This thesis aimed to describe the epidemiology of HCV in South Australian prisons - prevalence, transmission and risk factors. This thesis also aimed to determine the impact of incarceration on reported risk behaviours. A related objective was to evaluate the epidemiological effectiveness of the ELISA - 3 HCV antibody test using PCR as the gold standard. Finally, this thesis aimed to explore the potential for minimising HCV risk in the South Australian prison population. Methods: Two case note audits were conducted at each of eight publicly operated SA prisons ( in summer and winter ) to identify any documented HCV - antibody test results. Prisoners recruited at entry to prison were offered tests for HCV - antibody and completed a pre - entry risk factor survey. Participants completed additional risk factor surveys and ( if HCV - negative at last test ) underwent further antibody tests at three - monthly intervals for up to 15 months. A sample of participants also provided blood specimens for HCV - RNA testing. Limited stakeholder consultations with prison officers and nurses were also conducted. Quantitative data were analysed using univariate and multivariate techniques. Results: 1347 case notes were audited in summer, and 1347 in winter and an overall HCV prevalence of 42 % was estimated. In both univariate and multivariate analyses, HCV prevalence was significantly higher in female prisoners ( 65 % ), those aged above 28 years ( 48 % ), and in Indigenous prisoners originating from metropolitan areas ( 56 % ). Indigenous prisoners originating from remote areas had significantly lower HCV prevalence ( 20 % ). 666 prisoners were recruited at entry, and 42 % were estimated to be HCV - antibody positive. Three seroconversions were noted in 151 initially HCV - seronegative negative individuals followed up for a median time of 121 days - a rate 4.6 per 100 person years - but community exposure could not be ruled out. Overall agreement between HCV - antibody and HCV - RNA assays was 86 % ( 100% in the HCV negative samples ) - kappa = 0.71. Injecting history was highly prevalent in prison entrants ( 70 % ) and both community and prison injecting ( but not tattooing ) were independent predictors of entry HCV status. Prison history was also independently associated with entry HCV status. Injecting in prison during the study was infrequently reported, but significantly more likely in those testing HCV - antibody positive at prison entry ( risk ratio = 2.48, P = 0.046 ). Stakeholders were most supportive of strategies to increase education and to minimise risks associated with hair clippers, but did not support most other suggested preventive strategies. Other issues related to communicable diseases and infection control were explored in the stakeholder interviews. Conclusions: HCV prevalence in South Australian prisoners is extremely high and may have contributed to a ' ceiling effect ' , minimising the seroconversion rate observed in this population. Injecting is relatively infrequently reported in prison, but more likely in those already infected with HCV. Thus, contaminated injecting equipment represents a significant threat to other prisoners and prison staff. Strategies aimed at reducing HCV risk in prisons, which address the concerns of those expected to implement them, are proposed in this thesis. / Thesis (Ph.D.)--School of Population Health and Clinical Practice, 2006.

O estudo analisa relações sociais e de poder em uma micro-unidade penitenciária de hospital geral, no Rio Grande do Sul, no período compreendido entre julho a outubro de 2004. Para tanto, examina o processo de atendimento à saúde do preso doente que necessita internação hospitalar, destacando o modo como ele chega ao hospital, como é atendido e recebe alta. Focaliza o caso do Hospital Vila Nova, embora também examine o modo como esse atendimento era feito anteriormente, quando ainda funcionava o Hospital Penitenciário do estado. Os dados coletados e analisados referem-se, principalmente, às dinâmicas sociais estabelecidas através das práticas de atendimento médico hospitalar, das práticas de vigilância e das estratégias dos presos doentes na busca de ampliar sua capacidade de negociação e aumentar seu grau de liberdade. Desse modo, verificou-se como a disciplina funcionou como técnica de controle sobre o preso, revelando a supremacia do poder médico no processo de atendimento ao preso doente hospitalizado na micro-unidade penitenciária em foco. O estudo também permite uma apreciação crítica das condições de saúde, a qual a população encarcerada está submetida. / This paper analyzes the social and power relations in a micro-unit of prisoners of a general hospital in Rio Grande do Sul State during the period from July to October 2004.Thus, it examines the hospital attendance process of sick prisoners who need hospitalization, focusing on how they arrive at the hospital, how they are cared and discharged. It focuses on Vila Nova hospital, although it also examines the way how these patients attendance used to happen previously, when the State Prison Hospital was open. The collected and analyzed data is mainly concerned with the social dynamics established through medical hospitalar care practices, surveillance practices and strategies of the sick prisoners who aim at expanding their capacity of negotiation and having a higher degree of freedom.Thus, the discipline worked as a control technique on prisoners, demonstrating the supremacy of the medical power in the attendance process of the prisoners hospitalized in the micro-unit in focus.This study also allows a critical appreciation of the health conditions faced by prison population.

O estudo analisa relações sociais e de poder em uma micro-unidade penitenciária de hospital geral, no Rio Grande do Sul, no período compreendido entre julho a outubro de 2004. Para tanto, examina o processo de atendimento à saúde do preso doente que necessita internação hospitalar, destacando o modo como ele chega ao hospital, como é atendido e recebe alta. Focaliza o caso do Hospital Vila Nova, embora também examine o modo como esse atendimento era feito anteriormente, quando ainda funcionava o Hospital Penitenciário do estado. Os dados coletados e analisados referem-se, principalmente, às dinâmicas sociais estabelecidas através das práticas de atendimento médico hospitalar, das práticas de vigilância e das estratégias dos presos doentes na busca de ampliar sua capacidade de negociação e aumentar seu grau de liberdade. Desse modo, verificou-se como a disciplina funcionou como técnica de controle sobre o preso, revelando a supremacia do poder médico no processo de atendimento ao preso doente hospitalizado na micro-unidade penitenciária em foco. O estudo também permite uma apreciação crítica das condições de saúde, a qual a população encarcerada está submetida. / This paper analyzes the social and power relations in a micro-unit of prisoners of a general hospital in Rio Grande do Sul State during the period from July to October 2004.Thus, it examines the hospital attendance process of sick prisoners who need hospitalization, focusing on how they arrive at the hospital, how they are cared and discharged. It focuses on Vila Nova hospital, although it also examines the way how these patients attendance used to happen previously, when the State Prison Hospital was open. The collected and analyzed data is mainly concerned with the social dynamics established through medical hospitalar care practices, surveillance practices and strategies of the sick prisoners who aim at expanding their capacity of negotiation and having a higher degree of freedom.Thus, the discipline worked as a control technique on prisoners, demonstrating the supremacy of the medical power in the attendance process of the prisoners hospitalized in the micro-unit in focus.This study also allows a critical appreciation of the health conditions faced by prison population.

O estudo analisa relações sociais e de poder em uma micro-unidade penitenciária de hospital geral, no Rio Grande do Sul, no período compreendido entre julho a outubro de 2004. Para tanto, examina o processo de atendimento à saúde do preso doente que necessita internação hospitalar, destacando o modo como ele chega ao hospital, como é atendido e recebe alta. Focaliza o caso do Hospital Vila Nova, embora também examine o modo como esse atendimento era feito anteriormente, quando ainda funcionava o Hospital Penitenciário do estado. Os dados coletados e analisados referem-se, principalmente, às dinâmicas sociais estabelecidas através das práticas de atendimento médico hospitalar, das práticas de vigilância e das estratégias dos presos doentes na busca de ampliar sua capacidade de negociação e aumentar seu grau de liberdade. Desse modo, verificou-se como a disciplina funcionou como técnica de controle sobre o preso, revelando a supremacia do poder médico no processo de atendimento ao preso doente hospitalizado na micro-unidade penitenciária em foco. O estudo também permite uma apreciação crítica das condições de saúde, a qual a população encarcerada está submetida. / This paper analyzes the social and power relations in a micro-unit of prisoners of a general hospital in Rio Grande do Sul State during the period from July to October 2004.Thus, it examines the hospital attendance process of sick prisoners who need hospitalization, focusing on how they arrive at the hospital, how they are cared and discharged. It focuses on Vila Nova hospital, although it also examines the way how these patients attendance used to happen previously, when the State Prison Hospital was open. The collected and analyzed data is mainly concerned with the social dynamics established through medical hospitalar care practices, surveillance practices and strategies of the sick prisoners who aim at expanding their capacity of negotiation and having a higher degree of freedom.Thus, the discipline worked as a control technique on prisoners, demonstrating the supremacy of the medical power in the attendance process of the prisoners hospitalized in the micro-unit in focus.This study also allows a critical appreciation of the health conditions faced by prison population.

No description available.

In recent years there has been a strong movement to replace outdated and inadequate jails throughout the United States. According to the National Sheriff's Association 15.9% of all jails have been under a court order to improve services or conditions at one time or another. In addition, 960 jails of the 3,493 existing jails in the United States were built prior to 1950. This need for new construction or renovation has given birth to a new area of expertise among architects and contractors--jail design and construction. While design and construction techniques have improved, little is known of the effects of physical environment on the social climate of a jail. This research seized upon a natural experiment in which an old, antiquated jail (Rocky Butte Jail) was replaced by a new, ultra-modern 470 bed high-rise jail (Multnomah County Detention Center). The question of what kind of physical environment change affects the social climate of a jail has broad implications with regard to design and construction of jails and other secure facilities. If the answer to this question can be determined, then it may be possible to provide improved service delivery in local jails, increase staff satisfaction with the work environment of jails, and improve mental and emotional health of jail staff and inmates; all of which can be translated into savings to the taxpayer. This study is a pre- and post-event research investigation that used the Rocky Butte Jail and the Multnomah County Detention Center as the setting for this inquiry. The Sonoma County (California) and Salt Lake County (Utah) jails served as control jails. The Correctional Institution Environmental Scale was administered to 877 inmates and staff in the four jails in 1983 and 1984. While the evidence is somewhat inconclusive, the Analysis of Covariance suggests that the inmates and staff as a group believe that there is a positive social climate in the Multnomah County Detention Center. This is expressed in terms of perceived support from fellow inmates and fellow officers and that the jail is orderly and well managed. In addition, inmates and staff as separate groups and in toto have a clear perception of what is expected of them. More important, perhaps, is the indication that well written and clear Policies and Procedures contribute greatly to the orderly management of an institution of this size. Finally, the data leads one to the conclusion that it may never be possible to gain a complete grasp of social climate in an institution of this nature. In general, this research provides a contribution to the literature and to future discussions of jail construction and design.

Thesis (MTech (Surface Design))--Cape Peninsula University of Technology, 2007 / This thesis focuses on an educational Surface Design Intervention (SDI) for inmates. It covers the present day situation, from 2006 to 2007, in a Western Cape correctional facility, regarding the needs of a selected group of inmates. This group of 20 inmates consists of 10 HIV/Aids positive and 10 HIV/Aids negative participants. The thesis argues that there is potential to plan, design and implement an educational SDI, in a group-work situation, with these participants in order to establish the SDI as a skills-development programme and a therapeutic-intervention and income-generating resource. In addition, this research study aims to understand and interpret how the various inmate participants, in a social setting, construct the world around them and what effect and impact the SDI has on them. This intervention is facilitated by two qualified art therapists and involves the use of different art materials through which the prison inmates express and explore their thoughts, feelings and concerns in a safe, contained and supportive space. The health and wellness literature provided the conceptual scaffolding against which to frame the SDI. The literature indicated that a holistic approach to rehabilitation and instruction is vital to help inmates function optimally in daily life. Ultimately, the SDI process indicates the value of identity formation, emotional expression and ethical development. The thesis concludes that oppositional discourses present in the lives of these prisoners can, and indeed should be reconciled in order for them to achieve a positive affirmation of their status. These polarities, once bridged, offer a moderating influence on these prisoners' lives, which contribute to their wellbeing and success both inside and potentially outside of prison.

Thesis (MPhil)--Stellenbosch University, 2014. / ENGLISH ABSTRACT: The South African prevalence is estimated at just over 17.1%, but efforts to reduce the number of HIV and AIDS deaths have dramatically changed. What is disturbing is that HIV prevalence rate in South African correctional facilities is higher than in general population. At 44%, HIV prevalence rate in South African correctional facilities are more than double of the just over 17.1% HIV prevalence rate in general population at the end of 2012 (UNAIDS, 2013). South African department of correctional services should regard these as a serious challenge given the increased number of sexual assaults and rape in correctional facilities as the Minister of correctional services Sbu Ndebele recently stated in Prison Brief. These could be worsening if the DCS does not come up with proactive strategies to reduce this prevalence in our Correctional facilities. These come back to the very same correctional officers who are not even aware of this state of HIV prevalence in their correctional facilities. This is because the findings of this study illustrate that majority of the correctional officers stationed in Johannesburg management area have limited knowledge about HIV and AIDS general information and they do not trust their management and their employee assistant staff when it comes to HIV and AIDS and this deny them necessary support and care from their employer. As the global HIV and AIDS epidemic enters its fourth decade, we are confronted by new challenges. In recent years, research related to HIV and AIDS has abounded as scholars continue to seek insight into the reciprocal influence of the pandemic on the one hand and various social systems on the other (Ebersohn, 2008). The purpose of this study was to explore the knowledge, attitudes and sexual practices of correctional officers relating to HIV in Johannesburg management area, Gauteng Region: South Africa. In this study the emerging findings are that Johannesburg management area are implementing their workplace HIV and AIDS programmes without a KAP study conducted to establish the baseline information about their employees, let alone conducting the KAP study on the regular basis to establish the effect of their workplace HIV and AIDS programmes. This was evident when majority of the respondents in this study had a limited knowledge about HIV in general and HIV prevalence in their country and their correctional facilities. Furthermore, there were also a poor monitoring and evaluation of such programmes. Another disturbing finding was that correctional officers in this management area did not have trust on their employee assistant staff and this was evident when 56% of the respondents responded that they would not use their internal EAP in HIV/AIDS related matters. This was the same when it comes to correctional officers attitudes towards management of this management area. This is evident when 71% of the respondents responded that if tested positive for HIV, they would not inform their immediate supervisors, managers, EAP and let alone their chaplain. This implies that there is a lack of trust between the management and their employees and between the employees and the employee assistant programme staff. However, correctional officers attitudes towards offenders living with HIV and AIDS is very good and encouraging and if correctional officers of this management area are given enough HIV information, they may pass it easily to all offenders as they interact with them on a daily basis. Given correctional officers‟ response on HIV testing and the use of EAP it is recommended that external service providers unknown to correctional officers should be used instead if management is unable to conduct a successful capacity building within the management area. Majority of the correctional officers according to this study had a limited knowledge about HIV treatment, cure and vaccine as they are unable to differentiate between the three and this is should be a serious concern for the department of correctional services. Although correctional officers sexual practices in this study findings indicated that correctional officers are well equipped when it comes to safe sexual practices, workplace HIV and AIDS programmes should include cultural beliefs, religion, tradition and myths to fight the spread of this epidemic. / AFRIKAANSE OPSOMMING: Die doel van hierdie studie was om die kennisvlakke asook die houdings en seksuele praktyke van korrektiewe offisiere binne die Departement van Korrektiewe Dienste in die Gauteng Streek in Suid-Afrika te ondersoek. Indien die korrektiewe offisier nie die nodige kennis en vaardighede besit om die verspreiding van die MIV-virus te beperk nie, kan hulle nie 'n doeltreffende rol speel in die Suid-Afrikaanse tronke nie. 'n Vraelys is vir die inwin van data gebruik en 'n steekproef van korrektiewe offisiere is vir die studie gebruik. Die data is op 'n beskrywende vlak ontleed en gevolgtrekkings is gemaak. Die studie bevind dat 'n minderheid van korrektiewe offisiere oor 'n voldoende kennisvlak van MIV beskik. Daar is verder bevind dat daar nie voldoende opleidingsfasiliteite vir hierdie korrektiewe amptenare bestaan nie en dat die programme wat wel aangebied word, nie behoorlik gemonitor en ge-evalueer word nie. Daar is egter bevind dat korrektiewe amptenare wel 'n positiewe houding het teenoor oortreders wat wel MIV-positief is en dat hulle wel die beperkte kennis waaroor hulle beskik na die beste van hulle vermoë oordra aan die oortreders gesurende hulle daaglikse interaksie. Voorstelle word in die studie gemaak vir die ontwikkeling en aanbieding van doeltreffende opleidingsprogramme vir korrektiewe offisiere. Daar word ook voorgestel dat korrektiewe offisiere op 'n veel groter skaal bewus gemaak word van die komplekse interaksie tussen tradisie, vooroordele en mites wat rondom suksesvolle MIV/Vigs-bekamping bestaan.

Risk taking behaviours such as drug use, sexual activities and tattooing are prevalent in the correctional institutions, including those in South Africa. Such behaviours pose a serious challenge as regards health care of inmates. In particular, these behaviours contribute to the transmission of HIV/AIDS which results in morbidity and mortality. Harm reduction components are employed as effective measure to curb the spread of the pandemic. These components are lauded owing to their considerable impact. They consist of needle exchange programmes, substitution therapy, condom provision and education. Various developing (Morocco, Brazil and Egypt) and developed (Scotland and Canada) countries make use of such components to address risk taking behaviours in correctional institutions. Although condom provision and education have been implemented by the South African Department of Correctional Services in state institutions, there is an urgent need to enhance the efforts. This study investigates the extent of risk taking behaviours amongst inmates at the Leeuwkop Correctional Centre. It also determines the level of knowledge of inmates and staff regarding HIV/AIDS. The researcher employed a qualitative form of methodology, collecting data by means of a structured questionnaire. The data was coded and analysed by means of the Statistical Package for the Social Sciences (SPSS) software. The findings reveal that the risk taking behaviours are prevalent at the Leeuwkop Correctional Centre. Furthermore, the analysis of the knowledge items regarding HIV/AIDS indicates that there are certain deficits that require attention. They are also notable differences in the primary sources of HIV information for inmates and staff. It was found that a dire need exists to enhance and expand current harm reduction initiatives in correctional institutions in order to offer health care services that are compliant with international conventions such as the Dublin Declaration on HIV/AIDS as well as the South African Constitution. Reluctance to do so is tantamount to housing inmates in „de facto‟ death chambers. Hence the augmentation of such initiatives is strongly recommended. / Penology / D. Litt. et Phil. (Penology)

Risk taking behaviours such as drug use, sexual activities and tattooing are prevalent in the correctional institutions, including those in South Africa. Such behaviours pose a serious challenge as regards health care of inmates. In particular, these behaviours contribute to the transmission of HIV/AIDS which results in morbidity and mortality. Harm reduction components are employed as effective measure to curb the spread of the pandemic. These components are lauded owing to their considerable impact. They consist of needle exchange programmes, substitution therapy, condom provision and education. Various developing (Morocco, Brazil and Egypt) and developed (Scotland and Canada) countries make use of such components to address risk taking behaviours in correctional institutions. Although condom provision and education have been implemented by the South African Department of Correctional Services in state institutions, there is an urgent need to enhance the efforts. This study investigates the extent of risk taking behaviours amongst inmates at the Leeuwkop Correctional Centre. It also determines the level of knowledge of inmates and staff regarding HIV/AIDS. The researcher employed a qualitative form of methodology, collecting data by means of a structured questionnaire. The data was coded and analysed by means of the Statistical Package for the Social Sciences (SPSS) software. The findings reveal that the risk taking behaviours are prevalent at the Leeuwkop Correctional Centre. Furthermore, the analysis of the knowledge items regarding HIV/AIDS indicates that there are certain deficits that require attention. They are also notable differences in the primary sources of HIV information for inmates and staff. It was found that a dire need exists to enhance and expand current harm reduction initiatives in correctional institutions in order to offer health care services that are compliant with international conventions such as the Dublin Declaration on HIV/AIDS as well as the South African Constitution. Reluctance to do so is tantamount to housing inmates in „de facto‟ death chambers. Hence the augmentation of such initiatives is strongly recommended. / Penology / D. Litt. et Phil. (Penology)