Prison Inmates' Intention to Demand That Bleach Be Used for Cleaning Tattooing and Piercing Equipment
Gagnon, Hélène, Godin, Gaston, Alary, Michel, Lambert, Gilles, Lambert, Léo-Daniel, Landry, Suzanne, Canadian Journal of Public Health
Objective: The aim of this study was to document the phenomenon of tattooing and piercing in prisons in Quebec and to identify factors underlying the intention of inmates to demand that equipment used in prison for piercing and tattooing be cleaned with bleach.
Method: A total of 1,434 inmates recruited in seven prisons completed a questionnaire with the help of a community worker. The questionnaire was developed using an integrative model based on the Theory of Planned Behaviour.
Results: One third of respondents had been tattooed in prison in the past and 2.6% had a piercing; 27.2% of the tattooing and 30.5% of the piercing were carried out using unsafe equipment. Three quarters of the respondents expressed a firm intention to demand that equipment used for tattooing or piercing be cleaned with bleach. Logistic regression analysis showed that personal normative beliefs (OR 5.09; 95% CI 3.54-7.32), perceived behavioural control (OR 3.55; 95% CI 2.48-5.08) and role beliefs (OR 3.23; 95% CI 1.72-6.06) were the significant determinants of intention.
Conclusion: Interventions aimed at encouraging safer tattooing and piercing activities in prison should focus on inmates' sense of responsibility, obstacles impeding adoption of this behaviour and promotion of this behaviour as an integral part of the culture in the prison environment.
MeSH terms: Prisons; HIV; hepatitis C; tattooing; body piercing
Health officials in Canada are increasingly concerned about the rate of infections caused by the human immunodeficiency virus (HIV) and the hepatitis C virus (HCV) among inmates.1 Several studies have shown that the rate of HIV is higher among inmates than among the general population,2,3 and others have demonstrated that the proportion of individuals infected with HCV is even higher than first thought.4 A recent study of inmates in Quebec correctional facilities established the rate of HIV and HCV at 2.3% and 16.6%, respectively, among men and at 8.8% and 29.2%, respectively, among women.5
Several epidemiological studies have associated injection drug use with HIV and HCV infections among inmates;2,4,6 the main risk factor appears to be use of contaminated needles prior to detention. Since HCV is easily transmitted, it has also been associated with other risk factors among inmates, such as tattooing and piercing.7 In 1995, a survey by the Canadian Correctional Service revealed that almost half of all inmates had been tattooed during their stay in prison.8 Since prison regulations forbid piercing and tattooing, the risk of non-sterilized material being used is very high.
Hoping to reduce the risk of HIV and HCV transmission in prison, programs to provide access to bleach have been implemented in most Canadian correctional institutions.9-11 Although the efficacy of bleach as a disinfectant is controversial,12 it has been suggested that its use can help to prevent HIV and HCV infection.13
The aim of this study was to document the phenomenon of tattooing and piercing in prisons in Quebec and to identify factors underlying inmates' intention to demand that tools used in prison for piercing and tattooing be cleaned with bleach.
Ajzen's Theory of Planned Behaviour (TPB)14 served as the basis for organizing the theoretical framework. According to Ajzen,14 the immediate determinant of any behaviour is an intention to do or not to do something in particular. Three fundamental concepts influence intention: attitude, social norms and perceived behavioural control. Attitude designates an individual's favourable or unfavourable assessment of adopting any given behaviour. Social norms correspond to an individual's perception of approval or disapproval of the adoption of any given behaviour by people or a group of people. Perceived behavioural control is defined as the degree of facility or difficulty with which any given behaviour can be adopted. …