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Hep C in Prisons, CALD & Indigenous Communities
Prisons and hepatitis C
  • HCV prevalence among entrants to or inmates of prisons was assessed nationally in 2004 with a number of other assessments in particular states and territories, largely New South Wales and Victoria prior to this. The national study of prison entrants, and studies in New South Wales and Victoria indicate HCV prevalence rates of the order of 40-60% of all prisoners over the period 1991-2004.
  • National rates of HCV prevalence in prison entrants have been estimated to be 34%, slightly lower than the estimates seen in New South Wales and Victoria, and hence are probably in the range of 30% to 40% of all male prisoners.
  • In NSW in 2001, 20% of all hepatitis C notifications were from inmates in NSW prisons.
  • The total prison population in Australia in the June quarter of 2005 was 25,353 persons in full time custody.
  • Studies at the national level and in New South Wales and Victoria indicate that HCV prevalence rates were 50% to 100% higher in women than men. This may reflect that a greater proportion of women than men in prison are imprisoned for drug related offences.
  • The revolving door syndrome that many people who inject drugs experience means that prisons remain incubators for hepatitis C and are a source of transmission into the community. Prisons remain an independent risk factor for hepatitis C transmission.
  • No government in Australia is at present willing to trial prison based syringe exchange programs.
  • The laws of the Australian Government recognise that a person's capacity to access health services is not compromised by reason of imprisonment and that all people have a basic right to health. This recognition is acknowledged in Australia's international treaty obligations.
  • A range of services need to be made available in prisons to curb the transmission of hepatitis C and include, options to access hepatitis C treatment, appropriate drug treatment options, peer based services and harm reduction programs.
  • Alternatives to custodial sentences need to be explored.

Statistical information taken from Hepatitis C Virus Projections Working Group: Estimates and Projections of the Hepatitis C Virus Epidemic in Australia 2006, Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis C Sub-Committee.

Culturally and Linguistically Diverse Communities (CALD)
  • The 2001 census showed that 22% of people living in Australia were born overseas.
  • 15% of people living in Australia speak a language other than English at home.
  • The numbers of people from CALD varies across the country.
  • It has been stated that about 15% of people living with hepatitis C are from CALD backgrounds.
  • People from CALD backgrounds experience multi-layered discrimination and stigma and often face heightened social and economic deprivation
  • Access to information on hepatitis C and injecting drug use is less available in languages other than English.

The Multicultural HIV/AIDS and Hepatitis C Service (MHAHS) has a website that provides HIV/AIDS and hepatitis C information in the following languages: Amharic, Arabic, Bosnian, Burmese, Chinese, Croatian, English, Indonesian, Italian, Khmer, Portuguese, Serbian, Somali, Spanish, Tagalog, Thai, Turkish, and Vietnamese. http://www.multiculturalhivhepc.net

Indigenous Communities
  • Discrimination, stigma and disadvantage experienced by Aboriginal and Torres Strait Islander people affect their access to and the provision of primary health care services. These experiences also complicate efforts to deal with hepatitis C in Indigenous communities.
  • Where primary health care services are administered by community members, identification as a person with hepatitis C (and the subsequent association with injecting drug use) can inhibit access to or the provision of health care and social support services offered by that community.
  • Community and cultural interpretations of shame can result in Aboriginal and Torres Strait Islander communities denying the existence of risk practices associated with hepatitis C transmission. These practices can range from injecting drug use to other practices that involve blood-to-blood contact, or they can be the result of a confluence of factors, such as cultures of sharing and their effect on injecting drug use.
  • Reducing the discrimination, stigma and isolation experienced by Aboriginal and Torres Strait Islander people affected by hepatitis C requires initiatives that take into account these cultural determinants. This can occur only if Aboriginal and Torres Strait Islander people are afforded the same opportunities to participate in the development of these initiatives and the same levels of access to primary health care services as are proposed for the broader community.