Title : Institutional gaps and healthcare inequalities: Blood-borne virus healthcare from prison to the community
Abstract:
People in prison and prison leavers experience disproportionately poorer health outcomes compared to the general population, including a relatively higher prevalence of blood-borne viruses. This is often reported as due to a higher likelihood of risk factors such as sexual practice, sexual assault, and intravenous drug use. Existing research points to compounding stigma associated with prison leaver and blood borne virus diagnosis status contributing to barriers to health maintenance after release. Yet, limited research explores the role of the state and prison system contributing to the health outcomes of this specific population and how this, often intertwined with stigma, contributes to health inequality in Scotland. Isolated approaches to both healthcare and re-entry ignore the reality of how these facets interact with each other, and the overall impact on life after release. Building off of a pilot study, this presentation addresses systemic concerns across the National Health Service (NHS) and Scottish Prison Service (SPS) on initiating, maintaining, and bridging blood borne virus healthcare through custodial sentences and release. As part of the CSO Health-Justice Nexus project, this PhD research addresses shortcomings of Scottish health-justice policy, the impact on health inequality, and target areas for improving blood borne virus healthcare for those particularly vulnerable. Critiquing the lauded ‘Equivalence of Care’ model adopted by the NHS within UK prisons, this presentation argues that efforts to improve blood borne virus healthcare within prisons to match the efforts and quality of care found in the community is not sufficient in addressing these health outcomes. Instead, an ‘Equity of Care’ model is more appropriate, to address the additional needs required by this population to maintain blood borne virus healthcare amongst competing priorities and challenges after release.
