by The Canadian Press
Posted: July 31, 2007 – 5:00 pm ET
(Toronto, Ontario) Offenders who are admitted to Ontario remand facilities are 11 times more likely to be infected with HIV and 22 times more likely to be infected with hepatitis C than members of the general population – numbers that point to the need for better education and preventive measures among inmates, a new study suggests.
The study, published in the Canadian Medical Association Journal, indicates injection drug use is by far the most important risk factor in the transmission of HIV and hepatitis C among inmates of Ontario’s remand facilities.
“This shows the importance of education, because in some cases, there were people who knew they were infected and still were engaging in behaviors that would transmit the infection,” said Liviana Calzavara, one of the authors of the study.
Calzavara, who is deputy director of the HIV Social, Behavioral and Epidemiological Studies Unit at the University of Toronto’s department of public health sciences, added that one-third of the inmates who tested positive for hepatitis C weren’t aware they were infected.
“This study draws attention to issues around education for individuals in terms of how to avoid it, how to avoid transmitting it to others and treatment that is available that would limit the health effects,” she said.
This is particularly important because inmates tend to spend relatively short periods of time in remand centers – an average of 32 days – before moving on to somewhere else, said Calzavara. The study found that 56,000 adult and young offenders are admitted to remand facilities in Ontario each year, where they await the outcome of legal proceedings, serve sentences under 60 days, or await transfer to provincial or federal jails.
This means there are significant opportunities for transmission of diseases to other populations through high-risk behaviors such as injection drug use or unsafe sex, said Calzavara.
“I think that’s something that society needs to think about, because the typical attitude is, ‘Who cares, they’re incarcerated,’ and people don’t realize that the amount of time spent in prison is actually fairly short,” she said.
The study found that two per cent of inmates tested in Ontario remand facilities were infected with HIV and 17.6 per cent were infected with hepatitis C.
Many educational and preventive measures are already in place in Ontario’s correctional facilities, but the province is always looking to improve its procedures, said Stuart McGetrick, a spokesman for Ontario’s Ministry of Community Safety and Correctional Services.
McGetrick said Ontario’s prisons work closely with local public health units to teach inmates about high-risk behaviors.
“As well as public health officials coming in and talking about the risks of sexually transmitted diseases, the risks of infection from intravenous drug use, we also have programs that help inmates deal with substance abuse and other behaviors that are high risk that might lead them to become infected,” he said.
Correctional Services also offers voluntary HIV and hepatitis C testing for inmates and will work with others who may have come in contact with the inmate if he or she is found to be infected, said McGetrick.
Another study published in the same issue of the medical journal found that 3.4 per cent of inmates at Quebec provincial prisons are infected with HIV and 18.5 per cent are infected with hepatitis C. More than 90 per cent of those infected with either virus reported using injection drugs.
These numbers show without a doubt the necessity of preventive programs in all Canadian correctional facilities, said Joanne Csete, executive director of the Canadian HIV-AIDS Legal Network.
“It’s a really tragic and unnecessary public health concern, not just for the people who are in prisons but for the communities to which they will return,” said Csete. “This is completely avoidable.”
Programs in which inmates are given sterile syringes with which to inject drugs _ similar to Vancouver’s safe injection site _ have “effectively stopped HIV transmission in its tracks” in other countries, said Csete.
But in Canada “there is this idea that people who use drugs should be able to abstain and get clean, and that’s just not realistic,” she said.
“There are some people who just can’t get clean instantly or predictably, and harm reduction measures allow us as a matter of public policy not to throw those people away or say that it doesn’t matter if they get infected with a disease.”
Csete added that a sterile syringe program would pay for itself if it could avert one case of hepatitis C per year because of the health care costs associated with treating the disease.
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