Safer tattooing interventions in prison: a systematic review and call to action
Creators: name: Tran, Nguyen Toan
Publisher: name: Université de Genève
Year: 2018
Subjects: info:eu-repo/classification/ddc/616.89
Tattoo
Prison
Harm reduction

description: Background: Worldwide more than ten million people are incarcerated at any given time. Between 5 and 60% of people experiencing incarceration report receipt of a tattoo in prison – mostly clandestine, which is associated with risks of blood-borne infections. Although safer tattooing techniques are effective in preventing the transmission of blood-borne infections and available to the general population, there is limited knowledge about the impact of safer tattooing strategies in prison settings in terms of health outcomes, changes in knowledge and behaviors, and best practice models for implementation. The objective of this research was to identify and review safer tattooing interventions in prison settings. Methods: We conducted a systematic review of the literature using search strings which combined terms related to safer tattooing with terms related to detention. Forward and backward snowballing was used to capture additional studies. Studies of all design types were included if they were published until 27 June 2018, the population was incarcerated adults, they reported quantitative outcomes, and were published in English, French, or Spanish. The authors identified during an international conference an unpublished safer tattooing project, for which in-depth interviews with key actors were conducted to capture their current practice. Results: Of 55 papers retrieved from the initial search, no peer-reviewed article was identified. One paper from the grey literature described a multi-site pilot project in Canada. Its evaluation suggested that the project was effective in enhancing knowledge of incarcerated people and prison staff on standard precautions, had the potential to reduce harm, provided vocational opportunities, and was feasible although enhancements were needed to improve implementation issues and efficiency. Conclusions: Although access to preventive services, including to safer tattooing interventions, is a human right and recommended by United Nations agencies as part of a comprehensive package of harm reduction interventions in prisons and other closed settings, this review identified only a few promising strategies for safer tattooing interventions in detention settings. We call upon governments, criminal justice authorities, non-governmental organizations, and academic institutions to implement safer tattooing projects in prisons. These interventions should adhere to the following guiding principles: i) integration of methodologically-rigorous implementation research; ii) involvement in the project design, implementation, and research of key stakeholders, including people who are incarcerated, criminal justice and prison authorities, and research partners; iii) integration into a comprehensive package of blood-borne infection prevention, treatment, and care, using a stepwise approach that considers local resources and acceptability; and iv) publication and dissemination of findings, and scaling up efforts.