Healthy prison cultures: factors influencing male prisoners' engagement in exercise and subsequent healthy behaviours.

PURPOSE: The purpose of this paper is to identify the factors which influence male prisoners' motivation for, and engagement in, exercise and subsequent healthy behaviours. DESIGN/METHODOLOGY/APPROACH: The first authors conducted 20 semi-structured interviews with male prisoners inside an English medium-security male prison. Interviews were recorded and transcribed, themes were identified using thematic analysis and a critical realist perspective applied to understand objective processes behind prisoners' experiences and shared meanings of exercise and engaging in healthy behaviours in prison. FINDINGS: Emerging themes indicate that in the context of healthy behaviours male prisoners aspired to a masculine ideal that was characterised by a culture of either adaptive behaviours, or maladaptive behaviours. The former fostered an adaptive exercise culture which promoted psychological well-being through an autonomy-supportive environment, consequently internalising motivation and minimising perceived barriers to engaging in healthy behaviours. Conversely, a culture of maladaptive behaviours fostered a maladaptive exercise culture which led to negative psychological well-being, underpinned by external forms of motivation which emphasised barriers to engaging in healthy behaviours. PRACTICAL IMPLICATIONS: Findings emphasise the need for prisons to promote an internal perceived locus of control for male prisoners when engaging in healthy behaviours. ORIGINALITY/VALUE: The authors adopt a rare interdisciplinary approach combining a psychological theory of motivation and criminological perspectives of prison culture to understand how best to minimise the impact of prisons as an institution on the psychological well-being of male prisoners.

COVID-related disruptions and adaptations to prison-based mental health and substance use services: a narrative review.

PURPOSE: Public health experts and advocates have long raised concerns about the pandemic preparedness of prison systems worldwide - an issue that became increasingly salient at the start of the COVID-19 pandemic. People in prison experience poorer health outcomes compared to the general population, making timely access to adequate health services in prison critical for their health and wellbeing. This study aims to identify the extent of the literature on initial changes in mental health and substance use services for people in prison during the COVID-19 pandemic, summarize and synthesize the findings and identify areas in need of further study. DESIGN/METHODOLOGY/APPROACH: The authors conducted a review of the academic literature published internationally in English between 2019 and December 1, 2020 to describe the disruptions and adaptations to mental health and substance use services in prisons during the onset of the COVID-19 pandemic. FINDINGS: The authors found that mental health and substance use services in prisons around the world were widely disrupted due to the COVID-19 pandemic - predominantly consisting of the complete suspension of services, discontinuation of transfers to off-site treatment sites and limitations on service capacity. Adaptations ranged from virtual service delivery and changes to treatment dispensation processes to information sessions on overdose prevention. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first review to examine the nature and extent of the literature on delivery of mental health and substance use services in prisons during the COVID-19 pandemic.

How effective are digital/e-health interventions for supporting prisoners with mental ill-health? An integrative review.

PURPOSE: There has been a move towards the implementation of digital/e-health interventions for some time. Digital/e-health interventions have demonstrable efficacy in increasing individual empowerment, providing timely access to psychological interventions for those experiencing mental ill-health and improving outcomes for those using them. This study aims to determine the efficacy of digital/e-health interventions for individuals detained in prison who experience mental ill-health. DESIGN/METHODOLOGY/APPROACH: A systematic search of five academic databases - CINAHL, ASSIA, PsycINFO, Embase and Medline - was completed in December 2020 and updated in February 2022. The review was guided by the Whittemore and Knafl (2005) framework for integrative reviews. A total of 6,255 studies were returned and screened by title and abstract. A full-text screening of nine (n = 9) studies was conducted. FINDINGS: No study met the inclusion criteria for the clinical efficacy of digital/e-health interventions in a prison setting. Subsequently, a review of the literature that made it to the full-text review stage was conducted, and gaps in the literature were identified to inform policy, practice and future research. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first integrative review conducted on the efficacy of digital/e-health interventions for mental ill-health in prison settings.

Prison food and the carceral experience: a systematic review.

PURPOSE: This study aims to focus on studies that qualitatively explore prison food experience. The goal is to elaborate a framework to better understand how prison food shapes the worldwide carceral experience. DESIGN/METHODOLOGY/APPROACH: This systematic literature review was based on the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) statement. It consists of four phases: identifying the studies, screening the studies, evaluating the eligibility of screened studies and inclusion of studies. After the four phases, ten studies (nine qualitative studies and one with mixed methods) were included in the review. FINDINGS: There is a consensus among the researchers in the reviewed literature that prison food shapes the carceral experience. More specifically, four themes that encompass the experience of people with prison food emerged from the reviewed literature: food appreciation (taste of the prison food and perceived nutritional value), food logistics (preparation, distribution and consumption), food variety (institutional menu and commissary store) and food relationships (symbol of caring or power or punishment). ORIGINALITY/VALUE: The literature reviewed demonstrated that when incarcerated individuals have a negative view of prison food, the carceral experience is negatively impacted. This systematic review identified four dimensions that encompass the food experience within the prison environment, providing a framework for navigating this subject.

Suicide, suicide attempts and self-harm in Moroccan prisons.

PURPOSE: High rates of suicide and self-harm are reported in prisons in Western countries, while fewer studies exist from a non-Western context. This study aims to identify rates of suicide, non-fatal suicide attempts and self-harm in Moroccan prisons and to better understand the context, methods, tools, predictors and profile of persons engaged in the acts. DESIGN/METHODOLOGY/APPROACH: The authors report findings from a mixed-methods study carried out before an intervention project. The study consists of a systematic literature review, an analysis of suicide case files, a quantitative survey on suicide attempts and self-harm, as well as interviews and focus group discussions. The authors calculate suicide, suicide attempt and self-harm rates and present descriptive data on the incidents. The authors use regression models to explore the association between the number of incidents per individual and selected predictors, adjusting for clustering by institution. FINDINGS: Over a four-year period, 29 detained persons in Morocco died by suicide (average annual suicide rate 8.7 per 100,000). Most were men under the age of 30. Hanging accounted for all but one case. In one year, 230 suicide attempts were reported. Over a three-months period, 110 self-harm cases were reported from 18 institutions, cutting being the most common method. Self-harm was significantly more prevalent among persons with a life sentence or repeated incarcerations. RESEARCH LIMITATIONS/IMPLICATIONS: To make the study manageable as part of an intervention project, the authors collected data on suicides and suicide attempts from all prisons, while data on self-harm were collected from fewer prisons and over a shorter time period. The authors did not collect comparable information from detained persons who did not die by suicide, attempt suicide or self-harm. This prevented comparative analyses. Further, it is possible that self-harm cases were not reported if they did not result in serious physical injury. Data were collected by prison staff; thus, the voice of incarcerated persons is absent. PRACTICAL IMPLICATIONS: This study provided a solid basis for designing an intervention project including the development of a national prison policy and guidelines on suicides, suicide attempts and self-harm and a country-wide training program for prison staff. It also led to a better surveillance system, allowing for trend analysis and better-informed policymaking. The qualitative results helped create an understanding of how staff may trivialize self-harm. This was integrated into the training package for staff, resulting in the creation of prison staff trainers who became the strongest advocates against the notion that self-harm was best ignored. ORIGINALITY/VALUE: To the best of the authors' knowledge, this is the first published data on suicide and self-harm in Moroccan prisons. It underscores the necessity for the intervention project and gives valuable insights into suicide and self-harm in a non-Western prison context. Further research is needed to assess whether the findings are typical of the region.

The role and effectiveness of occupational therapy in prison rehabilitation programs: systematic review.

PURPOSE: The purpose of this study was to research studies in the literature regarding the role of the occupational therapist within penitentiary facilities. DESIGN/METHODOLOGY/APPROACH: The study design is a systematic review using five different databases. FINDINGS: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society. RESEARCH LIMITATIONS/IMPLICATIONS: It is necessary for clinical practice, and especially to increase the health of people within prisons, to update the occupational therapist interventions in the literature that are effective within prisons. PRACTICAL IMPLICATIONS: According to this study, the intervention of occupational therapists in the prison setting reduces recidivism and contributes to social and work reintegration. This has positive effects in terms of costs related to incarceration. ORIGINALITY/VALUE: Findings can therefore ascertain the potential role of occupational therapists in penitentiary institutions because they can contribute to the rehabilitation of prisoners both inside and outside prisons with a view to their reintegration into society.

Partnering to Address Health Inequities among Incarcerated Populations: Prisons, Jails, and COVID-19 Vaccination.

BACKGROUND: Incarcerated people have been disproportionately affected by the COVID-19 pandemic and face significant challenges to COVID-19 vaccine confidence. OBJECTIVES: (1) Describe our partnerships with community members directly impacted by incarceration, (2) discuss the partnership's process for co-developing and implementing project interventions to increase COVID-19 vaccine confidence, and (3) share lessons learned from this unique community-engaged partnership. METHODS: An advisory board of 14 formerly incarcerated community members participated in this project. Their wisdom and experience led to the development and implementation of interventions to increase confidence in COVID-19 vaccines among incarcerated people. LESSONS LEARNED: Valuable lessons learned were centering community, leaning into trusted sources of information, acknowledging historical and present harms, and investing in community-engaged work. CONCLUSIONS: Centering lived experiences of those directly impacted by incarceration has been crucial to increasing vaccine confidence among this population. Doing so reinforced the importance of long-term investments in community-based collaborations with communities impacted by incarceration.

Evaluation of the Cultural, Social and Emotional Wellbeing Program with Aboriginal women in the Boronia Pre-Release Centre for Women: a mixed methods study.

OBJECTIVE: To assess the effectiveness of the Cultural, Social and Emotional Wellbeing Program for reducing psychological distress and enhancing the social and emotional wellbeing of Aboriginal women preparing for release from prison. STUDY DESIGN: Mixed methods; qualitative study (adapted reflexive thematic analysis of stories of most significant change) and assessment of psychological distress. SETTING, PARTICIPANTS: Aboriginal and Torres Strait Islander women at the Boronia Pre-release Centre for Women, Perth, Western Australia, May and July 2021. INTERVENTION: Cultural, Social and Emotional Wellbeing Program (two days per week for six weeks). The Program involves presentations, workshops, activities, group discussions, and self-reflections designed to enhance social and emotional wellbeing. MAIN OUTCOME MEASURES: Themes and subthemes identified from reflexive thematic analysis of participants' stories of most significant change; change in mean psychological distress, as assessed with the 5-item Kessler Scale (K-5) before and after the Program. RESULTS: Fourteen of 16 invited women completed the Program; ten participated in its evaluation. They reported improved social and emotional wellbeing, reflected as enhanced connections to culture, family, and community. Mean psychological distress was lower after the Program (mean K-5 score, 11.3; 95% confidence interval [CI], 9.0-13.6) than before the Program (9.0; 95% CI, 6.5-11.5; P = 0.047). CONCLUSION: The women who participated in the Program reported personal growth, including acceptance of self and acceptance and pride in culture, reflecting enhanced social and emotional wellbeing through connections to culture and kinship. Our preliminary findings suggest that the Program could improve the resilience of Aboriginal and Torres Strait Islander in contact with the justice system.

A Qualitative Program Evaluation of a Digital Peer Support Group for Formerly Incarcerated People.

OBJECTIVES: A qualitative program evaluation of the Formerly Incarcerated Peer Support (FIPS) group, a peer-led mutual support group for formerly incarcerated people, was conducted to understand participant perceptions of (1) digital delivery via Zoom, (2) curriculum content, (3) roles of group participants, and (4) therapeutic value of FIPS group as it relates to traumatic experiences in prison and ongoing challenges after release. METHODS: Using a community-based participatory action research approach, a qualitative evaluation was conducted with participants in either the 2020 or 2021 curriculum. Semi-structured interviews were conducted via Zoom, transcribed, de-identified, coded, and analyzed via applied thematic analysis and results reviewed with participants. RESULTS: Of 75 formerly incarcerated participants, 20 interviews were conducted and recorded (n = 20). All participants were male, 85% were Black, and the average age was 54.8 years old. Zoom delivery was not preferred, but feasible. Most appreciated the comprehensive and holistic curriculum that enabled peers to gain practical and emotional social support in different areas of life after release. The facilitator's experience with prison programs and relationships within peer networks was essential for recruitment and retention. Participants described (1) feelings of acceptance, (2) examples of teaching and learning from peers' improved insight, trigger management, response modification to stressors, and (3) improved understanding within relationships with those who have not been incarcerated. CONCLUSIONS: Digital delivery of peer-led psychosocial support groups for formerly incarcerated people is feasible and impactful. Future research can further characterize the lingering impacts of institutional traumas and quantify changes.

Aggravated solitary confinement in Turkey. A form of institutionalised torture.

Last January 2023, 36 international jurists, journalists and pol-iticians from 8 countries were part of the International Delega-tion Against Isolation that travelled to Turkey to hold meetings with civil society organisations and political circles regarding the prison situation1 . The Delegation was divided into three groups travelling to different cities: Ankara, Amed and Istan-bul. The three groups met on 28 January in Istanbul for an International Forum against Isolation.

Presence of Inmates with Mental Health Problems in Detention and Correctional Centers in the Republic of Kosovo.

BACKGROUND: Conventions adopted by the United Nations and Council of Europe pay special importance to the treatment of prisoners with mental health problems. Their treatment is close-ly related to respect for human dignity, and the prohibition of torture, cruel and degrading treatment or punishment. The Eu-ropean Court of Human Rights, in many cases, has ruled that the detention of a mentally-ill person can raise issues under Ar-ticle 3 of the European Convention on Human Rights and that the lack of adequate medical care can result in treatment in con-travention of this article. The Republic of Kosovo is not a mem-ber of the United Nations and Council of Europe. However, it has incorporated in its Constitution a number of Conven-tions adopted by the United Nations and Council of Europe. Also, Kosovo has adopted a legal framework which prohibits torture, cruel and degrading treatment or punishment in ac-cordance with the international human rights standards. The Constitution also provides that human rights and fundamen-tal freedoms guaranteed by the Constitution shall be interpret-ed in accordance with the case law of the European Court of Human Rights. METHODS: Review of Ombudsperson's, Committee for the Prevention of Torture, Prison Health Department of Kosovo Ministry of Health reports, as well as reports of the NGOs in Kosovo.

Examining body mass index and health-related fitness marker progression of incarcerated minority youth engaged in a sport-leadership program.

PURPOSE: The purpose of this study was to examine the impact of a sport-leadership program on minority incarcerated young adults' health-related fitness markers. DESIGN/METHODOLOGY/APPROACH: This study occurred at an all-male juvenile detention center. A total of 41 participants in this study were obtained from a sample of 103 incarcerated young adults. Data collection entailed body mass index (BMI) evaluation, cardiovascular endurance tests and 1-min pushups and situps at two different time periods (before and after three months). A 2 × 2 mixed factorial analysis of variances was used to test for differences among the within subjects' factors (time [pre × post]) and between subjects' factors (groups [flex × control]) for the above-mentioned dependent variables. FINDINGS: Over the course of three consecutive months of engagement, preliminary indications demonstrated participants had a slight reduction in BMI and significant increases in cardiovascular endurance and muscle strength. Contrarily, during this same time period, non-participating young adults exhibited significant increases in BMI and decreases in cardiovascular endurance and muscle strength. ORIGINALITY/VALUE: Integration of sport-leadership programs is generally not free but can be a low-cost alternative for combatting many issues surrounding physical activity, weight gain and recreational time for those incarcerated.

Effectiveness of oral health education on oral hygiene status among adult male inmates in central jail, Kolkata - an interventional study.

PURPOSE: Oral health is an integral part of general health. Different population groups have been assessed for oral health status in India, but still, many have been neglected; one such group is the prisoners. The prison population is a unique and challenging one with many health problems, including poor oral health, which may be due to lack of knowledge about good oral health practices. This study aims to assess effectiveness of oral health education on oral health knowledge, attitude and practices and oral hygiene status among the male prison inmates of central jail in Kolkata, India. DESIGN/METHODOLOGY/APPROACH: An interventional study was done among 240 male convicts. The data was elicited using a structured proforma; oral health status was assessed by recording OHI-S index, and the severity of gingivitis was assessed by recording the gingival index. Oral health education was delivered by using audio-visual aid. Oral health knowledge, attitude, practices and oral hygiene and gingival status were reassessed among the inmates before and after dental education at the end of three and six months. FINDINGS: A significant change in oral health knowledge, attitude and practices was seen, which in turn resulted in an appreciable decrease in the mean gingival index score (1.73 ± 0.382 to 1.20 ± 0.321) and OHI-S (3.31 ± 0.815 to 2.57 ± 0.551) in all the inmates after oral health education program over the period of time. ORIGINALITY/VALUE: The oral health education with reinforcement proved to be an effective tool to instil good oral hygiene practices in the inmates.

A model of care for Aboriginal and Torres Strait Islander prisoner health and wellbeing in South Australia.

PURPOSE: Aboriginal and Torres Strait Islander (Aboriginal) people are overrepresented in Australian prisons, where they experience complex health needs. A model of care was designed to respond to the broad needs of the Aboriginal prisoner population within the nine adult prisons across South Australia. The purpose of this paper is to describe the methods and findings of the Model of Care for Aboriginal and Torres Strait Islander Prisoner Health and Wellbeing for South Australia. DESIGN/METHODOLOGY/APPROACH: The project used a qualitative mixed-method approach, including a rapid review of relevant literature, stakeholder consultations and key stakeholder workshop. The project was overseen by a Stakeholder Reference Group, which met monthly to ensure that the specific needs of project partners, stakeholders and Aboriginal communities were appropriately incorporated into the planning and management of the project and to facilitate access to relevant information and key informants. FINDINGS: The model of care for Aboriginal prisoner health and wellbeing is designed to be holistic, person-centred and underpinned by the provision of culturally appropriate care. It recognises that Aboriginal prisoners are members of communities both inside and outside of prison. It notes the unique needs of remanded and sentenced prisoners and differing needs by gender. SOCIAL IMPLICATIONS: Supporting the health and wellbeing of Indigenous prison populations can improve health outcomes, community health and reduce recidivism. ORIGINALITY/VALUE: Only one other model of care for Aboriginal prisoner health exists in Australia, an Aboriginal Community Controlled Health Organisation-initiated in-reach model of care in one prison in one jurisdiction. The South Australian model of care presents principles that are applicable across all jurisdictions and provides a framework that could be adapted to support Indigenous peoples in diverse prison settings.

Accessing opioid agonist treatment in prison in England and Scotland remains problematic - the views of people with lived experience.

PURPOSE: The purpose of this paper is to examine lived experiences of opioid agonist treatment (OAT) during and immediately following release from detention in prisons in England and Scotland. DESIGN/METHODOLOGY/APPROACH: Surveys were completed by serving prisoners in both countries and by those recently released from prison (England only). The survey findings were discussed in focus groups of people with lived experience. The combined findings from the surveys and focus groups were shared with an expert group of prison OAT providers and people with lived experience with the purpose of making recommendations for more accessible and effective OAT in custodial environments and continuity of OAT on release. FINDINGS: The quality and accessibility of OAT varied considerably between establishments. It was reported to be harder to access OAT in Scottish prisons. It was often hard for people in prison to get the dosage of OAT they felt they needed and it was generally harder to access buprenorphine than methadone in English prisons. Only Scottish people in prison were aware of long-lasting forms of buprenorphine. People in English prisons had mixed experiences of the help available in prison, with no improvement recorded since a 2016 study. People in Scottish prisons were more likely to rate the help available as poor. RESEARCH LIMITATIONS/IMPLICATIONS: The number of people accessed while actually in prison (73) was reduced by the impact of the pandemic, making it more difficult to access people in prison and because some were resistant to participating on the basis that they had already been consulted for a wide variety of research projects focused on the impact of COVID. The Scottish cohort (a total of 19 individuals comprising 14 survey respondents and five focus group members) is clearly too small a number on which to base robust claims about differences in OAT provision between the English and Scottish prison systems.. PRACTICAL IMPLICATIONS: The study identifies key barriers to accessing OAT in prisons and suggests key components of more user-friendly approaches. SOCIAL IMPLICATIONS: This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release and offers valuable recommendations on how to make service provision more effective and consistent. ORIGINALITY/VALUE: This study provides an overview of the recent lived experiences of people accessing OAT in prison and on release in England and Scotland and offers valuable recommendations on how to make service provision more effective and consistent.

Factors associated with non-treatment for long-term illness among incarcerated individuals.

PURPOSE: The prison population is seldom studied and often overlooked in many countries despite their vulnerability to long-term illness. This study aims to explore the factors associated with the non-treatment for long-term illnesses among incarcerated individuals. DESIGN/METHODOLOGY/APPROACH: This study is a cross-sectional analysis. The authors conducted a secondary data analysis using information collected in the Peruvian census of incarcerated individuals. The study population consisted of incarcerated individuals diagnosed with a long-term illness. To evaluate the factors associated with non-treatment, the authors used a Poisson regression model. FINDINGS: The authors included 12,512 incarcerated individuals (age: 40.9 ± 13.1 years), and 39% of them did not receive treatment for their long-term illness. The authors observed that non-treatment was statistically associated with gender, age, having children, use of the Spanish language, sexual identity, judicial situation, penitentiary location, discrimination inside the penitentiary and health insurance before incarceration. However, only having children (prevalence ratio [PR]: 1.11, confidence interval [CI]95% 1.03-1.19), using the Spanish language (PR: 1.15, CI95%: 1.01-1.31), being in a penitentiary not in Lima (PR: 1.11, CI95%: 1.06-1.17) and perceiving discrimination inside the penitentiary (PR: 1.12, CI95% 1.06-1.18) increased the prevalence of non-treatment. ORIGINALITY/VALUE: Identifying the factors associated with non-treatment will allow us to implement measures for prioritizing groups and developing strategies for the evaluation, close follow-up of their health and management of comorbidities.

Unravelling the experiences of incarcerated individuals living with HIV on ART: a qualitative study in Ghanaian prisons.

PURPOSE: The Joint United Nations Programme on HIV/AIDS (UNAIDS) goal to end the acquired immunodeficiency syndrome (AIDS) epidemic as a public health threat by 2030 emphasises the importance of leaving no one behind. To determine progress towards the elimination goal in Ghana, an in-depth understanding of human immunodeficiency virus (HIV) care from the perspective of vulnerable populations such as persons living with HIV in incarceration is necessary. This study aims to explore the experiences of incarcerated individuals living with HIV (ILHIV) and on antiretroviral therapy (ART) in selected Ghanaian prisons to help inform policy. DESIGN/METHODOLOGY/APPROACH: The study adopted a qualitative approach involving in-depth interviews with 16 purposively selected ILHIV on ART from purposively selected prisons. Interviews were conducted between October and December 2022. Thematic analysis was performed using the ATLAS.Ti software. FINDINGS: Three themes were generated from the analysis: waking up to a positive HIV status; living with HIV a day at a time; and being my brother's keeper: preventing HIV transmission. All participants underwent HIV screening at the various prisons. ILHIV also had access to ART although those on remand had challenges with refills. Stigma perpetuated by incarcerated individuals against those with HIV existed, and experiences of inadequate nutrition among incarcerated individuals on ART were reported. Opportunities to improve the experiences of the ILHIV are required to improve care and reduce morbidity and mortality. ORIGINALITY/VALUE: Through first-hand experiences from ILHIV in prisons, this study provides the perception of incarcerated individuals on HIV care in prisons. The insights gained from this study can contribute to the development of targeted interventions and strategies to improve HIV care and support for incarcerated individuals.

Extent and patterns of drug use in prison in Burkina Faso: findings from a cross-sectional study in central prison of Ouagadougou.

PURPOSE: Drug use in prisons remains a public health concern because it is often the place of drug initiation. The purpose of this study was to analyze the drug use in prison in Burkina Faso. DESIGN/METHODOLOGY/APPROACH: We conducted cross-sectional study in the prison of Ouagadougou. The adult prisoners (male and female) incarcerated for more than one month at the largest prison of Burkina Faso were included in the study. Participants were selected using a systematic random sampling. Data were collected from October 28 to November 26, 2018. The face-to-face interviews were conducted in the prison grounds. Logistic multivariate regression was used to identify factors associated with in prison drug use. All analysis was done using Stata. FINDINGS: A total of 379 prisoners were included in this study. Approximately one-third inmates (32.71%; n = 124) experienced illicit drug in lifetime. Nearly one-third (28.76%; n = 109) of the prisoners were drug users before incarceration and 11.87% (n = 45) used drug inside the prison, of which 33.33% (n = 15) initiated drug use in the prison. Cannabis was the first drug used by the prisoners (71.11%) followed by tramadol (62.22%), diazepam (13.33%) and cocaine (2.22%). Four prisoners (3.63%) had reported Heroin use before incarceration. Cannabis was mainly smoked. Tramadol, diazepam and amphetamines were swallowed or mixed with food. Cocaine is smoked and snorted. Case of injection of cocaine and heroin was reported before incarceration. Main factors independently associated with drug use in prison is drug use before prison and young age of inmates. Indeed, inmates who had reported drug use before prison had 4.01 time {adjusted odd ratio (AOR: 4.01 [95% CI: 1.91-8.41])} higher odds to use drug in prison. RESEARCH LIMITATIONS/IMPLICATIONS: To conduct the interviews in the prison grounds could be a limitation due to social desirability bias. Indeed, the prisoners may understate drug use in prison for the fear of likely additional sentence. Availability of biological tests for drug markers might help addressed this bias. Nevertheless, the findings of this study should help to plan effective drug use prevention and care programs for prisoners. PRACTICAL IMPLICATIONS: The actions must include the implementation of a medical and psychological care in continuum of healthcare system in Burkina Faso. This system should include screening at entry and adequate health and psychological care in prison for drug users for an effective control of drugs use in prison. SOCIAL IMPLICATIONS: Most of these drug users in prison have a low level of education and are unemployed. Education activities and training on occupational activities to prepare drug users for a successful social reintegration less dependent on drugs is essential. This study can be a basis to explore more possibilities and find out what is available to help those with substance use disorder, manage these cases in prison and prevent relapse on release. ORIGINALITY/VALUE: To the best of the authors' knowledge, this study is the first study on drug use in prison in Burkina Faso. It indicates that the repressive strategy against drug use seems ineffective because former users continue their consumption inside and also new users are initiated to use drugs in prison.

Women's Shelter, a prison in reverse: when the protection of victims imprisons them. / Casa-abrigo, uma prisão às avessas: quando a proteção às vítimas as aprisiona.

This article aimed to know a Shelter for women in situations of intimate partner violence at imminent risk of death located in the state of Rio de Janeiro from the perception of its professionals. To this end, this qualitative research adopted semi-structured interviews with seven professionals directly involved with the care and assistance to the Shelter's user population. The findings were interpreted through Bardin's thematic content analysis. Moreover, the profile of the women and children sheltered in 2021 was drawn based on the data provided by the institution. In conceptual terms, this work focused on intersectional feminist theoretical references. Among the results, we argue that the shelter is permeated by contradictions, from its normative idealizations to institutional practices: on the one hand, the shelter represents the possibility of salvation, that is, of interrupting the escalation of violence and, therefore, preventing femicide. However, on the other hand, it appears as an upside-down prison, which "incarcerates" the victims. We highlight the importance of thinking about new ways to ensure protection for women who need this shelter.

O artigo teve como objetivo conhecer uma casa-abrigo para mulheres em situação de violência por parceiros íntimos (VPI) em risco iminente de morte localizada no estado do Rio de Janeiro a partir da percepção de seus profissionais. Para tanto, a pesquisa teve abordagem qualitativa e foram realizadas entrevistas semiestruturadas com sete profissionais envolvidos/as diretamente no atendimento e na assistência às mulheres atendidas pela casa-abrigo. A interpretação dos achados se deu por meio da técnica de análise de conteúdo temática preconizada por Bardin. Além disso, foi traçado o perfil das mulheres e crianças abrigadas no ano de 2021, com base nos dados disponibilizados pela instituição. Em termos conceituais, este trabalho debruçou-se sobre referenciais teóricos feministas interseccionais. Entre os resultados, argumenta-se que a casa-abrigo está permeada por contradições, desde suas normativas às práticas institucionais: por um lado, representa uma possibilidade de "salvação", isto é, de interrupção da escalada da violência e, portanto, de impedimento do feminicídio, mas, por outro, aparece como uma prisão "às avessas", que "prende" as vítimas. Aponta-se a importância e a urgência de pensar novas formas de garantir proteção às mulheres que necessitam desse tipo de abrigamento.