The Prison and Transition Health (PATH) Cohort Study: Study Protocol and Baseline Characteristics of a Cohort of Men with a History of Injecting Drug Use Leaving Prison in Australia

Abstract

People who inject drugs (PWID) are disproportionately represented among individuals who experience imprisonment and often have more complex physical and mental health needs than people in prison without injecting histories. The trajectories of PWID after prison release are poorly understood, hampering the development of effective strategies to address their distinct health needs. The Prison and Transition Health (PATH) Cohort Study is characterising the post-release trajectories of incarcerated male PWID in Victoria, Australia. We outline study methodology and baseline characteristics of participants prior to their release. Four hundred participants were recruited from three prisons and completed researcher-administered baseline interviews covering socio-demographics, social supports, physical health, mental health, alcohol and other drug use, and pre-release and transitional service utilisation. The median age among participants was 36 years (IQR 30–42), and they reported a median of five (IQR 3–9) previous adult incarcerations. Almost half (49%) were reliant on government payments prior to incarceration. One quarter (25%) of participants reported removal from their parents’ care as children and 64% reported being a parent or primary caregiver to children. Most participants (81%) reported a previous mental health diagnosis and 44% reported three or more diagnoses. The most common drugs injected prior to incarceration were crystal methamphetamine (80%) and heroin (62%), and most (85%) reported being under the influence of drugs at the time of committing offences for which they were currently incarcerated. Injecting drug use during their current sentence was reported by 40% of participants, and 48% reported engaging with some form of drug treatment during their current sentence. Study participants are characterised by significant mental health and substance use morbidities, social disadvantage and criminogenic histories that present challenges for the provision of post-release support services. Data from the PATH Cohort Study will help inform strategies to improve the health and social outcomes of this population.

Strategies to maximise study retention and limit attrition bias in a prospective cohort study of men reporting a history of injecting drug use released from prison: The Prison and Transition Health study

“…The PATH study protocol, and baseline recruitment and participants' characteristics, have been published elsewhere. 19 Study eligibility criteria included self-reporting IDU at least monthly in the six months prior to the index period of imprisonment, being aged ≥ 18 years at baseline, being sentenced (i.e., not on remand), and consenting to participate in the baseline and up to three interviews after release from prison. Year of index prison entry ranged from 2001 to 2016, with a median sentence length of 183 days (IQR 105-363).…”

Mental Health Contact Episodes in the Year Prior to First Adult Imprisonment Among Men Who Inject Drugs in Victoria, Australia

“…The PATH study protocol and participants' baseline/prerelease characteristics have been published elsewhere. 10 Study eligibility involved self-reporting at least monthly injecting drug use in the six months prior to imprisonment, being ≥ 18 years of age, being sentenced, and consenting to the baseline and three follow-up interviews. Baseline interviews occurred between September 2014 and May 2016, a median of 39 days (IQR 15, 69) prior to release from prison.…”

“They just don’t care about us!”: Police custody experiences for young men with histories of injecting drug use

“…The transcripts of in-depth interviews conducted with 28 young men (aged 19–24) with histories of injecting drugs are the focus of our analysis. Participants were recruited from the Prison and Transition Health (PATH) study (see Kirwan et al., 2019), which is examining the health and criminal justice trajectories of 400 male prisoners 3 with recent injecting drug use histories. Thirty-seven PATH participants were aged 18–24 years.…”