Search

Introduction: Despite a decline in unintended teenage pregnancy in Australia, rates remain higher amongst justice-involved adolescent girls, who are more likely to be from disadvantaged socio-economic backgrounds, have histories of abuse, substance use and/or mental health issues. Furthermore, exposure to the criminal justice system may alter access to education and employment and opportunities, potentially resulting in distinct risk-factor profiles. We examine factors associated with unintended pregnancy, non-contraceptive use and Long-Acting Reversible Contraception (LARC) in a sample of sexually active, justice-involved adolescent girls from Western Australia and Queensland. Methods: Data from the Mental Health, Sexual Health and Reproductive Health of Young People in Contact with the Criminal Justice System (MeH-JOSH) Study was analysed on 118 sexually active adolescent girls. Participants were aged between 14 and 17 years, purposefully sampled based on justice-system involvement and completed an anonymous telephone survey. We constructed two multivariate models taking reproductive outcomes as the dependent variables. Results: Over one quarter (26%, 30/118) reported a past unintended pregnancy, 54 did not use any contraception at their last sexual encounter, and 17 reported LARC use. Following adjustments in the multivariate analysis, lifetime ecstasy use was associated with both unintended pregnancy (aOR 3.795, p = 0.022) and non-contraception use (aOR 4.562, p = 0.004). A history of physical abuse was also associated with both any contraception (aOR 3.024, p = 0.041) and LARC use (aOR 4.892, p = 0.050). Identifying as Aboriginal & Torres Strait Islander, education/employment status and geographic location appeared to have no association. Conclusion: Our findings suggest that justice-involved adolescent girls have distinct risk factors associated with unplanned pregnancy and contraception use compared to the general population, but more research is required to understand the mechanisms and contexts underlying these risk factors. How exposure to physical violence may encourage contraception and LARC use, in particular, warrants further attention as does the association with ecstasy use. [ABSTRACT FROM AUTHOR]

Background: It is unclear what factors are associated with sexually transmissible infections (STI) and HIV testing and diagnosis among justice-involved adolescents, and if these differ for Aboriginal or Torres Strait Islander peoples. Methods: A cross-sectional survey of 465 justice-involved adolescents (aged 14–17 years) from Australia was conducted between 2016 and 2018. Participants were asked about sexual behaviours, STI/HIV knowledge, and prior STI diagnoses and testing. Results: Approximately 38% (n = 130) of those sexually active had ever been screened for STI/HIV and 17.8% (n = 23) had been diagnosed with an STI. No participant reported living with HIV. For Aboriginal participants, being male (aOR 3.6, 95% CI 1.3–10.1) and having under three sexual partners in the past 12 months (aOR 3.1, 95% CI 1.2–8.0) was associated with never having had an STI/HIV test. For non-Aboriginal participants, being male (aOR 2.7, 95%CI 1.2–5.7), single (aOR 2.4, 95% CI 1.2–4.9), attending school (aOR 2.4, 95% CI 1.1–5.1), not having sought sexual health information (aOR 2.8, 95% CI 1.4–5.8), and having a lower STI/HIV knowledge score (aOR 2.3, 95% CI 1.1–5.0) were associated with never having had an STI/HIV test. Factors associated with STI diagnosis were non-heterosexual sexual orientation (aOR 5.6, 95% CI 1.1–28.2), transactional sex (aOR 11.2, 95% CI 3.0–41.3), and having sought sexual health information (aOR 3.5, 95% CI 1.0–12.5). Conclusions: Males, particularly Aboriginal male adolescents, should be engaged with sexual health promotion and testing services as soon as they come into contact with the justice system. Approaches should consider different cultural, gender and sexual orientations. This paper reports on the sexual behaviours of Aboriginal and non-Aboriginal adolescents who have come into contact with the Australian justice system and looks at factors associated with testing for sexually transmissible infections (STI) and HIV, and diagnosis of sexually transmissible infections. Findings suggest there are different factors associated with STI/HIV testing for Aboriginal and non-Aboriginal justice-involved adolescents. Sexual health education should start early and consider gender, cultural and sexual orientation differences. [ABSTRACT FROM AUTHOR]

Objectives: To overcome key knowledge gaps in relation to justice involved and vulnerable young people and their sexual health and to compare this group with their peers from other youth health surveys in Australia to determine the extent of the issues. Methods: Young people, aged between 14 and 17 years, who had ever been or were currently involved with the criminal justice system were purposively sampled. The survey was anonymous and delivered using Computer Assisted Telephone Interview (CATI). Results: A total of 465 justice involved MeH-JOSH young people, aged between 14 and 17 years, participated in the study: 44% Aboriginal and/or Torres Strait Islander (Indigenous) and 37% not attending school. Of the total valid responses, 76% (n = 348) reported having ever had sex, with sexual initiation at a median age of 14 years. We compared these data with their peers in other Australian surveys and found that young people in our study had a higher engagement in sex and start having sex at a younger age, reporting more sexual partners at all ages. Conclusions: The sexual behaviours of young people involved in the justice system in this study suggest they may be at a greater risk for sexually transmissible infections than their age-matched peers in the general population. Policymakers should elevate them to a priority population for targeting sexual health services and health promotion. [ABSTRACT FROM AUTHOR]

Background: Hepatitis C virus infection (HCV) has a significant global health burden with an estimated 2%–3% of the world's population infected, and more than 350,000 dying annually from HCV-related conditions including liver failure and liver cancer. Prisons potentially offer a relatively stable environment in which to commence treatment as they usually provide good access to health care providers, and are organised around routine and structure. Uptake of treatment of HCV, however, remains low in the community and in prisons. In this study, we explored factors affecting treatment uptake inside prisons and hypothesised that prisoners have unique issues influencing HCV treatment uptake as a consequence of their incarceration which are not experienced in other populations. Method and Findings: We undertook a qualitative study exploring prisoners' accounts of why they refused, deferred, delayed or discontinued HCV treatment in prison. Between 2010 and 2013, 116 Australian inmates were interviewed from prisons in New South Wales, Queensland, and Western Australia. Prisoners experienced many factors similar to those which influence treatment uptake of those living with HCV infection in the community. Incarceration, however, provides different circumstances of how these factors are experienced which need to be better understood if the number of prisoners receiving treatment is to be increased. We developed a descriptive model of patient readiness and motivators for HCV treatment inside prisons and discussed how we can improve treatment uptake among prisoners. Conclusion: This study identified a broad and unique range of challenges to treatment of HCV in prison. Some of these are likely to be diminished by improving treatment options and improved models of health care delivery. Other barriers relate to inmate understanding of their illness and stigmatisation by other inmates and custodial staff and generally appear less amenable to change although there is potential for peer-based education to address lack of knowledge and stigma. [ABSTRACT FROM AUTHOR]

Twenty-four sites in northern Tasmania on Ferrosols formed on Tertiary basalt were sampled in 1997, 2005, and 2010. The farming systems at the sites during this period were either (a) continuous pasture, (b) continuous cropping of vegetable, cereal, and other cash crops in rotation, or (c) a mix of pasture and cropping (intermittent cropping). Average organic carbon (OC) concentrations across all sites and both sample depths (0–150 mm and 150–300 mm) decreased from 4.0% in 1997 to 3.5% in 2005 and 3.3% in 2010 (P< 0.001). Average OC was greater at 0–150 mm (4.1%) than at 150–300 mm (3.1%) (P< 0.001). Average total soil nitrogen (N) in 2010 (0.42%) at 0–150 mm was not significantly different (P = 0.07) from the average in 1997 (0.38%). Soil pH in water (pHw) showed the opposite trend to OC, increasing with time from 6.0 in 1997 to 6.2 in 2010. This reflects the consistent use of calcite and dolomite in Tasmanian farming because the natural pHwof these soils is less than 5.5. Exchangeable calcium and magnesium were also greater in 2010 compared with 1997. Bicarbonate-extractable phosphorus (P) averaged across both depths increased (P< 0.001) steadily from 77 mg kg−1in 1997 to 95 mg kg−1in 2005 to 126 mg kg−1in 2010. At the five sites that remained under continuous cropping throughout the study, average 2010 OC in the topsoil was 3.2%, a decrease of 0.5% since 1997; pHwwas unchanged at 6.4; and bicarbonate-extractable P increased by an average of 73 mg kg−1to 211 mg kg−1. For the three sites that remained in pasture the corresponding topsoil changes were 0.3% less OC to an average of 4.8%; pHw0.4 units greater at 6.0; and 41 mg kg−1more bicarbonate-extractable P to an average of 99 mg kg−1. At the six sites converted from continuous pasture to intermittent cropping the average 2010 topsoil OC was 4.5%, a loss of 1.3%; pHwincreased by 0.5 units to 6.1; and bicarbonate-extractable P increased by 35 mg kg−1to 97 mg kg−1. There was a highly significant (R2= 0.82) exponential relationship between topsoil OC in 2010 and the number of years each site had been cropped during the 38 years 1972–2010, for which reliable records were available (OC = 4.933e−0.018years), which suggested an equilibrium topsoil OC concentration of about 2.5% under continuous cropping on these soils. These results indicate that Tasmanian farmers on Ferrosols continue to increase the pHwand P fertility of their soils and that increasing cropping intensity on these soils comes at the expense of soil carbon. [ABSTRACT FROM AUTHOR]

This study aimed to identify key transitional pathways in the criminal justice system from adolescence to adulthood and the risk factors associated with the escalation of criminal justice involvement over time. We retrospectively linked offending records from 1994 to 2022 and mental health records from 2001 to 2022 for a cohort of 1556 adolescents identified through four health surveys in New South Wales, Australia. Transition probabilities were calculated using the Aalen-Johansen method, and the hazards of transition-specific covariates were estimated. The median age of adolescent entry was 15 years. The cohort was predominantly male (87.5%) and non-Indigenous (65.6%). Among incarcerated adolescents, 76.8% transitioned to adult incarceration. Transition probabilities were the highest among those aged 10–13 years. Among those with mental disorders, psychosis was associated with transitions to adolescent and adult incarceration. Other risk factors for future incarceration include being male, Indigenous, socio-economically disadvantaged, having a history of adolescent incarceration, and being diagnosed with substance use and behavioural disorders. Younger adolescents have higher transition probabilities to more intense criminal justice involvement. Legislative and policy reforms are needed to delay the onset of adolescent criminal justice involvement and ensure age-appropriate rehabilitative strategies to reduce recidivism. • Multi-state modelling can be used to assess criminal justice transitions from adolescence to adulthood. • Younger adolescents have higher probabilities of further incarceration after entry into the criminal justice system. • Adolescent incarceration is associated with adult incarceration and has a leveling effect regardless of age at entry. • Mental disorders increase the risk of incarceration during adolescence and adulthood. [ABSTRACT FROM AUTHOR]

Background: Mental health services are available for young people involved with the criminal justice system. However, they have unmet mental health needs after the expiration of criminal justice supervision., Objective: To determine the incidence rate and identify predictors of psychiatric hospitalisations within 24 months after the expiration of criminal justice supervision among young people involved with the New South Wales (NSW) criminal justice system., Methods: Retrospective data from 1556 individuals aged 14-22 years who participated in four surveys of justice-involved young people in NSW were harmonised and linked to four NSW data collections. We calculated the incidence rates of psychiatric hospitalisations within 24 months postsupervision and identified predictors of these hospitalisations using a competing risks regression analysis., Results: Within 24 months postsupervision, 11.4% had a psychiatric hospitalisation compared with 3.5% during supervision. 20.7% of those admitted had a known history of mental illness and engaged with community-based and outpatient mental health services postsupervision. Predictors of psychiatric hospitalisations were: female sex (adjusted subdistribution HR (asHR) 1.84, 95% CI 1.24 to 2.73); previous incarceration (highest asHR for ≥4 episodes 1.67, 95% CI 1.01 to 2.78); head injury (asHR 1.63, 95% CI 1.20 to 2.21); personality disorder (asHR 3.66, 95% CI 2.06 to 6.48) and alcohol and substance use disorder (asHR 1.89, 95% CI 1.29 to 2.77)., Conclusion: Justice-involved youth have higher rates of psychiatric admissions after criminal justice supervision. Engagement with mental health services postsupervision is important in addressing emerging or persisting mental health needs., Competing Interests: Competing interests: No, there are no competing interests., (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. Published by BMJ.)

Background: Reducing the over-representation of Aboriginal children in the child protection system is a key target for the Australian government., Objective: We aimed to provide more recent evidence on the population-level cumulative incidence of contacts for Aboriginal children with child protective services (CPS) in Western Australia (WA)., Participants and Setting: Linked administrative data was provided for WA CPS between 2000 and 2015 for 33,709 Aboriginal children born in WA between 2000 and 2013., Methods: Descriptive summaries and cumulative incidence estimates were used to examine changes in CPS contact trends over time and within sibling groups., Results: There was an increase in early-childhood contacts for children born more recently, with 7.6 % and 2.3 % of children born in 2000-2001 having a notification and placement in out-of-home care by age one, respectively, compared to 15.1 % and 4.3 % of children born in 2012-2013. Among sibling groups where at least one sibling had a CPS contact, approximately half of children had their first contacts on the same date as another sibling. For children born after one of their siblings had been placed in out-of-home care, 31.9 % had themselves been placed in out-of-home care by age one., Conclusions: Multiple children tend to be placed into out-of-home care when at least one sibling is, which is likely to have a significant impact on families affected. The additional risk of placement also carries over to children born after the first removal in a sibling group, highlighting the need for further support to prevent future removals., (Copyright © 2023 The Authors. Published by Elsevier Ltd.. All rights reserved.)

Health disparities in incarcerated populations should guide investment in the health care and research of these communities. Although users of health-care services are important in providing input into decisions about research, the voices of people in prison are absent regarding research into their health. In this Health Policy paper, we present priorities for research into the health of people in prison according to people in prison themselves. By use of a deliberative research approach, citizens' juries were conducted in six prisons (three men's and three women's prisons) in Australia. Participants were selected following submissions of expression of interest forms that were distributed within the prisons. Prerecorded information by experts in the health of incarcerated people was shown to participants. Participants deliberated for up to 4 h before agreeing on five research priorities. All citizens' juries endorsed mental health as a number one research priority. Prison health-care services, alcohol and other drug use, education, and infectious diseases were identified as research priorities by most citizens' juries. Focal points within priorities included serious mental illness; grief and trauma; medication management; health-care service access, quality, and resources; drug withdrawal and peer support; prison-based needle and syringe programmes; and health and life skills education. If endeavours in research priority setting are to consider health equity goals, the views of our most health affected citizens need to be included., Competing Interests: Declaration of interests PLS reports grants from the National Health and Medical Research Council, during the conduct of the study. TB reports grants from the National Health and Medical Research Council, during the conduct of the study. JG and JJ declare no competing interests., (Copyright © 2021 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY-NC-ND 4.0 license. Published by Elsevier Ltd.. All rights reserved.)

Objective: To describe the social, emotional and physical wellbeing of Aboriginal mothers in prison., Methods: Cross-sectional survey, including a Short Form Health Survey (SF-12) and Kessler Psychological Distress Scale (5-item version) administered to Aboriginal women who self-identified as mothers., Results: Seventy-seven Aboriginal mothers in New South Wales (NSW) and 84 in Western Australia (WA) participated in the study. Eighty-three per cent (n=59) of mothers in NSW were in prison for drug-related offences, 64.8% (n=46) of mothers in WA were in prison for offences committed under the influence of alcohol. Sixty-eight per cent (n=52) of mothers in NSW and 35% (n=28) of mothers in WA reported mental health problems. Physical (PCS) and Mental (MCS) component scores of SF-12 varied for mothers in NSW and WA. Mothers in NSW experienced poorer health and functioning than mothers in WA (NSW: PCS 49.5, MCS 40.6; WA: PCS 54.4, MCS 48.3) and high levels of psychological distress (NSW: 13.1; WA 10.1)., Conclusions: Aboriginal mothers in prison have significant health needs associated with physical and mental health, and psychological distress. Implications for public health: Adoption of social and emotional wellbeing as an explanatory framework for culturally secure healthcare in prison is essential to improving health outcomes of Aboriginal mothers in prison in Australia., (© 2019 The Authors.)

Purpose: The rise in the incarceration of Aboriginal and Torres Strait Islander mothers is a major public health issue with multiple sequelae for Aboriginal children and the cohesiveness of Aboriginal communities. The purpose of this paper is to review the available literature relating to Australian Aboriginal women prisoners' experiences of being a mother., Design/methodology/approach: The literature search covered bibliographic databases from criminology, sociology and anthropology, and Australian history. The authors review the literature on: traditional and contemporary Aboriginal mothering roles, values and practices; historical accounts of the impacts of white settlement of Australia and subsequent Aboriginal affairs policies and practices; and women's and mothers' experiences of imprisonment., Findings: The review found that the cultural experiences of mothering are unique to Aboriginal mothers and contrasted to non-Aboriginal concepts. The ways that incarceration of Aboriginal mothers disrupts child rearing practices within the cultural kinship system are identified., Practical Implications: Aboriginal women have unique circumstances relevant to the concept of motherhood that need to be understood to develop culturally relevant policy and programs. The burden of disease and cycle of incarceration within Aboriginal families can be addressed by improving health outcomes for incarcerated Aboriginal mothers and female carers., Originality/value: To the authors' knowledge, this is the first literature review on Australian Aboriginal women prisoners' experiences of being a mother.