OTTAWA - Setting up tattoo parlours and needle-exchange programs in penitentiaries would help reduce the spread of hepatitis C, the federal prison service has told the Trudeau government.
A Correctional Service memo obtained under the Access to Information Act advises Public Safety Minister Ralph Goodale the proposals "warrant consideration" to round out existing and planned measures to fight hepatitis and HIV in prison.
Prison tattooing and needle-exchange programs for drug users have generated intense controversy over the years and the March 2017 memo says detailed research should be carried out before embarking on a syringe needle program, in particular, "to avoid unintended and negative consequences for inmates."
In response to questions, the prison service and Goodale's office said Monday they were exploring options "to better prevent, control and manage infectious diseases" but did not provide details about possible tattoo or needle programs.
The current approach to prevent and control blood-borne and sexually transmitted infections includes screening, testing, education, substance-abuse programs and treatment.
The prevalence of HIV among federal inmates decreased to 1.19 per cent in 2014 from just over two per cent in 2007, according to the memo. But it stood at six times that of the general Canadian population.
Similarly, the proportion of inmates with the hepatitis C virus fell to 18.2 per cent in 2014 from 31.6 per cent in 2007. Yet the incidence was still about 23 times that of the general population.
Federal prison ombudsman Ivan Zinger recently called on the Correctional Service to bring back its safe tattooing program.
His annual report said tattooing in prison frequently involves sharing and reusing dirty homemade equipment - linked to higher rates of hepatitis C and HIV among inmates - and there is often no safe means of disposing of used tattoo needles.
In 2005, the prison service began a pilot program involving tattoo rooms in six federal institutions, but two years later, the Conservative government of the day ended it.
The memo to Goodale says an internal evaluation of the pilot indicated that it increased awareness about disease prevention and had the potential to reduce exposure to health risks. In addition, neither inmates, staff, nor volunteers reported health and safety concerns with the program.
"In fact, the evaluation indicated that the majority of staff believed the initiative made the institution safer for both staff and inmates."
Safer tattooing could reduce hepatitis C virus transmission within federal prisons by 17 per cent a year, the memo says.
The Correctional Service has tried to keep illicit drugs from entering prisons, but acknowledges that some still make their way into penitentiaries. Although the prison service has made bleach available, it has drawn the line at offering clean needles.
A program to provide clean drug-injection needles to prisoners could reduce the spread of hepatitis C by 18 per cent a year, the memo says.
In the case of both safer tattooing and needle programs, it wasn't possible to gauge the potential effect on HIV prevalence or spread among prisoners due to the existing low HIV rates.
The Canadian HIV/AIDS Legal Network has long argued for needle-exchange programs in Canadian prisons. However, Correctional Service officials have raised concerns about syringe needles being used as weapons.
The memo to Goodale recommends weighing the effect a needle program might have for workplace safety regimes, and it suggests more research be done on the effectiveness of such an initiative from both clinical and cost standpoints.
Jim Bronskill
The Canadian Press
Feb 19 2018