cohort Study.

To describe the population-level risk of infant and maternal outcomes for women who experience imprisonment and compare outcomes with the general population. We conducted a retrospective cohort study. We used linked correctional and health data for women released from provincial prisons in 2010. We defined three exposure groups for Ontario singleton deliveries from 2005-2015: deliveries to women who were in prison during pregnancy but not necessarily for delivery, prison pregnancies; deliveries to women who had been in prison but not while pregnant, prison controls; and general population deliveries. We compared groups using generalized estimating equations. Primary outcomes were preterm birth, low birth weight, and small for gestational age birth weight. Secondary outcomes included NICU admission, neonatal abstinence syndrome, placental abruption, and preterm prelabour rupture of membranes. In prison pregnancies (n = 544) and prison controls (n = 2156), respectively, preterm birth risk was 15.5% and 12.5%, low birth weight risk was 13.0% and 11.6%, and small for gestational age birth weight risk was 18.1% and 19.2%. Adjusted for maternal age and parity and compared with general population deliveries (N = 1 284 949), odds ratios were increased for prison pregnancies and prison controls, respectively, at 2.7 (95% CI 2.2-3.4) and 2.1 (95% CI 1.9-2.4) for preterm birth, 3.1 (95% CI 2.4-3.9) and 2.7 (95% CI 2.3-3.1) for low birth weight, and 1.6 (95% CI 1.3-2.1) and 1.8 (95% CI 1.6-2.0) for small for gestational age birth weight. There is an increased risk of adverse infant outcomes in women who experience imprisonment compared with the general population, whether they are in prison during pregnancy or not.

Учреждение Рязанской губернской тюремной инспекции и деятельность ее руководителей в 1912–1916 годах

Учреждение Рязанской губернской тюремной инспекции и деятельность ее руководителей в 1912–1916 годах

P.634 Predictors of suicide risk in bipolar disorder: A study of 140 patients

To measure the predictive power of the Suicide Probability Scale (SPS) in a male inmate population (federal penitentiary) with the added contribution of actuarial data.SPS scores and data from the files of 518 inmates were analyzed in relation to their suicidal behaviors over the following 10 years.During this period, 12 inmates committed suicide (2.32%), 43 engaged in non-lethal self-harm (8.3%) and 15 expressed serious suicidal intention (2.9%), for a total of 70 (13.51%) who manifested at least one form of suicidal behavior. The records of the 518 inmates allowed identifying seven actuarial variables (out of 24 documented) that distinguished the group that acted out. These variables were tested in combination with the SPS score to determine the best predictive models of suicidal behavior. Depending on type of suicidal behavior and on observation period, the following seven variables could prove useful in improving the predictive capacity of the SPS: age, prior suicidal behavior, borderline personality disorder, length of sentence, number of sentences, prior incarceration in a provincial prison, and juvenile priors. However, analyses did not allow developing a better predictive model for the specific subgroup of suicide completers.SPS is improved when adding actuarial data.

90-90-90 for everyone?: Access to HIV care and treatment for people with HIV who experience imprisonment in Ontario, Canada

ABSTRACT We examined HIV care and treatment in prison and after release for people with HIV in Ontario, Canada, and compared HIV care and treatment with the general population. We used administrative data to identify people with HIV released from provincial prison in 2010 and in the general population. We calculated the proportion of people with HIV who accessed HIV care in prison. We compared HIV care use between people with HIV on prison release and in the general population. We estimated the proportion of people with HIV on antiretroviral therapy in prison as the ratio of the average numbers of people prescribed antiretroviral therapy in prison in 2009/2010 and people with HIV in prison in January 2010. We compared the proportion of people with HIV on public drug benefits that filled an antiretroviral therapy prescription within 6 months for people postrelease and in the general population. Of 344 people with HIV on prison admission, 34.0% received HIV care in prison. Over 1 year, 63.6% of 330 people with HIV on prison release and 67.7% of 15,819 people with HIV in the general population accessed HIV care (p = 0.118), and 43.3% of people with HIV on prison release and 55.2% of people with HIV in the general population had 2 or more HIV care visits (p < 0.001). In prison, 52.4% of people with HIV (39.5/75.4) were on antiretroviral therapy. Of those accessing drug benefits, 60.1% of 226 people with HIV on prison release and 79.6% of 7458 people with HIV in the general population claimed an antiretroviral therapy prescription within 6 months (p < 0.001). Access to HIV care and treatment were suboptimal in prison, and sustained HIV care and treatment were worse for people post-release compared to the general population. Interventions are needed to support HIV care for this population.

The hepatitis C virus cascade of care in a Quebec provincial prison: a retrospective cohort study.

Hepatitis C virus (HCV) microelimination efforts must target people in prison; however, although some inmates may qualify for treatment in provincial prisons, it may not be routinely provided. Our aim was to characterize the cascade of HCV care in Quebec's largest provincial prison. We conducted a retrospective study of all HCV-related laboratory tests requested at the Établissement de détention de Montréal (men's prison with on-demand screening), between July 1, 2017, and June 30, 2018. We defined 8 HCV care cascade steps: 1) total sentenced inmates, 2) screened for HCV (via HCV antibody [HCV Ab]), 3) HCV Ab positive, 4) tested for HCV RNA, 5) HCV RNA positive, 6) linked to care, 7) HCV treatment initiated and 8) achieved sustained virologic response. We measured proportions of inmates at each step using denominator-numerator linkage. We also calculated the proportion screened among inmates with a sentence duration of at least 1 month, during which time screening should be feasible. Of the 4931 sentenced inmates, 344 (7%) were screened for HCV, of whom 38 (11%) were HCV Ab positive. Thirty-five (92%) of the 38 received HCV RNA testing, which showed positivity in 16 (46%). Ten (62%) of the 16 inmates were linked to care; treatment was initiated in 3 (30%), 2 of whom (67%) achieved a sustained virologic response. Among inmates with a sentence duration of at least 1 month (n = 1972), the proportion screened increased to 17%. A small proportion (7%) of men at a Canadian provincial prison with on-demand HCV testing were screened, and rates of treatment initiation were low in the absence of formal HCV cure pathways. To eliminate HCV in this subpopulation, opt-out HCV testing should be considered.

Emergency department use in people who experience imprisonment in Ontario, Canada.

The aims of this study were to describe emergency department (ED) utilization by people in provincial prison and on release, and to compare with ED utilization for the general population. We linked correctional and health administrative data for people released from provincial prison in Ontario in 2010. We matched each person by age and sex with four people in the general population. We compared ED utilization rates using generalized estimating equations, by sex and for high urgency and ambulatory care sensitive conditions. People who experienced imprisonment (N = 48,861) had higher ED utilization rates compared with the general population (N = 195,444), with rate ratios of 3.2 (95% CI 3.0-4.4) for men and 6.5 (95% CI 5.6-7.5) for women in prison and a range of rate ratios between 3.1 and 7.7 for men and 4.2 and 8.8 for women over the 2 years after release. Most ED visits were high urgency, and between 1.0% and 5.1% of visits were for ambulatory care sensitive conditions. ED utilization rates increased on release from prison. People experiencing imprisonment in Ontario have higher ED utilization compared with matched people in the general population, primarily for urgent issues, and particularly in women and in the week after release. Providing high-quality ED care and implementing prison- and ED-based interventions could improve health for this population and prevent the need for ED use.

Fentanyl behind bars: The implications of synthetic opiates for prisoners and correctional officers

Background and AimsFentanyl and derivatives are lethal components of North America’s opioid crisis. Prisons often house a disproportionate number of illicit opiate users. To date, no on-the-ground empirical research exists on how opioids are altering the health and risk profile of prisons. The objectives of this study were to examine (1) how fentanyl and its analogues have shaped the prison experience for prisoners; and (2) how these opioids have altered the occupation of correctional officers (CO’s). MethodsWe conducted semi-structured interviews with 587 adult prisoners and 131 COs across four provincial prisons in Western Canada. Prisoners were recruited on their housing units and randomly selected. COs were recruited through non-probability, theoretical sampling. We employed a generalized prompt guide and asked a range of questions pertaining to how the presence of fentanyl and its analogues have changed the prison experience for prisoners and have impacted the work routine of COs. Interviews were digitally recorded, transcribed verbatim, thematically coded and analyzed using Nvivo 11. ResultsFor prisoners, we identified four main results: (1) the presence of fentanyl leads to an increased number of overdoses; (2) prisons are nonetheless perceived as a comparatively safe place to use drugs; (3) fentanyl is often mixed into other drugs, making it hard for drug users to avoid fentanyl; and (4) prisoners fear fentanyl is being weaponized. For officers, we identified: (1) increased fears about inadvertent personal exposure or widespread institutional opioid contamination; (2) fear of targeted poisonings; (3) changing attitudes towards opioid-using prisoners; and (4) a declining commitment to correctional careers. ConclusionThe presence of fentanyl in prisons has significantly influenced how prisoners experience prison and relate to each other and how COs perceive their job. COs now identify fentanyl as the greatest risk to their safety in prisons.

Otto Kahler a jeho rod II: Léta zrání v Praze

Otto Kahler (1849-1893), a son of a wound physician at the Provincial Prison, spent his childhood and youth in his native Prague. After graduated from Charles-Ferdinand University (1871, 1872) he became a second-generation physician in an old German-Czech peasant family. He thereafter worked as an intern (from 1873) and assistant (from 1875) with Prof. Joseph Halla at the IInd Medical Clinic of the General Hospital. Shortly before habilitation (1878), in collaboration with Arnold Pick from the Insane Asylum, he began an intense research on pathology and pathological anatomy of the central nervous system (1878-1880) which resulted in discovery of the rule for arrangement of fibres in the posterior funiculi of the spinal cord - the Kahler-Pick law (1880). Then he coedited the weekly Prager medicinische Wochenschrift (1880-1889). After the division of the University according to teaching language the recently appointed extraordinary professor (1882) as well as the whole IInd Medical Clinic belonged to the German Charles-Ferdinand University. His encounter of a case of multiple myeloma in the Prague Merchants´ Hospital in December 1885 attracted his attention to symptomatology of this disease.

The Acceptability and Feasibility of Implementing an Online Educational Intervention With Nurses in a Provincial Prison Context

Correctional nursing requires a strong knowledge base with access to continuing education (CE) to maintain and enhance competencies. Nurses working in provincial prisons have reported many challenges in accessing CE, with online learning being identified as a potential solution. Limited research was found, however, which examined the correctional context in the development and delivery of online learning for nurses. The purpose of this study was to develop an online educational intervention tailored to correctional nurses and determine the feasibility and acceptability of implementing the intervention in a provincial prison context. A sequential mixed methods study was conducted. Participants included nurses from three correctional settings in the province of Ontario, Canada. Semistructured interviews examined contextual factors and educational needs. Delphi surveys determined the educational topic. Preintervention and postintervention questionnaires examined the context, educational content, and intervention's acceptability and feasibility. The online intervention focused on mental health and addictions with two 30-minute webinars delivered back-to-back over 15 weeks. Respondents expressed satisfaction with the convenience of online learning at work using short webinars, as well as the topics, relevance of information, and teaching materials, but dissatisfaction with presentation style. The feasibility of the intervention was limited by access to technology, time to attend, education space, and comfort with technology. The findings from this study provide insight to guide the future development of online CE for correctional nurses. If changes are made within correctional facilities in collaboration with nurses and managers, online learning holds the potential to facilitate access to ongoing professional development.

Assessment of need for inpatient treatment for mental disorder among female prisoners: a cross-sectional study of provincially detained women in Ontario

BackgroundInternational studies show a consistent finding of women in prisons as having a high prevalence of mental disorder. Most will be treated within the prison however the most severely ill require transfer to a hospital facility. The primary aim of our study was to survey the total provincial female prison population in Ontario, Canada, to determine the proportion that require treatment in a psychiatric hospital, and the security level required. The secondary aim was to investigate the validity and psychometric properties of DUNDRUM-1 and DUNDRUM-2 in making these assessments.MethodsWe carried out a cross-sectional study of all remand and sentenced female inmates detained in all 16 provincial jails that hold women in Ontario. The severity of mental health need was categorised by mental health staff on a five-point scale. Two forensic psychiatrists then examined all medical files of prisoners that had been categorised in the highest two categories and a random sample of nearly a quarter of those in the third category. An overall opinion was then made as to whether admission was required, and whether a high intensity bed was needed, and files were rated using DUNDRUM-1 and DUNDRUM-2.ResultsThere were 643 female inmates in provincial prisons in Ontario. We estimated that approximately 43 (6.7%) required admission to a hospital facility, of which 21.6 [prorated] (3.4%) required a high intensity bed such as a psychiatric intensive care bed within a secure hospital. The DUNDRUM-1 and -2 tools showed good internal validity. Total scores on both DUNDRUM-1 and DUNDRUM-2 were significantly different between those assessed as needing admission and those who did not, and distinguished the level of security required.ConclusionThis is the first study to determine level of need for prison to hospital transfers in Canada and can be used to inform service capacity planning. We also found that the DUNDRUM toolkit is useful in determining the threshold and priorities for hospital transfer of female prisoners.

Health care utilization by people with HIV on release from provincial prison in Ontario, Canada in 2010: a retrospective cohort study

ABSTRACTLimited evidence suggests that at the time of release from prison, people with HIV face barriers to health care, which may contribute to worsening HIV clinical outcomes. We aimed to describe health care utilization for people with HIV released from provincial prison in Ontario in 2010, and to compare rates of use with prisoner and general population controls.We used Ontario’s administrative health records and data from the Ontario Ministry of Community Safety and Correctional Services on all persons released from provincial prison in 2010. We matched each person with HIV released from provincial prison by age and sex with three controls in each of three groups: people with no HIV released from provincial prison, people with HIV in the general population, and people with no HIV in the general population. We compared rates of use of primary care, non-primary ambulatory care, emergency departments, and hospitalization in the year after the first release from provincial prison in 2010 and in the corresponding period for matched controls.We identified 330 persons with HIV released from provincial prison in 2010. Their median time to first HIV-ambulatory care visit after prison release was 177 days (SD 136–239). Compared to all control groups, people with HIV released from provincial prison had higher rates of primary care use, unscheduled emergency department visits and hospital admissions at 30, 90 and 365 days after release.People with HIV released from provincial prison have a long time to first contact with HIV ambulatory care, and higher rates of health care utilization across health care settings. Interventions are required to facilitate post-release linkage to care for this population.

Cervical Cancer Screening Access for Women Who Experience Imprisonment in Ontario, Canada

Women who experience imprisonment have higher rates of cervical cancer. Lack of access to cervical cancer screening in the community or in prison may contribute to increased cervical cancer incidence. To determine cervical cancer screening rates for women in provincial prison in Ontario, Canada, and to compare these data with data for the general population. This retrospective cohort study used correctional and health administrative data from January 1, 2006, to December 31, 2013. Participants included Ontario women aged 21 to 69 years during the follow-up period with no history of cervical cancer or hysterectomy. Analyses were conducted between July 2017 and September 2018. Women admitted to Ontario provincial prison in 2009 or 2010 and released in 2010 were considered exposed, and women in the general population of Ontario were considered unexposed. Whether women were overdue for cervical cancer screening at the time of admission to prison or on July 1, 2010, for the general population, defined as not having been screened in the previous 3 years, and whether women who were overdue were still overdue after 3 years. There were 4553 women in the prison group and 3 647 936 women in the general population group. The median (interquartile range) age was 36 (29-43) years in the prison group and 43 (34-53) years in the general population. Women in the prison group had 2.20 times (95% CI, 2.08-2.33) the odds of being overdue for cervical cancer screening compared with women in the general population after adjusting for neighborhood income quintile, at 53.9% (95% CI, 51.8%-56.1%) compared with 32.9% (95% CI, 32.8%-33.0%) (P < .001). Women in the prison group also had nearly twice the odds of still being overdue at 3 years, with an odds ratio of 1.87 (95% CI, 1.76-1.99) after adjusting for neighborhood income quintile, and rates of still being overdue of 36.2% (95% CI, 34.5%-38.0%) compared with 21.9% (95% CI, 21.8%-21.9%) (P < .001). Women who experience imprisonment have worse cervical cancer screening access than women in the general population. Work should be done to promote cervical cancer screening awareness and to improve access to acceptable screening in prison and in the community after prison release.

Primary care utilization in people who experience imprisonment in Ontario, Canada: a retrospective cohort study

BackgroundAccess to primary care is an important determinant of health, and data are sparse on primary care utilization for people who experience imprisonment. We aimed to describe primary care utilization for persons released from prison, and to compare utilization with the general population.MethodsWe linked correctional data for all persons released from provincial prison in Ontario, Canada in 2010 with health administrative data. We matched each person by age and sex with four general population controls. We compared primary care utilization rates using generalized estimating equations. We adjusted rate ratios for aggregated diagnosis groups, to explore this association independent of comorbidity. We examined the proportion of people using primary care using chi squared tests and time to first primary care visit post-release using the Kaplan-Meier method.ResultsCompared to the general population controls, the prison release group had significantly increased relative rates of primary care utilization: at 6.1 (95% CI 5.9-6.2) in prison, 3.7 (95% CI 3.6-3.8) in the week post-release and between 2.4 and 2.6 in the two years after prison release. All rate ratios remained significantly increased after adjusting for comorbidity. In the month after release, however, 66.3% of women and 75.5% of men did not access primary care.ConclusionsPrimary care utilization is high in prison and post-release for people who experience imprisonment in Ontario, Canada. Increased use is only partly explained by comorbidity. The majority of people do not access primary care in the month after prison release. Future research should identify reasons for increased use and interventions to improve care access for persons who are not accessing care post-release.

Remand as a Cross-Institutional System: Examining the Process of Punishment before Conviction

Currently in Canada, there are more legally innocent people in custody in provincial/territorial prisons than there are sentenced prisoners. This group, known as remand prisoners, constituted 37% of the total prison population – federal and provincial/territorial – in Canada in 2015. Despite growing public attention and legal awareness of the remand problem, little is known about the human costs of pre-trial detention. I outline some of these costs to individuals through a discussion of three distinctive dimensions of remand imprisonment: arrest, court appearances, and daily life in custody. Based on interviews with 120 remand prisoners (60 male, 60 female) at four maximum-security provincial prisons in Ontario, I demonstrate that the system imposes many punishments on individuals long before – and often in the absence of – conviction. The consequences of remand custody have implications for our understanding of the nature of punishment before conviction and for contemporary legal debates in Canada on the issue of pre-trial credit.

Relationship, Accountability, Justice: A Conversation about Community-Engaged Research

In 2015, a coalition of six Saskatoon community organizations (the Elizabeth Fry Society of Saskatchewan, AIDS Saskatoon, STR8 UP 10,000 Little Steps to Healing, Inc., the Mennonite Central Committee, the Micah Mission, and Community Legal Assistance Services for Saskatoon Inner City [CLASSIC])1 and a university researcher (Sarah Buhler from the University of Saskatchewan College of Law) came together to address the issue of telephone access in Saskatchewan’s provincial correctional centres. Together we established an informal research coalition that we called “Project Access.” The issue of telephone access in provincial prisons had been identified by the six community organizations through their ongoing work with prisoners and former prisoners. Specific concerns included the exorbitant costs of the prison telephone system and unfair and uneven application of policies regarding telephone access. As we met to discuss the issue, it became clear to us that in order to advocate effectively for changes to the system, we needed to research the issue and to learn more about the ways the current telephone access policies were being implemented in provincial prisons.

HIV and hepatitis C virus infections in Quebec’s provincial detention centres: comparing prevalence and related risky behaviours between 2003 and 2014-2015

To compare the prevalence of HIV, hepatitis C virus (HCV) infections, and related risky behaviours among inmates in Quebec's provincial prisons between 2003 and 2014-2015. Cross-sectional data were anonymously collected from May 2014 to March 2015 for men (n = 1315) and women (n = 250) and combined with data collected in 2003 to evaluate trends in the last decade. Participants completed a questionnaire and provided saliva samples. The data from the 2003 and 2014-2015 surveys were merged for statistical analysis. HIV prevalence was stable between 2003 and 2014-2015 for men (2.4% vs. 1.8%, p = 0.4), whereas it decreased for women (8.8% vs. 0.8%, p < 0.001). HCV prevalence decreased between 2003 and 2014-2015 for both men (16.6% vs. 11.9%, p < 0.001) and women (29.2% vs. 19.2%, p = 0.02). HIV and HCV prevalence were higher among people who inject drugs (PWID), for both sexes and both studies. PWID-specific prevalence did not change between 2003 and 2014-2015, except for a decrease in HIV prevalence in PWID women. However, the proportion of prisoners reporting a history of injection drug use outside prison was lower in 2014-2015 than in 2003 for men (19.8% vs. 27.7%, p < 0.0001) and women (28.6% vs. 42.6%, p = 0.002). The lower proportion of PWID inmates in 2014-2015 compared to 2003 explained in large part the decrease in HIV and HCV prevalence. Despite the decrease in prevalence, HIV and HCV infections among incarcerated individuals still represent a major public health problem due to the sizable increase of individuals in Quebec's correctional system over the same period.