An opt-out approach to hepatitis C virus testing in English prisons: the literature underpinning the policy

Abstract

Background: The World Health Organization's aim to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030 is dependent on testing people. HCV prevalence is higher in prisons, so to increase test uptake an ‘opt-out’ approach to blood-borne virus testing in English and Welsh prisons was introduced. Aims: This literature review examines the evidence behind the introduction of this public health policy. Methods: Four healthcare databases were searched for publications between January 2000 and February 2020 on the opt-out approach to blood-borne virus testing in prisons. Findings: Sixteen studies published between 2009 and 2019 were included. Analysis of their findings showed that an increase in HCV test uptake in prisons occurs when an opt-out approach is used in combination with additional interventions. Contextual differences between UK and US prisons may affect HCV test uptake. Conclusion: An opt-out approach to HCV testing in prisons can increase test uptake as part of a complex of interventions.

Nursing in a prison context: A focused mapping review and synthesis of international nursing literature

“…There were range of approaches and methodologies used in the included articles. Of the 14 articles, five ( n = 5) were editorials (Peate, 2018, 2019, 2021a, 2021b, 2022), one ( n = 1) commentary (Shelton et al, 2020), one discursive paper (Jack & Irving, 2020) and one ( n = 1) literature review (Jack, 2021). Of the six primary research papers, four ( n = 4) articles used quantitative methods (Duran et al, 2018; Emerson et al, 2018; Kearney & Byrne, 2018; Kızılkaya et al, 2022) and two ( n = 2) used qualitative methods (Cukale‐Matos & Champion, 2022; Geana et al, 2021).…”

“…Most of the articles were written by individuals from the UK ( n = 7) (Jack, 2021; Jack & Irving, 2020; Peate, 2018, 2019, 2021a, 2021b, 2022), five ( n = 5) from the USA (Cukale‐Matos & Champion, 2022; Emerson et al, 2018; Geana et al, 2021; Kearney & Byrne, 2018; Shelton et al, 2020) and two ( n = 2) from Turkey (Duran et al, 2018; Kızılkaya et al, 2022). Table 5 provides an overview of the included articles.…”

“…There were range of approaches and methodologies used in the included articles. Of the 14 articles, five (n = 5) were editorials (Peate, 2018(Peate, , 2019(Peate, , 2021a(Peate, , 2021b(Peate, , 2022, one (n = 1) commentary (Shelton et al, 2020), one discursive paper (Jack & Irving, 2020) and one (n = 1) literature review (Jack, 2021). Of the six primary re- open-coded analysis (Geana et al, 2021).…”

“…The authors advocate for the use of DBS to increase testing for viral hepatitis as the procedure is acceptable to both staff and patients alike and may help to achieve the goal set by the World Health Organization to eliminate viral hepatitis in the UK by 2025(Jack & Irving, 2020). In the same context, a literature review byJack (2021) discusses the introduction of 'opt-out' policies for viral hepatitis testing in prisons in England and Wales. The review concludes that opt-out policies can lead to increased uptake of testing but also illuminates the 'coercive psychosocial cultural context' of prison and how decision-making processes, related to testing, may be impacted by the prison environment(Jack, 2021(Jack, , p. 1163).…”

“…In the same context, a literature review byJack (2021) discusses the introduction of 'opt-out' policies for viral hepatitis testing in prisons in England and Wales. The review concludes that opt-out policies can lead to increased uptake of testing but also illuminates the 'coercive psychosocial cultural context' of prison and how decision-making processes, related to testing, may be impacted by the prison environment(Jack, 2021(Jack, , p. 1163).…”