Injecting Risk Into Prison Sentences

• Published date: 01 September 2011
• DOI: 10.1177/0032885511409893
• Date: 01 September 2011
• Author: Kevin Denys Bonnycastle,Charles Villebrun

The Prison Journal

91(3) 325 –346

© 2011 SAGE Publications

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DOI: 10.1177/0032885511409893

http://tpj.sagepub.com

409893TPJ91310.1177/0032885511409893B

onnycastle and VillebrunThe Prison Journal

© 2011 SAGE Publications

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1Saint Mary’s University, Halifax, Nova Scotia, Canada

2Charles Villebrun is a federal Canadian prisoner serving a life sentence

The Prison Journal is saddened by

the recent death of Dr.

Bonnycastle and is honored to

publish her last research article.

Injecting Risk Into Prison

Sentences:

A Quantitative Analysis

of a Prisoner-Driven

Survey to Measure

HCV/HIV Seroprevalence,

Risk Practices, and Viral

Testing at One Canadian

Male Federal Prison

Kevin Denys Bonnycastle1

and Charles Villebrun2

Abstract

This article draws on penal epidemiological studies to analyze data from a

prisoner-driven survey measuring HCV/HIV seroprevalence and risk behaviors

in one Canadian male prison. Our data illuminate confounding points of

potential blood exchange among injectors and noninjectors, HCV/HIV car-

riers and noncarriers, tested and untested prisoners, and prison and free

326 The Prison Journal 91(3)

community members. The survey finds higher HCV/HIV incidence and testing

rates among injectors, and a penal population educated about high-risk prac-

tices. This study includes the first point-in-time estimate by penal injectors

on the number and condition of needles/syringes, identifying an overlooked

HCV conduit: the transfer of abandoned syringe components to new(er)

syringes.

Keywords

HCV/HIV seroprevalence, risk behaviors, prison needles/syringes

Few journal publications explore the health damage wrought by Western

systems of punishment generally and penal antidrug strategies specifically.

Although some medical journals—particularly, the British Medical Journal—

have published in the area of hepatitis C (HCV) and human immunodeficiency

virus (HIV) prevalence and transfer in prison populations, elsewhere, the penal

policies and practices that sustain viral transfer—are not a widespread object

of investigation, notwithstanding some exceptions (Chu & Elliott, 2009; Krebs,

2002). With reference to extant penal epidemiological studies, this article

analyzes findings from a quantitative prisoner-driven survey measuring HCV/

HIV seroprevalence and risk behaviors in one Canadian male prison operated

by the Correctional Service of Canada (CSC). The CSC has responsibility for

approximately 13,000 federally sentenced males and females serving 2 or more

years. The study also includes the first reported point-in-time estimate by penal

injectors on the number and condition of needles and syringes.

The survey was spearheaded by two prisoner peer education counselors

(hereafter, “PEC”)—holding the institutional job titles of Harm Reduction and

Assistant Harm Reduction Coordinators—acting with the consent and support

of the elected members of that prison’s inmate committee. The survey’s goals

were practical and twofold: first, that the questionnaire in and of itself would

encourage prisoners to become more self-reflective regarding their high-risk

and viral testing practices and, second, that the data, once tabulated and dis-

seminated, would motivate prisoners to seek regular viral (re)testing. In light

of these objectives, rather than constructing a multiple regression model to

isolate independent variables associated with HCV/HIV seropositivity, this

survey represents a snapshot over one time period of the prevalence of HCV/

HIV, viral testing, risk behaviors, and the multiple and intersecting avenues

for transmitting HCV/HIV within this prison and beyond.