Few inmates use flawed needle exchange program to protect against HIV: report

“The problem we have now is that there are so few participants. This suggests to me that there are probably still a lot of dirty needles out there and people are making bad choices because they are not convinced that the program the service has implemented is the right one for them, ”Zinger said.

Corrections announced the program in 2018 and it has been implemented in nine federal prisons. The harm reduction strategy reduces the sharing of unsterile needles among inmates, which can reduce the transmission of blood-borne diseases.

In May 2020, the service suspended the process of re-implementing the program, which required extensive consultation and face-to-face meetings, due to the COVID-19 pandemic.

Zinger said that in reviewing the program recently, only four prisons continued to operate it, with a total of 42 participants.

Ginette Clarke, director general of health policies and programs at Correctional Service Canada, said the program is available at all nine sites and that they continue to receive requests to participate in the program “on an ongoing basis.”

Sandra Ka Hon Chu, Executive Director of the HIV Legal Network, expressed concern about low participation in the program, as rates of HIV and hepatitis C are very high in the federal prison system, and drug use by injection is one of the ways people get infected.

“It’s not good for health in prison, for public health or for the health of people. We want people to participate and have access to this health service as they do in the community, ”said Ka Hon Chu.

Zinger noted that the prisons that implemented the program have seen a dramatic reduction in the spread of communicable diseases.

The report, led by Professor Lynne Leonard of the University of Ottawa, said low turnout needs to be investigated to identify barriers that might prevent attendance.

The report showed that three of the nine participating prisons did not receive any expressions of interest in the program.

A lack of discretion or anonymity for attendees was a barrier to uptake of the program, according to the report.

In some prisons, certain aspects of the program have the effect of identifying an inmate as a participant with guards, guards and inmates.

The process of exchanging used needles for new sterile needles has, in some cases, exposed an inmate to the risk of disclosing their participation in the program to guards.

Some attendees reported that when they had to present their equipment on demand, they had to do it in a loud and vocal manner.

Inmates in the program said they were subjected to negative and stigmatizing remarks by correctional staff, according to a memo retrieved through an access to information request by the HIV Legal Network.

Zinger said the safety-focused aspects of the program reflect the fact that the commissioner has had to address the concerns of correctional officers and unions.

This approach is contrasted with an approach focused solely on health care, “which other jurisdictions have done and certainly played a role in preventing higher turnout,” Zinger said.

Although Clarke did not respond directly to a question about the tension between the safety and health aspects of the program, she said CSC will continue to ensure that its services meet community standards and provide the “best and most efficient services possible”.

She said CSC was reviewing Leonard’s report and recommendations. The service has already started implementing some of the recommendations, including updating health promotion material, it added in a follow-up email.

Jeff Wilkins, president of the Union of Correctional Officers of Canada, said security measures must be put in place for the program for fear the needles could be used as weapons.

“The needle is in the inmate’s cell. They could use it to inflict injuries and assault staff members, they could use it to assault other inmates, ”Wilkins said.

The program’s report found that there is not enough evidence to show that needle stick injuries have increased in prisons where the program is in place.

When syringes are given to inmates to keep them in their cells without being advised or supervised by health professionals, “it is essentially on the backs of correctional officers or security guards to manage this program.” Wilkins said.

Ka Hon Chu said she agreed that the program should be health-focused squarely and that correctional officers should not be managing it.

She referred to models elsewhere in the world where correctional officers do not manage the program, such as the peer program in Moldova, where fellow inmates are trained in harm reduction and distributing supplies to those who wish to be there. to access.

The model adopted by Correctional Service Canada is unique and “problematic” for this reason, said Ka Hon Chu.

The Correctional Service of Canada plans to continue delivering the programs in existing institutions and “when the time is right, with COVID-19 in mind” to consider implementing the program in all federal prisons, Clarke said. .

A major concern for Zinger is that barriers to accessing the program mean people will continue to use drugs in unsafe ways.

“Then we’ll see incidents of overdose and maybe even fatalities as opposed to trying to deal with a problem that’s clearly happening. It will continue to happen.

This report by The Canadian Press was first published on December 18, 2021.


This story was produced with the financial assistance of Facebook and the Canadian Press News Fellowship.

Erika Ibrahim, The Canadian Press

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