title: Trials and tribulations of conducting bio-behavioral surveys in prisons: implementation science and lessons from Ukraine.
abstract: Purpose - Ukraine is home to Europe's worst HIV epidemic, overwhelmingly fueled by people who inject drugs who face harsh prison sentences. In Ukraine, HIV and other infectious diseases are concentrated in prisons, yet the magnitude of this problem had not been quantified. The purpose of this paper is to evaluate the systematic health survey of prisoners in the former Soviet Union (FSU). Design/methodology/approach - Qualitative interviews were carried out with research and prison administrative staff to assess the barriers and facilitators to conducting a bio-behavioral survey in Ukrainian prisons. Findings - Crucial barriers at the institutional, staff, and participant level require addressing by: first, ensuring Prison Department involvement at every stage; second, tackling pre-conceived attitudes about drug addiction and treatment among staff; and third, guaranteeing confidentiality for participants. Originality/value - The burden of many diseases is higher than expected and much higher than in the community. Notwithstanding the challenges, scientifically rigorous bio-behavioral surveys are attainable in criminal justice systems in the FSU with collaboration and careful consideration of this specific context.
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine AND Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University, New Haven, Connecticut, USA.
authors.forename: Lyuba
authors.initials: L
authors.lastname: Azbel
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
authors.forename: Yevgeny
authors.initials: Y
authors.lastname: Grishaev
authors.affiliation: Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University, New Haven, Connecticut, USA.
authors.forename: Jeffrey A
authors.initials: JA
authors.lastname: Wickersham
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine AND Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University, New Haven, Connecticut, USA.
authors.forename: Olena
authors.initials: O
authors.lastname: Chernova
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine.
authors.forename: Sergey
authors.initials: S
authors.lastname: Dvoryak
authors.affiliation: Ukrainian Institute on Public Health Policy, Kyiv, Ukraine AND Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University, New Haven, Connecticut, USA.
authors.forename: Maxim
authors.initials: M
authors.lastname: Polonsky
authors.affiliation: Department of Internal Medicine, Section of Infectious Diseases, AIDS Program, Yale University, New Haven, Connecticut, USA AND Division of Epidemiology of Microbial Diseases, School of Public Health, Yale University, New Haven, Connecticut, USA.
authors.forename: Frederick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D000328:Adult; D003141:Communicable Diseases / Q000453:epidemiology* / Q000635:transmission; D003219:Confidentiality / Q000592:standards*; D004196:Disease Outbreaks / Q000517:prevention & control* / Q000706:statistics & numerical data; D005260:Female; D015658:HIV Infections / Q000453:epidemiology; D015438:Health Behavior; D006306:Health Surveys / Q000379:methods; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology; D006801:Humans; D007407:Interviews as Topic; D008297:Male; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons / Q000458:organization & administration / Q000592:standards*; D036301:Qualitative Research; D019966:Substance-Related Disorders / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology; D014455:Ukraine / Q000453:epidemiology
keywords: Ethics; Former Soviet Union; Health status; Implementation science research; Infectious diseases; Prisoners; Substance use disorders; Ukraine