Theme: Social Science & Policy Research Year: 2016
THE PRISON ECONOMY OF NEEDLES AND SYRINGES: WHAT
OPPORTUNITIES EXIST FOR BBV RISK REDUCTION WHEN PRICES ARE SO
HIGH?
Treloar C1
, McCredie L2, Lloyd A
2
1 Centre for Social Research in Health, UNSW Australia, Sydney, NSW, Australia,
[email protected]
2
Inflammation and Infection Research Centre, School of Medical Sciences, UNSW
Australia
Abstract: Background: A formal Needle and Syringe Program (NSP) is not provided
in Australian correctional centres. Injecting equipment circulates in prisons as part of
an informal and illegal economy. This paper examined how this economy generates
blood-borne virus (BBV) risk and risk mitigation opportunities for inmates.
Method: The HITS-p cohort recruited NSW inmates who had reported ever injecting
drugs and who had a negative HCV serological test within 12 months prior to
enrolment. Cohort participants were monitored every three to six months for HCV
antibodies and viraemia, and via behavioural risk practices questionnaire. For this
study, qualitative interviews were conducted with 30 participants enrolled in HITS-p.
Results: A needle/syringe was nominated as being typically priced in the ‘inside’
prison economy at $100-$150, with a range of $50-$350. Purchase or hire of
equipment was paid for in cash (including transactions that occurred outside prison)
and in exchange for drugs and other commodities. A range of other resources was
required to enable successful needle/syringe economies, especially relationships
with visitors and other prisoners, and violence to ensure payment of debts.
Strategies to mitigate BBV risk included retaining one needle/syringe for personal
use while hiring out others, keeping drug use (and ownership of equipment) “quiet”,
stealing used equipment from the prison health clinic, and manufacture of syringes
from other items available in the prison.
Conclusions: The provision of prison NSP would disrupt the inside economies built
around contraband needles/syringes, as well as minimise BBV risk. However, any
model of prison NSP should be interrogated for any unanticipated markets that could
be generated as a result of its regulatory practices.