By Hannah Branch & Sofia Bartlett SEPTEMBER 26, 2022, CATIE Blog People who have experienced incarceration are disproportionately affected by sexually transmittedRead more
People with lived/living experience of incarceration (PWLLE-I) are at higher risk for Sexually Transmitted & Blood Borne Infections (STBBIs) than the general public for several reasons (see STBBIs education for health care workers).
The purpose of the You Matter Pathways to STBBI care project is to improve STBBI testing and linkage to care for PWLLE-I specifically in correctional facilities in British Columbia.
Currently, there are no publicly available policies and guidelines for universal testing and linkage to care for STBBIs in any provincial correctional centres in Canada. In fact, in-depth guidance on how to provide STBBI testing and linkage to care in correctional settings is lacking globally. Although STBBI screening is available on request in correctional centres across Canada, without accepted best practices for universal STBBI testing and linkage to care, there is inconsistent implementation of pre- and post-test STBBI counselling in corrections, and STBBI tests during reception at corrections are not universally or even routinely offered in many facilities, resulting in poor linkage to care for STBBIs among people with lived/living experience of incarceration (PWLLE-I). There are also many gaps in linkage to STBBI care after release from corrections, due to a lack of guidance on accepted best practices and standards.
The development of foundational policies and guidelines for universal STBBI testing and linkage to care in corrections and after release is necessary to create accountability frameworks, streamline care pathways, reduce the occurrence of unintended harms, and increase the likelihood that PWLLE-I will have positive experiences when engaging in healthcare. If developed with input from healthcare workers, corrections staff, and PWLLE-I, such policies and guidelines have the potential to catalyze system changes in how health care services are provided in correctional institutions.
Adherence to policies and guidelines for universal STBBI testing and linkage to care at reception could:
- Enhance the participation and success of the implementation of opt-out or universal STBBI testing and linkage to care by Correctional Health Services;
- Improve PWLLE-I linkage to care for STBBIs;
- Facilitate broader system-level changes in provincial corrections pertaining to health services engagement, such as reduced stigma and increased violence and trauma informed care;
- Facilitate PWLLE-I engagement in health care services upon re-entry to community, including for addictions-related care, and
- Serve as a model of change that could be adapted for other Canadian regions or internationally. To ensure that policies and guidelines incorporate and balance experiences and preferences of PWLLE-I and corrections staff, this project includes consultations, interactive workshops, and communications with: PWLLE-I and people with experience of incarceration, BC’s Correctional Health Services staff, and BC Corrections staff.