Exploring HIV infection in a UK vulnerable prisoner population in response to newly identified cases.

PURPOSE: Prison populations are considered at elevated risk of blood borne virus (BBV) transmission. Between December 2015 and February 2016, four new cases of HIV infection were diagnosed across two male vulnerable prisoner (VP) custodial units in Wales, UK. Cases were identified through routine BBV testing. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH: As a result of identifying four new HIV cases, targeted BBV testing across the VP units using dried blood spot testing for HIV, Hepatitis C (HCV) and Hepatitis B was undertaken. FINDINGS: A total of 617 men were offered testing, 256 (41 per cent) were tested. No further cases of HIV were identified. Eight men were identified as HCV antibody positive. There was no evidence to suggest the four original cases of HIV were linked. PRACTICAL IMPLICATIONS: Embedding universal BBV screening within prison health provision will ensure timely identification of cases. Further research is needed to better understand BBV transmission risks within subsets of the prison population such as the VP and sex offending groups. ORIGINALITY/VALUE: Little is known about the prevalence of BBVs in vulnerable prison populations. The findings add to the knowledge available for practitioners in the field.

Impact of repeat flooding on mental health and health-related quality of life: a cross-sectional analysis of the English National Study of Flooding and Health.

OBJECTIVE: To assess the association between flooding/repeat flooding and: (1) psychological morbidity (anxiety, depression, post-traumatic stress disorder (PTSD)) and (2) health-related quality of life (HRQoL) at 6 months post-flooding. DESIGN: Cross-sectional analysis of data from the English National Study of Flooding and Health. SETTING: Cumbria, England. PARTICIPANTS: Questionnaires were sent to 2500 residential addresses at 6 months post-flooding; 590 people responded. OUTCOMES: Probable depression was assessed using the Patient Health Questionnaire, probable anxiety using the Generalised Anxiety Disorder scale and probable PTSD using the short-form PTSD checklist (PCL-6). HRQoL was assessed using the EQ-5D-5L. Mental health outcomes were analysed using logistic regression; HRQoL dimensions using ordinal regression; and summary index/Visual Analogue Scale scores using linear regression. RESULTS: One hundred and nineteen participants had been flooded, over half of whom were experiencing a repeat flooding event (54%; n=64). Mental health outcomes were elevated among flooded compared with unaffected participants (adjusted OR for probable depression: 7.77, 95% CI: 1.51 to 40.13; anxiety: 4.16, 95% CI: 1.18 to 14.70; PTSD: 14.41, 95% CI: 3.91 to 53.13). The prevalence of depression was higher among repeat compared with single flooded participants, but this was not significant after adjustment. There was no difference in levels of anxiety or PTSD. Compared with unaffected participants, those flooded had lower EQ-5D-5L index scores (adjusted coefficient: -0.06, 95% CI: -0.12 to -0.01) and lower self-rated health scores (adjusted coefficient: -6.99, 95% CI: -11.96 to -2.02). There was, however, little difference in HRQoL overall between repeat and single flooded participants. CONCLUSIONS: Interventions are needed to help minimise the impact of flooding on people's mental health and HRQoL.