Heath in Prisons in Fiji Research Report

8/13/2019 Heath in Prisons in Fiji Research Report

1/43

2013

A B .


2/43


3/43

..................................................................................................................... 3

1. ......................................................................................................................... 7

2. A .................................................................................................................................... 8

3. .............................................................................................................................. 8

3.1 S D ............................................................................................................................ 8

3.2 P, .................................................................... 9

3.3 M ............................................................................................................................... 10

3.4 Q ..................................................................................................... 13

3.5 S ................................................................................................................. 143.6 E ............................................................................................................ 14

4. ............................................................................................................................... 15

4.1 S C .......................................................................................................... 16

4.2 H .......................................................................................................................... 18

4.3 HIV/STI ................................................................................................................ 20

4.5 S : , ....................... 23

4.6 A, .................................................................................... 24

4.7 U ................................................................................... 25

4.8 P ................................................................................... 25

5. D .......................................................................................................................... 26

5.1 HIV , .................................................................. 26

5.2 H ................................................................................................ 27

5.3 L ............................................................................................................................. 28

6. C .................................................................................... 30

................................................................................................................................ 33


4/43

T F ( F) B

I ( M, A) E P F. F

R W (@..), S K

(.@..) K S (.@..).

W, R., S, K., K, S. H F. R B

I E P S P C, M, S

2013.

T F ( F)

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S P F C S ,

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F () S P C

(SPC) HIV STI R F J 2011 J 2013. W

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5/43

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O A G .

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6/43

A F , HIV 2001

1, 2. R

F

(STI) 36.

G, HIV 79,

(AOD)

10. A

1114 79,

1518, 19. T

,

15, 2022.

T B I, F NGO E P,

S P C (SPC) HIV STI R F

F.

A

T :

1. E HIV F;

2. F 4 , ;

3. A , ;4. S

, .

U , 200 F

4 . P HIV

() (DBS)

, ,

, . T ,

HIV , . D

( 3) .

T F N R E C ( 65/2010)

A A H H R E C ( 400/10).


7/43

P 4 34

O 198 , 80.3% :

75.8% 48.5%

. F (=87)

. M , T (I F) 36 .

K :

T HIV (1.0%) (1.0%) . T

.

K HIV STI :

. O

/ HIV, STI / . S

HIV .

O 12 . T

.

A ( )

.

A, () . H ,

.

M . T

.

A .C ,

,

.

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T , , F

,

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, .

W HIV

F, ,

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. W HIV


8/43

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.

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9/43

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10/43

P 7 34

A F , HIV 2001

1, 2. A

420 1989 D 2011,


11/43

P 8 34

T B I, F NGO E P ( P C

S S) S P C (SPC) HIV STI

R F 2010

F.

T :

1. E HIV F;

2. F 4 , ;

3. A , ;4. S

, .

D , A 3

. T

, .

3.1 U , 200 F

(


12/43

P 9 34

3.2 , P 24J 2012 30A

2013. W (N=200) F. D

, () .

P ( ) ,

. C ,

.

S, :

1. 18 ;2. 4 & ;3. , ;4. V L V L ; 5. .

A F (V L V L)

. A V L. T ,

, T 1 .

Table 1: Recruitment prisons in Fiji*

A

S C C 279

R

C/ M

W B, S,

V L

N C

M C C

M C C

P C

112

170

45

C

C

C

M S, V L

N 140 C M N, V L

B 22R

C/M

N, B,

V L

L C C 134R

C/M

N, L,

V L

L 48R

C/M

L,

V L

W C C 28R

C/F

W B, S,

V L*P F C S ://..././

/13/ 27

A 2013.

P (.. ) F C

S . A

. I


13/43

P 10 34

,

.

D () ,

. I .

P (A ) FJD $5

.

3.3 W

, , , HIV/STI ,

. T . F

, , () . Q

( ), (

). W ,

. S 3.3.1 3.3.9

S 3.3.10

.

3.3.1 ,

W , , , , ,

, , (

) , , ( )

(/ , , , , , )

. P

,

, .

N .

3.3.2

P ( ) ( / ): , , ,

, , , , . M

( / ) : , , ,

, . C

(/, , , ) K 10 41, 42.

P

( , , ).


14/43

P 11 34

3.3.3

P HIV/STI ,

, . P / /

. W

/ , .

P HIV, STI,

HIV / .

3.3.4 ,

T HIV, STI BBV

. S

. W (

(, )).

W ( 12 , ) ; /

/ , . F

(, , , , )

. A,

. N

. L,

( , , ,

).

M

, , .

P ,

43

49. I

.

3.3.5

P HIV B ( ,

12 , 12 )

. I , , HIV STI .

I STI ,

,

. A STI, , ,

STI. T

STI,

(

, STI):


15/43

P 12 34

//, //, ,

.

3.3.6

W HIV ()

. B

( ) A

( A 1 ). T

(DBS)

, (.. ) 50,

S. U

. T DBS M H ( S)

A .

F HIV , HIV 51,

52,

. F , B

I ,

. F,

. T HIV . A 2

.

F HIV , HIV

(ELISA) W . W

W , 1 250

000 51.

F () ,

IM (ELISA). T IM

53. S

, .

3.3.7 ,

T 12

W H O 10 A U D I T (AUDIT) 54

56. T AUDIT , ,

/ . D

, AUDIT (

).


16/43

P 13 34

W , ( , 12 ), ,

() ( , 12 ,

) . T : , , ,

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, , (.. ),

, () (.. , , ),

. T

W H O A, S

S I S T (ASSIST) 57, 58. T ASSIST

(, , , ),

. A AUDIT, ASSIST

. F , .

P ( ) /

,

.

3.3.8

P

(, , ). W

( ) HIV, STI .

T (, , , ,

) ,

.

3.3.9

W ,

. P

,

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3.3.10

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AOD , . W

.

3.4

Q E B H

:


17/43

P 14 34

1. B E P E B H.

2. A E.

3. T (E ) . W ( )

2 E I 4

.

I B, E H / F

.

3.5

P HIV ,

. C, F E .

3.

T F N R E C (

65/2010) A A H H R E C ( 400/10).

O ,

,

. P

,

, .

D ( ) HIV

. HIV

. D HIV/STI

,

, .

I HIV STI

,

.


18/43

P 15 34

T

(

) (). S 5

, .

T (N=204)

J 2012 A 2013. O ,

. D 198

.

T 2 .

Table 2: Number and proportion recruited from each participating prison

(%)

S M 48 (24.2)

N C 23 (11.6)

B 20 (10.1)

N 24 (12.1)

L/N 27 (13.6)

L 45 (22.7)

S W 11 (5.6)

A 198 (100.0)

O 198 , 80.3% : 75.8%

48.5%

. F (=87) (F 2).

Figure 2: Recruitment and follow-up flowchart

T

, 11

, ( ,


19/43

P 16 34

) (T

3).

P T (59.2%) E

(19.9%) (19.4%). P 7

(: 095 ), 45 (: 15115 ).

4.1

T 3 (

). M , T 36 . D

1. T 4

. S S 5.3 .

P , ,

. T

, , HIV

, ,

.

Table 3: Sample characteristics at baseline, by follow-up status

(=198)

(%)

(=159)

(%)

(=39)

(%)

***

187 (94.4) 159 (100.0) 28 (71.8)

A

< 25

2630

3135

36+

56 (28.3)

39 (19.7)

49 (24.8)

54 (27.3)

45 (28.3)

27 (17.0)

40 (25.2)

47 (29.6)

11 (28.2)

12 (30.8)

9 (23.1)

7 (17.9)

1 173 (87.4) 137 (86.2) 36 (92.3)

C

O

180 (90.9)

17 (9.1)

142 (89.3)

17 (10.7)

38 (97.4)

1 (2.6)

S

I

94 (47.7)

103 (52.3)

72 (45.3)

87 (54.7)

22 (57.9)

16 (42.1)

98 (50.5) 77 (49.4) 21 (55.3)

2 106 (53.5) 81 (50.9) 25 (64.1)

1B : . F, .


20/43


21/43

P 18 34

(=198)

(%)

(=159)

(%)

(=39)

(%)

(AD)4

L/

M

H

V

58 (29.4)

51 (25.9)

33 (16.8)

55 (27.9)

47 (29.7)

45 (28.5)

26 (16.5)

40 (25.3)

11 (28.2)

6 (15.4)

7 (17.9)

15 (38.5)

B 5 47 (23.9) 34 (21.5) 13 (33.3)

D 6*

104 (58.4) 89 (62.2) 15 (42.9)

6 67 (38.1) 51 (36.7) 16 (43.2)

() 6 69 (38.1) 60 (40.5) 9 (27.3)

***

58 (29.3) 38 (23.9) 20 (51.3)

A 7***

121 (61.1) 88 (55.4) 33 (84.6)

*


22/43

P 19 34

27 (13.7)

11 (5.6)

8 (4.1)

3 (1.5)

/ 29 (14.6)

42 (21.3)

7 (3.1)

7 (3.1)

4.2.2

A (T 6),

K 10. T /

(27.3% 16.0%),

( 16.0% 6.3%). S, (21.7%)

, ,

11.3% (=4.90; =0.03).

H ,

( T 4).

W (=87)

,

(F 2). T /

, 44.8% 33.3%

( ), 6.9% ( = 12.74,


23/43

P 20 34

B

(=198)

(%)

1

(=150)

(%)

4

(=96)

(%)

/

N

G

G

15 (10.0)

127 (84.7)

8 (5.3)

10 (10.4)

79 (82.3)

7 (7.3)

2 13 (6.6)

C 5 (2.5) 1D

2D . C , , , ,

PTSD

Figure 3: Changes in psychological distress after release from prison among participants completing

all three interviews (n=87)

4.3 /

P HIV STI / /

. O, (63.5%) . T

T 7 .K HIV (..

, /), (..,

HIV ).

J (53.0%) / HIV

STI (49.5%) (52.5%).

T HIV STI F

M H ,

F R C S E P.

0

20

40

60

80

100

P 1

4

% /

/


24/43

P 21 34

Table 7: Proportion of participants correctly answering questions about HIV and STIs at baseline

C

(%)

? Y 174 (87.9)

( )? Y 158 (79.8)

? Y 155 (78.3)

? Y 154 (77.8)

? N 144 (72.7)

? Y 134 (67.7)

? N 126 (63.6)

HIV ? N 123 (62.1)

? N 99 (50.0)

? N 84 (42.4)

I STI T 183 (92.4)

O STI F 130 (65.7)

S STI ( ) T 112 (56.6)

P STI () T 96 (48.7)A , STI F 95 (48.0)

I STI F 87 (43.9)

M STI T 82 (41.4)

4.4

4.4.1

P (: 0100). O (56%)

12

. T

,

. A , 37%

12 . T

7% 9% .

O , (>75% )

. A 59

,


25/43

P 22 34

(=29), (=13), (=11)

(=10) (: ).

S STI .

O 184 , 94 (51%) ,

. F 21% (=38) , ( ) ,

STI . T 8

.

Table 8: Sexual and sexual risk behaviour prior to and after release from prison

B

(=198)

(%)

1

(=150)

(%)

4

(=96)

(%)

A

< 14

1517

18+

44 (25.9)

52 (30.6)

74 (43.5)

0

13

49

10+

4 (2.0)

50 (25.3)

54 (27.3)

90 (45.4)

C /1

N

A /

141 (78.8)

38 (21.2)

109 (73.2)

40 (26.9)

77 (81.9)

17 (18.1)

1

N

12

3+

96 (53.3)

40 (22.2)

44 (24.4)

133 (89.3)

13 (8.7)

3 (2.0)

83 (86.5)

8 (8.3)

5 (5.2)

C /1

N

A /

67 (37.2)

113 (62.8)

11 (7.4)

137 (92.6)

9 (9.4)

87 (90.6)

1

N

12

3+

141 (78.3)

29 (16.1)

10 (5.6)

132 (89.2)

15 (10.1)

1 (0.7)

84 (87.5)

12 (12.5)

0 (0.0)

C /1

N

A /

37 (20.6)

143 (79.4)

15 (10.1)

133 (89.9)

8 (8.4)

87 (91.6)

2 6 (3.5)

1I 12 (), (1 ) (4 )

2I

4.4.2


26/43

P 23 34

O

(T 9). S,

( ) (24.3%

). I

( ). P

(=0.02), (


27/43


28/43


29/43

P 26 34

U . O

,

. T

.

A . F (5.1%) 18 (18.4%) .

M . F

, ,

.

A , 33.3%

. T :

/ / (=11), /

(=6), (=2) (=2). A

, :

/ (=5) (=2).

5.1 , T 193 HIV

. W (1.0%),

F (0.1%) 59. H, HIV

HIV ,

. T F

, HIV 2, 33, 34.

W

IM . T IM

, (1.6%) 2.7%

2008 2 5%

6. T

, .

W HIV STI

( ),

( , HIV ).

K

. A

, 37% . A

. S HIV

F, . T

.


30/43

P 27 34

S ,

. T HIV F

/ HIV (53.0%) STI (49.5%). T

HIV STI .

A ,

HIV STI . O 8% HIV

. T HIV

,

60. T HIV STI

STI ,

. A,

F HIV;

( F ). T

,

. T

F 33. T STI

, HIV STI

. A

HIV STI

F.

5.2 D ,

, , ,

. A . T

,

6163. C ,

,

. P

,

. T

, .

L

( )

, . A

/

. I ,

, .

A 1 /

( 27.3% 16.0%), ,

(L ). I,


31/43

P 28 34

64 14, 65 ,

66, 67.

T , ,

65, 6871. A . I

, 72, 73. I

( )

/

. M F,

,

F.

5.3 A , , /

P,

. T .

W F,

,

. C , ,

15

. D ,

. F ,

( EMP (

)) . W

. C,

.

T 198 F ,

.

F, HIV

, . H,

(>10%) .

A

I (

). O, 1015%

. I , . I


32/43

P 29 34

, ,

; ,

6 ()

. A V L V L

. T

. I

. D F ,

,

. I ,

F . I

. I

.

T (50% ) .

T

( , ).

C,

. W

, (T 3 4). F ,

, , ,

.

O 50.9% , 87.5%

( )

(54.7% 42.1% ). T

74.

T 4

HIV . P

( STI).

N, ,

F , ,

.

A HIV ,

, . S

( ),

(

, ). W

,


33/43

P 30 34

,

.

W

,

. N, , .

T DBS

. A ,

. F,

. W

. T HIV ,

.

T , , F

,

/ . T

, .

W HIV

F, ,

, ,

. W HIV

STI (.. ) F,

,

. F ,

.

1. / .

.

.

2.


34/43


35/43

P 32 34

.

,

.

/

, ,

. ,

.


36/43


37/43

P 34 34

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A, 2001; 79: 871891.

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