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Results for infectious diseases

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Author: Zakaria, Dianne

Title: The Relationship between Knowledge of HIV and HCV, Health Education, and Risk and Harm-Reducing Behaviours among Canadian Federal Inmates

Summary: For inmates to make informed decisions about risk-behaviours, such as injection drug use and unprotected sex, they require knowledge about infectious disease transmission and prevention. Previous research suggests that greater human immunodeficiency virus (HIV) knowledge does not necessarily translate into less HIV risk-behaviours, but similar research examining the relationship between hepatitis C virus (HCV) knowledge and risk-behaviours is lacking. Moreover, past research has not extensively examined harm-reducing behaviours, such as bleaching injecting equipment, and no studies were identified which examined the association between knowledge and behaviour in the Canadian correctional context. To address these deficiencies in the literature, in 2007 the Correctional Service of Canada (CSC) conducted the National Inmate Infectious Diseases and Risk Behaviours Survey (NIIDRBS), a self-administered paper questionnaire completed by a large sample of Canadian federal inmates (n = 3,370). This report presents NIIDRBS data on Canadian federal inmates’ knowledge of HIV and HCV; the association between health education program attendance and knowledge; and, the association between knowledge and risk and harm-reducing behaviours. Overall knowledge was higher for HIV than HCV. On average, inmates correctly answered 80% (95% CI: 79, 80) of the HIV questions compared to 69% (95% CI: 68, 70) of the HCV questions. Inmates were most knowledgeable regarding the major modes of transmission for both HIV (M = 85%, 95% CI: 84, 85) and HCV (M = 83%, 95% CI: 82, 84). For HCV, however, knowledge of transmission through casual contact (M = 62%, 95% CI: 61, 64), prevention (M = 63%, 95% CI: 62, 65), and testing and treatment (M = 60%, 95% CI: 58, 61) were lower. The most substantial association between health education program attendance and knowledge was noted among women. Specifically, women attendees correctly answered, on average, 78% (95% CI: 77, 80) of the HCV questions compared to 68% (95% CI: 64, 71) for women non-attendees. Contrary to previously published research, there were instances where greater knowledge was associated with safer behaviour. First, inmates aware of the HIV-risk associated with injecting drugs with needles previously used by others were less likely to report injecting drugs during the past six months in prison compared to inmates who were unaware of the risk (14% vs. 22%, χ2(1, n = 2,922) = 5.84, p < 0.05). Second, among males who injected drugs during the past six months in prison, those aware of the HCV-risk were more likely to have last injected with a needle cleaned with bleach compared to those unaware of the risk (73% vs. 46%, χ2(1, n = 265) = 9.00, p < 0.05). Third, among males ever pierced on a CSC prison range, those aware of the HCV-risk were twice as likely to report consistently using piercing equipment cleaned with bleach compared to those unaware of the risk (63% vs. 31%, χ2(1, n = 306) = 8.15, p < 0.05). Finally, among currently sexually active women, those aware of the HIV-risk were less likely to report unprotected anal sex with women during the past six months in prison compared to those who were unaware of the risk (37% vs. 71%, χ2(1, n = 55) = 5.57, p < 0.05). Further, those aware of the HCV-risk were less likely to report unprotected vaginal sex with women compared to those unaware of the risk (67% vs. 91%, χ2 (1, n = 59) = 5.30, p < 0.05). Thus, greater knowledge may not consistently reduce the occurrence of a risk-behaviour, but it may increase an inmate’s tendency to use harm reduction items should he or she engage in the risk-behaviour. The NIIDRBS provided insight into the associations between knowledge of HIV/HCV, health education, and behaviour, but the cross-sectional survey design limited rigorous evaluation of these relationships, particularly with respect to causal effects. An intervention study1, which captures information about knowledge and behaviour over time, including after release into the community, could provide more accurate information about the impact of health education on knowledge and knowledge on behaviour. Such research should explore why inmates continue to engage in risk-behaviours, despite adequate knowledge.

Details: Ottawa: Correctional Service of Canada, 2010. 63p.

Source: Internet Resource: Research Report 2010 No R-195: Accessed April 16, 2012 at: http://www.csc-scc.gc.ca/text/rsrch/reports/r195/r195-eng.pdf

Year: 2010

Country: Canada

URL: http://www.csc-scc.gc.ca/text/rsrch/reports/r195/r195-eng.pdf

Shelf Number: 124987

Keywords:
Drug Offenders
Health Care, Prisons
HIV (Viruses)
Infectious Diseases
Inmates, Drug Abusing (Canada)
Prisoners, Drug Abusing