Hepatitis C antibody reactivity among high-risk rural women: opportunities for services and treatment in the criminal justice system

• Date: 11 June 2018
• Pages: 89-100
• Published date: 11 June 2018
• DOI: https://doi.org/10.1108/IJPH-03-2017-0012
• Author: Justin C. Strickland,Michele Staton,Carl G. Leukefeld,Carrie B. Oser,J. Matthew Webster
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Hepatitis C antibody reactivity among

high-risk rural women: opportunities for

services and treatment in the criminal

justice system

Justin C. Strickland, Michele Staton, Carl G. Leukefeld, Carrie B. Oser and

J. Matthew Webster

Abstract

Purpose –The purpose of this paper is to examine the drug use and criminal justice factors related to

hepatitis C virus (HCV) antibody reactivity among rural women in the USA recruited from local jails.

Design/methodology/approach –Analyses included 277 women with a history of injection drug use from

three rural jails in Kentucky. Participants completed health and drug use questionnaires and received

antibody testing for HCV.

Findings –The majority of women tested reactive to the HCV antibody (69 percent). Reactivity was

associated with risk factors, such as unsterile needle use. Criminal justice variables, including an increased

likelihood of prison incarceration, an earlier age of first arrest, and a longer incarceration history, were

associated with HCV reactive tests. Participants also endorsed several barriers to seeking healthcare before

entering jail that were more prevalent in women testing HCV reactive regardless of HCV status awareness

before entering jail.

Originality/value –Injection and high-risk sharing practices as well as criminal justice factors were

significantly associated with HCV reactivity. Future research and practice could focus on opportunities for

linkages to HCV treatment during incarceration as well as during community re-entry to help overcome real or

perceived treatment barriers. The current study highlights the importance of the criminal justice system as a

non-traditional, real-world setting to examine drug use and related health consequences such as HCV by

describing the association of high-risk drug use and criminal justice consequences with HCV among rural

women recruited from local jails.

Keywords Offender health, Cocaine, Substance use, Barriers, Jail, Injection drug use

Paper type Research paper

Introduction

Drug use and misuse are associated with physical health impediments to living a longer, healthier

life, including cardiovascular toxicity, respiratory damage, and the acquisition and transmission of

sexually transmitted infections (e.g. Stein, 1999). These outcomes may result from the direct

effects of the substance used or the increased likelihood of risky sexual or drug use behaviors

(e.g. unprotected sexual intercourse; unsterile needle use) throughout the procurement of,

engagement in, and period following substance use. For example, injection drug use (IDU)

increases transmission risk for infections such as the hepatitis C virus (HCV) (Alter, 2007).

Incarcerated populations may represent a population at particular risk for infection transmission

given the high rates of IDU among individuals in jails and prisons in the USA and internationally

(e.g. Boutwell et al., 2007; Dolan et al., 2015; World Health Organization, 1994). Targeting health

consequences of drug use could further elucidate risk factors underlying susceptibility and help

to identify novel venues for interventions in the criminal justice system.

Received 1 March 2017

Revised 5 July 2017

Accepted 11 July 2017

The authors affiliations can be

found at the end of this article.

DOI 10.1108/IJPH-03-2017-0012 VOL. 14 NO. 2 2018, pp. 89-100, © Emerald Publishing Limited, ISSN 1744-9200

j

INTERNATIONALJOURNAL OF PRISONER HEALTH

j

PAG E 89