How do people in prison feel about opt-out hepatitis C virus testing?

Area of Science:

• Public Health
• Infectious Diseases
• Criminology

Background:

• The prison population is critical for hepatitis C virus (HCV) elimination efforts.
• UK implemented an 'opt-out' testing policy for prisoners, aiming for 75% uptake.
• Observed uptake rates in the East Midlands were only 13.4%, significantly below the target.

Purpose of the Study:

• To qualitatively explore barriers and facilitators influencing HCV test uptake among incarcerated individuals.
• To understand the reasons behind the low test uptake rates in a UK category C prison.

Main Methods:

• Conducted semi-structured interviews with 45 people in prison.
• Employed thematic network analysis for data interpretation.
• Focused on experiences with hepatitis C virus testing.

Main Results:

• Identified key barriers: Fear, Insufficient Knowledge, Stigma, Privacy concerns, lack of Choice, and challenges of Prison Life.
• Identified Test Uptake Facilitators and perceived benefits of prison healthcare.
• Qualitative data revealed significant obstacles to achieving national HCV testing targets.

Conclusions:

• Significant changes in testing timing, location, and staff deployment are necessary.
• Providing comprehensive information on HCV transmission and treatment can mitigate fears and improve uptake.
• Flexible and informed approaches are crucial for meeting and sustaining HCV test uptake targets in prisons.