Hepatitis C testing and support in prison

Waverley Care is Scotland’s HIV and Hepatitis C charity. Its goal is to make a positive difference to the lives of people affected by HIV or Hepatitis C in Scotland. Its work focuses on prevention, education, testing and support and they strive to reduce new infections, scale-up diagnosis, provide support and challenge stigma throughout Scotland.

By Jennifer Goff, Waverley Care

The campaign

One in five people in Scottish prisons have hepatitis C. Sadly, many do not receive the support needed to finish a full course of treatment to clear their infection and many more remain unaware of their status.

HMP Low Moss is a low category prison near Glasgow. It is one of the prisons that we engage with as part of our Prison Link Service’s induction sessions. Our Prison Link Services work aims to increase awareness of blood borne viruses (BBVs), including viral hepatitis, in Scottish prisons. We work to increase prisoners’ knowledge to stop onward transmission, scale-up diagnosis and provide in-prison support to people who are diagnosed with BBVs.

Our outreach work at Low Moss was developed following interventions from a number of professionals working there, including prison staff, a Health Improvement Officer and the prison’s clinical staff. They felt there was a need to increase testing, treatment and awareness surrounding BBVs to scale-up new diagnosis and treatment uptake. Having been made aware of our work through our Prison Link Service sessions in HMP Barlinnie, North-East Glasgow, they got in contact with us.

Following a number of meetings between staff at HMP Low Moss and our outreach teams, it was agreed that our Prison Link Worker would provide sessions on BBVs, including viral hepatitis, during new prisoner inductions. It would then be the prisoner’s choice if they wanted to get tested or not. It was also agreed that all prisoners who decide to participate would then be referred on to the HMP Low Moss’ resident nurse for testing.

Since we started delivering this service at HMP Low Moss, 712 people have attended our induction sessions and 316 people who have attended these sessions have been referred on for testing.

Our in prison support has also enabled prisoners and ex-prisoners to get access to full courses of treatments. One example that we find particularly pertinent is James (not his real name). James was diagnosed with hepatitis C during a previous prison sentence. Despite wanting to receive treatment, he was refused because he was due to be liberated soon. This was a major blow. Following his re-admission to HMP Low Moss prison after re-offending, he got in contact with us through his induction session. He is now being supported by our Prison Link Worker and is due to commence treatment before he is liberated again.

Working with HMP has been fantastic. We have been able to work together to fill a gap in identifying people who are living with or are at-risk of viral hepatitis and other BBVs.

 

Top tips for success

The following aspects of this service have made our activity successful:

  • Prisoners are incentivised to get involved in induction sessions upon entering prison. This is because the inductions are part of a monetary incentivised scheme, alongside gym passes.
  • The service fills a gap identified by prison staff. Through delivering the sessions we are linking prisoners with clinical services from when they enter prison to when they are liberated. This builds a consistent care pathway from the start to end of someone’s journey within the criminal justice system.
  • Coming into the prison as an outside organisation significantly reduces any barriers to engagement prisoners may have with prison staff. Our prison link worker can better connect with people, encouraging them to know their status, get tested and treated.

Challenges

  • There have been a number of challenges in delivering this service, including:
    • Making sure the information we communicate is easily understood by all. There is significant diversity in the literacy levels of prisoners engaging in our induction sessions and so we need to make sure the information we provide is easy for everyone to understand. To overcome this barrier, we manage the group sensitively, responding to varying needs by providing information through multiple routes (visual, verbal, written) and communicating in everyday language.
    • The size of induction groups at HMP Low Moss is also a challenge. To address this we’ve made sure our Prison Link Worker (Billy Davidson) is highly skilled in group facilitation, creating a safe space for prisoners to express how they’re feeling and some of the challenges they might have in understanding the session content. Combined with working closely with prison staff to assess risk, this helps mitigate the potential risks within a high risk environment.

Achievements to date

Since we have begun delivering this service in HMP Low Moss:

  • 712 people have attended the induction sessions facilitated by our prison link service.
  • 316 people who attended the induction sessions have been referred on for testing.
  • Additionally, it has been a fantastic to work in partnership with HMP Low Moss. We have been able to work together to fill a gap in identifying people who are living with or at risk of BBVs.

Key learnings

  1. We can increase hepatitis C diagnosis, treatment and support by prison and third sector services working in partnership.
  2. People can complete treatment for hepatitis C if they are provided with a clear care pathway and support from entering prison to liberation into the community.
  3. People in prison can and do get tested for hepatitis C (and all BBVs) if they are provided with information in everyday language and a safe environment.

    Find out more

    If you’re interested in finding out more about this work, contact Waverley Care at Jennifer.goff@waverleycare.org.