This document explains the evidence base for the guidelines for the prevention, treatment and care of hepatitis C in custodial settings. It has been developed, at the same time as the guidelines, by the Prisons Working Group of the Hepatitis C Subcommittee of the Ministerial Advisory Committee on AIDS, Sexual Health and Hepatitis (MACASHH). Members of the working group have been drawn from Australian state and territory governments including the custodial, drug and alcohol and blood borne virus fields and the community sector (Appendix 1). The guiding principles for this document and other supporting documents are included in Appendix 2.

Many international agreements are relevant to inmate health and well-being and, by extension, to the provision of evidence-based preventive health services. They include the International Covenant on Civil and Political Rights and the International Covenant on Economic, Social and Cultural Rights.

In Australia, the provision of custodial services and their related health services varies across the states and territories. This is a barrier to the development and implementation of policies and programs in response to problems that are common to all jurisdictions. Custodial services across Australia are uniquely placed to provide interventions that will have a positive impact on the prevention, treatment and care of hepatitis C in the prisons and this benefit will consequently flow on to the community. While some areas addressed in this document are acknowledged as being contentious, the guidelines seek to progress these, using available evidence. These guidelines provide a standardised response to hepatitis C for all jurisdictions.

The guidelines have a number of objectives. They identify key issues that impact on the delivery of health care to inmates with hepatitis C and the prevention of hepatitis C transmission within custodial settings. They are premised on the need for inmates to be able to access health services which are equitable with those generally available to the community as a whole. These guidelines promote and assume the adoption of cooperative and collaborative activities between custodial authorities and health service providers to implement strategies to prevent hepatitis C transmission and to treat hepatitis C infection. Finally, the guidelines encourage partnerships between, and across, jurisdictions involved in the provision of custodial services and support to inmates, their families and communities.

The guidelines constitute outcomes or goals which custodial services should seek to achieve rather than a set of absolute standards or laws to be enforced. They represent a statement of national intent, around which each Australian state and territory jurisdiction should develop its own implementation plans and range of relevant legislative, policy and performance standards that can be expected to be amended from time to time to reflect ‘best practice’ and community demands at the state and territory level.

Effective hepatitis C prevention and care in custodial settings requires a collaborative and comprehensive approach. This involves bringing together the broadest range of stakeholders in the design and delivery of prevention and support services for inmates. The primary target audience for this document includes health, justice and human service ministers of state and territory governments and their administrators for custodial settings and the provision of health services in those settings.