Estimates of the prevalence of HIV in Canadian prisons range from 2% to 8%, close to 10 times the national prevalence for the general population. Substance use is prohibited inside Canadian prisons, yet contraband is relatively easy to secure and few harm reduction options are available. Incarcerated people are given an HIV test upon admission to prison, and HIV antiretrovirals (ARVs) are available to people who contract HIV inside Canadian prisons. Most incarcerated people return to their communities at the end of their sentences, making continuity of care for HIV diagnoses a significant concern.
When looking up the prescription history for a patient who has recently been released from prison on PharmaNet, instead of a name, ARVs are listed as “non-benefit drugs.” This category is overbroad and could lead to disruptions in the continuity of care. Without knowing this crucial piece of information, it would be relatively easy to gloss over this detail and affect continuity of care. A patient who initiated ARVs inside prison and was then released to reintegrate back into the community could easily fall through the cracks and not adhere to their medication regimen. Naturally, this information is widely applicable to all HIV-positive patients on ARVs.
The Collaborating Centre for Prison Health and Education at UBC recently released Guidelines for Family Physicians Working with Formerly Incarcerated People, which provides support to family physicians caring for this population. The guidelines are available online: http://ccphe.ubc.ca/guidelines-for-family-physicians.
—Blake Stitilis, MPH
—Ruth Elwood Martin, MD
Collaborating Centre for Prison Health and Education
School of Population and Public Health, UBC Faculty of Medicine
1. Lines R, Jurgens R, Glenn B, et al. Prison needle exchange: Lessons from a comprehensive review of international evidence and experience. Canadian HIV/AIDS Legal Network; 2004.
2. Public Health Agency of Canada. The effectiveness of bleach in the prevention of Hepatitis C transmission. Final Report. Ottawa, ON; 2004.
Above is the information needed to cite this article in your paper or presentation. The International Committee
of Medical Journal Editors (ICMJE) recommends the following citation style, which is the now nearly universally
accepted citation style for scientific papers:
Halpern SD, Ubel PA, Caplan AL, Marion DW, Palmer AM, Schiding JK, et al. Solid-organ transplantation in HIV-infected patients. N Engl J Med. 2002;347:284-7.
About the ICMJE and citation styles
The ICMJE is small group of editors of general medical journals who first met informally in Vancouver, British Columbia, in 1978 to establish guidelines for the format of manuscripts submitted to their journals. The group became known as the Vancouver Group. Its requirements for manuscripts, including formats for bibliographic references developed by the U.S. National Library of Medicine (NLM), were first published in 1979. The Vancouver Group expanded and evolved into the International Committee of Medical Journal Editors (ICMJE), which meets annually. The ICMJE created the Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals to help authors and editors create and distribute accurate, clear, easily accessible reports of biomedical studies.
An alternate version of ICMJE style is to additionally list the month an issue number, but since most journals use continuous pagination, the shorter form provides sufficient information to locate the reference. The NLM now lists all authors.
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For more information on the ICMJE Recommendations for the Conduct, Reporting, Editing, and Publication of Scholarly Work in Medical Journals, visit www.icmje.org