The Right to Hepatitis C Prevention, Diagnosis, and Care in Canada's Correctional Settings.

Why Focus on Correctional Settings?

People who are incarcerated (PWAI) are identified as a priority population for HCV care, as they are 40 times more likely to be exposed to HCV than Canada's general population.

In addition, people who are released from incarceration often face barriers to accessing health care in the community. While no one should ever have to be in the correctional system to access their right to health care, for many their incarceration may present an opportunity to access services including prevention, screening, early intervention, and treatment programs. This will improve individual and public health outcomes.

The delivery of HCV care to people in correctional settings in Canada is essential to HCV elimination.
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Report Contents

Download the full report.
  • Introduction
  • The Right to Care
  • The Intersection of Priority Populations
  • Current State
  • Recommendations: Overarching Guidelines
  • Recommendations: Federal
  • Recommendations: Provincial/Territorial
  • Bright Spots
  • References

Current State

​Federal 
Correctional Service of Canada (CSC) could be well-positioned to achieve HCV elimination in people incarcerated within federal Canadian correctional institutions by 2030, with best practices such as universal HCV screening, universal access to treatment, and some harm reduction services available. 
Provincial/Territorial
​The same standard of health care is not available to people in correctional centres as in the community in any province, and significant disparities in HCV care exist across provincial correctional centres. HCV elimination is unlikely to occur in the Canadian provincial/territorial prison system by 2030. 

Recommendations


Overarching Guidelines
​Health care in correctional settings should be:
  • an equivalent standard of care to what is available in the community, including harm reduction services
  • person-centred
  • trauma-informed
  • culturally safe
  • informed by people with lived experience
  • run by peers (where available and applicable)

Federal
  1. Implement Prison Needle Syringe Programs (PNSP) across all correctional centres using a model with multiple distribution channels for accessibility and anonymity. 
  2. Implement Overdose Prevention Sites (OPS) across all correctional centres. 
  3. Improve accessibility and acceptability of Opioid Agonist Therapy (OAT) across all correctional centres. 
  4. Review policies and implement training and education to promote health promotion and harm reduction, including HCV and other STBBIs, for both PWAI and staff. 
  5. Improve discharge planning to include linkage with community resources including health care.
  6. Develop pan-Canadian guidelines for STBBI testing that could be applied in correctional settings.

​Provincial/Territorial
  1. Transfer healthcare responsibility to Ministry of Health (where not yet done).
  2. ​Improve accessibility and acceptability of Opioid Agonist Therapy (OAT) across all correctional centres.
  3. Implement Prison Needle Syringe Programs (PNSP) across all correctional centres using a model with multiple distribution channels for accessibility and anonymity. This could be complemented by a suite of harm reduction services that mirror what is available in the community, including OPS.
  4. Offer universal STBBI testing to everyone admitted in all correctional centres, with informed consent, within 72 hours of admission.
  5. Offer treatment to everyone diagnosed with chronic HCV and a reflex referral to community-based supports, with consent, for continuity of care regardless of length of stay.
  6. Improve discharge planning to include linkage with community resources including healthcare.

* A bright spot shared in the report: BC's new guidelines and policy recommendations that were co-created with people with lived/living experience of incarceration on how to provide STBBI testing and linkage to care in correctional settings.
Now available here.

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