Relationships Matter: Social Capital Theory and Hepatitis C Treatment Uptake among Men in Prison

Abstract

Social capital is a valuable social resource that has the potential to influence health outcomes at both the individual and community level. The mechanisms upon which this occurs are extensive and are explored within this thesis. Hepatitis C is highly prevalent in the prison setting, with an estimated HCV-antibody prevalence of 26% among the global prison population. Although HCV treatment is available in the prison setting, a number of barriers exist resulting in low treatment uptake. This PhD thesis explores the social capital of men in prison living with hepatitis C. Chapter 1 of this thesis provides an overview of social capital, presents prisoner demographics in the Australian setting, and outlines hepatitis C prevalence among the prisoner population, risk factors for hepatitis C, and changes in the hepatitis C treatment landscape. Chapter 2 (published in Health & Justice) is a systematic literature review of social capital in the prison setting. Chapter 3 (published in Health & Justice) draws on thirty qualitative interviews completed with male inmates living with hepatitis C to identify social capital dimensions in the prison setting (e.g., trust and safety, reciprocity, agency, formal and informal networks). Chapter 4 (published in Social Science & Medicine) explores contextual differences of social capital between Aboriginal and non-Aboriginal inmates living with hepatitis C. The fifth chapter (published in the Journal of Viral Hepatitis) explores social capital (specifically, bonding and linking social capital) and its influence on hepatitis C education and treatment access in the prison setting. Following on from the qualitative interviews, the Inmate Social Capital Questionnaire – HCV (ISCQ-HCV) was developed for use with male inmates. Chapter 6 reports on the piloting of the ISCQ-HCV (to be submitted for publication). Chapter 7 provides discussion of the overall work within this thesis and includes suggestions and recommendations for practical changes within the prison setting to improve HCV treatment uptake among those incarcerated. Findings from this PhD research show that social capital theory is a useful strategy for exploring HCV treatment uptake among men in prison. It is anticipated that the results of this study are transferable to other health interventions among those incarcerated