Ex-prisoners with a history of injecting drug use will be followed for six months post-release to observe their drug use and health trajectories and examine discrepancies between their health needs and service access.

This project will provide a comprehensive examination of the health service needs of post-release prisoners with a history of injecting drug use in Victoria.

The project will also examine risk behaviours (in particular those associated with blood-borne virus transmission) among this group and seek to identify areas where the service system does not meet the actual and/or perceived needs of this group during a particularly vulnerable period.

The project will investigate the barriers and enablers linking people with a history of injecting drugs to health services during the immediate post-prison release period.

The project also includes a systematic review of research examining HCV transmission and service utilisation by post-release prisoners, in addition to a mapping exercise of services available to Victorian prisoners.

The distinct parts of the project are briefly described below.

Methods

• Cohort: One hundred and fifty ex-prisoners, with a history of injecting drug use, will be recruited through organisations around Metropolitan Melbourne in contact with post-release prisoners. The cohort will be recruited within one month of their prison release and administered a baseline interview. Participants will then be interviewed again at three and six months to examine their treatment utilisation, experiences in accessing health and support services, the perceived barriers and enablers to service access and their post-release and prison drug use patterns and BBV risk practices.
• Literature review: A systematic literature review of Australian and international research will examine health service utilisation by post-release prisoners and resultant implications for public health policy and practice. A qualitative mapping exercise of available health and support services for post-release prisoners in Victoria will follow.
• In-depth interviews: Approximately 30 ex-prisoners released more than six months previously and with a background of injecting drug use will be recruited to discuss issues similar to those covered in the cohort interview schedule. The data elicited from these in-depth interviews will provide a retrospective ‘lessons learned’ narrative of participant experiences regarding health needs, access to health and support services and post-release HCV risk practices.
• Family and key informant interviews: KIs will be recruited from areas such as Victorian corrections services, health and support service providers and drug user organisations, to identify and discuss issues including the post-release health and support needs of prisoners, and effective and ineffective aspects of service systems that facilitate or impede the provision of services. Interviews with prisoner family members (recruited from prisoner family support services) will broaden our field of enquiry to illustrate some of the collateral damage lack of access to, or utilisation of services, causes, and will also contribute to a mapping exercise of available services for this clientele.