Both IDUs and others consulted during this study frequently referred to unsafe injecting within the prison system, and saw prisons as offering fertile ground for the spread of hepatitis C in particular. In detention needles are 'definitely shared, out of necessity', said a worker in Cairns. It is a lot easier to get drugs into prison than a clean needle, commented a Perth stakeholder. As a Canberra interviewee described the situation, 'one fit may be used for three months in a prison wing' – with 30 or 40 people using it over time. Then, 'those prisoners go to other gaols'. In prison, said another stakeholder, 'No fit's clean after the first half hour'. In prison 'the needle gets used till it's falling apart' (Carnarvon worker).

On the other hand, prison was also said to be the most likely place for Indigenous Australians, whether male or female, to receive HCV treatment, and it also offers significant opportunities for BBV education (this is one aspect of the Hoops for Health project in Darwin, for example – see Appendix B 2.2).

The point was made in Melbourne that Aboriginal people tend to be gaoled for offences such as theft and assault (including family violence), rather than for drug offences; imprisonment, however, can lead to the take-up of drugs and drug injecting. 'A lot of our clients have gone into gaol clean and come out with hepatitis C' (because of either injecting or tattooing), said health workers consulted in Canberra. 'Gaols really need to wake up'. A Perth stakeholder made the important observation that prison health tends generally to be a low priority for governments, and that this has particularly negative consequences for the Indigenous population.