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.
Acknowledgements
The authors gratefully acknowledge the pivotal role played by the following partner organisations and key stakeholders in study planning and implementation: Justice Health & Forensic Mental Network; Corrective Services NSW; NSW Health; Hepatitis NSW; NSW Users and AIDS Association; the Community Restorative Centre; and the Aboriginal Health & Medical Research Council. We would like to recognise the contribution of current and past researchers and staff involved in the study at the participating correctional centres. Finally, the authors would like to thank the study participants for their generous contribution to the research.
Disclosure statement
The authors report no conflicts of interest.