Exploring risky practices, Opioid Substitute Therapy (OST) and disease transmission among prison inmates in India - A cross-sectional study
Abstract Background: Prison, a setting where high-risk persons including substance-use offenders are being convicted. They sometimes continue their risky behaviours which pose a risk to themselves, other prisoners and to the community. A cross-sectional study was conducted in ten correctional homes (CHs) in West Bengal to identify the substance use, sexual and hygiene practices among prison inmates inside correctional homes. Methods: In-depth interviews were conducted with 15 key informants posted inside prisons using an interview guide. Data were analysed using MS Excel 2019. Chi-Square tests were performed to ascertain the associations between variables.Results: This study confirmed the availability and use of substances within prisons, and homosexual as well as drug-injecting practices of inmates. According to key informants, many CH inmates have had infections such as contact dermatitis, scabies, UTIs, STIs, tuberculosis, HIV, and hepatitis B and C. Limited preventive and curative services such as healthy diet, isolation and treatment for HIV and TB were provided to infected inmates. The treatment completion rate in inmates who availed OST at CHs was 96.53%, while the re-addiction rate after released from prison was 98.07%. The routine screening for STIs and hepatitis, distribution of condom and needles, and treatment for hepatitis were absent in most CHs. The CHs lack mechanisms to ensure continuous drug supply, regular follow-up and treatment completion after incarceration, partner notification, hepatitis treatment, and health promotions.Conclusions: The improvements in infrastructure and uninterrupted health care delivery system can improve health outcomes of affected inmates and break the transmission to other inmates and general community.