The role of primary care providers in hepatitis C treatment for people in Canadian prison systems
Bibliographic record
Abstract
People in custody in Canadian provincial prisons experience disproportionately high rates of hepatitis C virus infection. Despite national and international calls for hepatitis C elimination, treatment access remains inconsistent within correctional settings. This integrative review examines the barriers primary care providers face in delivering hepatitis C care to people in custody in Canada. Following Whittemore and Knafl’s (2005) five-step framework, nine peerreviewed studies published between 2015 and 2024 were analyzed using thematic synthesis. Studies included qualitative, quantitative, and mixed method designs, and were drawn from Canada, Australia Austria, the United States, and international contexts. Five global themes emerged: (1) inconsistencies in screening, treatment access, and healthcare systems across institutions; (2) variable access to opioid agonist therapy and harm-reduction services; (3) challenges in implementing opt-out hepatitis C screening; (4) poor linkage to care post-release; and (5) education gaps among both providers and people in custody. Barriers were found to be compounded by the coercive nature of correctional environments, institutional fragmentation, and limited continuity of care. The review supports recommendations for transferring healthcare oversight to public health authorities, expanding nurse practitioner-led care, implementing harm reduction practices, and strengthening intersectoral collaboration to improve system level coordination. Addressing these systemic issues is essential to meeting hepatitis C elimination targets and improving health equity for incarcerated populations.,
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.009 | 0.029 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.003 | 0.005 |
| Science and technology studies | 0.008 | 0.003 |
| Scholarly communication | 0.007 | 0.002 |
| Open science | 0.002 | 0.002 |
| Research integrity | 0.002 | 0.002 |
| Insufficient payload (model declined to judge) | 0.004 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".