One in five prisoners who inject drugs say they began doing so while in custody, according to a report which examines the level of drug use and related illnesses in Irish prisons.
Published yesterday by the Department of Justice, Equality and Law Reform, the report was commissioned to explore the level of HIV, hepatitis B and C infection in the State's prisons. The report also found that over one-third of Irish prisoners suffered from hepatitis C.
Infection levels were found to be slightly higher in women than in men, with 42 per cent of women shown to have been infected with hepatitis C as opposed to 37 per cent of men.
The infection rates were highest among drug-users, where the prevalence of hepatitis B was 19 per cent, hepatitis C 81 per cent and HIV 4 per cent.
The prevalence of hepatitis C was higher in younger prisoners, and those who had spent longer in prison were more at risk from infection, the report found. Although injecting drug-use was associated with increased risk for all three infections, sexual practices were also a significant factor; a history of treatment for sexually-transmitted infections was linked to increased risk of both HIV and hepatitis B.
The study was carried out by the Department of Community, Health and General Practice at Trinity College among 1,205 prisoners in nine prisons in the State. Those taking part completed a four-page questionnaire and provided a sample of oral fluid for testing for antibodies to hepatitis B, hepatitis C and HIV.
Over half the respondents to the questionnaire reported opiate use and 43 per cent (60 per cent of women) admitted having injected drugs. The majority of these were in the higher-risk prisons in Dublin. Of those who injected in prison, 58 per cent said they had shared drug-injecting equipment. Just over one in five of those prisoners who injected said they had started in prison.
The director-general of the Prison Service, Mr Sean Aylward, said yesterday that he welcomed the report. He described the findings as "highly significant".
While accepting that the scientific basis of testing oral fluid samples was beyond doubt, he said that there was a "small question mark" over declared personal drug histories given by participants. "This is particularly relevant in relation to the claim that 21 per cent of respondents began injecting drugs in prison", he said. The figure might be correct, but it did not have the same scientific reliability as the others, he added.
Addressing recent calls for changes in the way the prison medical services are managed he confirmed that an overall review of the structure and organisation of healthcare was under consideration. "Unfortunately, there is not a queue of people in healthcare services lining up to work in the prisons", he said.
The 67-page study, which cost almost £50,000, was carried out in September and November last year. It includes a number of unsolicited comments and observations from the survey team, such as the fact that prisoners expressed concern about the sharing of toothbrushes and razors in prisons.
According to the report, some prisoners also mentioned that they would not want to be tested for any of the viral diseases, as they were likely to be interrogated rather than counselled. "If they had a disease", the report stated, "they were treated with a very obvious non-touch technique. This disease seemed more contemptible than their crime."
People with HIV, hepatitis and TB were reported to be treated very poorly by prison officers, as there was an abnormal fear of contracting the diseases.
All the findings of the survey team would be taken into consideration, Mr Aylward said.