Programs and Services

Hep C Program

The John Howard Society gratefully acknowledges the contribution of the Canadian Liver Foundation, in particular, Manitoba Division’s Jim Nichols’ assistance in guiding our writing team to current hepatitis C information.

The hepatitis C webpage was developed as part of a Public Health Agency of Canada funding initiative that promotes the importance of delivering educational material on hepatitis C.  It is intended to raise awareness among the prison and inmate community with whom John Howard Society works.  We also hope to lend a voice to the growing number of organizations which support the ongoing research and delivery of medical services.  

Hepatitis C is a disease that affects the liver, and it is caused by the hepatitis C virus (HCV).  The virus causes hepatitis (inflammation in the liver), which can progress to cirrhosis (extensive scarring that prevents the liver from performing its normal functions.)  Acute hepatitis means the virus has been present in the person’s blood for less than six months.  Chronic hepatitis means the person has had the virus for more than six months.

Quick Facts1:

It is estimated that only 30% of all HCV-infected persons have been diagnosed in Canada to date (Remis 1998).

By 1998, the number of HCV infections in Manitoba was 6,178.  Since, 1999, there have been approximately 450 to 730 newly diagnosed cases of HCV each year in Manitoba (Manitoba Health 2000, 2001a).

In 2001, the rate of newly diagnosed cases among known residents of Manitoba was 56.9 per 100,000.  Self-reported information describing ethnicity indicated that approximately 75% of those infected were Caucasian and approximately 21% were Aboriginal.

The mode of HCV transmission was determined for only 59% of the cases.  However, the information provided indicated that injection drug use (IDU) accounted for nearly 30% of all individuals who tested positive.  Other identified modes of transmission include recipient of blood products (approximately 18%), tattoos and piercing (approximately 9%), and possible sexual transmission (about 3%)

In Canada, approximately 25% of IDUs reported that they were incarcerated at the time when they first injected drugs.  The prevalence of HCV within prisons in Canada is estimated at between 25% and 40%.  A 1995 Correctional Service Canada’s national inmate survey showed that 11% of 4,285 inmates self-reported IDU at their current institution (CSC 1996).  13% obtained a tattoo in prison, and were unsure about the safety of the equipment used on them at the time (CSC 1996).

The proportion of prisoners with HCV is at least 30 times higher (and in some prisons 100 times higher) than that of Canadians who are not in prison (Canadian HIV/AIDS Legal Network 2002).

Most Frequently Asked Questions:

How do I become infected with Hepatitis C?

Hepatitis C is contracted from blood-to-blood contact.  This means that you probably became infected by blood containing the virus entering your bloodstream.   You many never discover how you contracted hepatitis C, but now that you are aware of your infection, it is up to you to take precautions to protect your family, friends, co-workers, or anyone else who may come in contact with your blood.  If you use common sense and educate people around you with the facts about hepatitis C, you and those around you can live risk free.

What are the symptoms?

Common symptoms affecting people with hepatitis C can include: headaches, nausea, pain below the belly button and/or sharp pain just below the ribs on the right side, night sweats, lack of energy and complete fatigue, low energy causing loss of sex drive, general aches and pains in muscles and joints like the flu, depression, easy bruising or bleeding gums, insomnia, constipation, feeling bloated or diarrhea, dark urine, skin conditions, wounds heal slowly, grouchiness, unclear thinking, diabetes problems especially with First Nations people, and thinning hair.

What happens if I test positive?

Testing positive means that you are infected with the hepatitis C virus. If you test positive, you should take care of yourself, live a healthy lifestyle, and protect others from getting infected.

  • Do not drink alcohol
  • Avoid any drug use
  • Eat a nutritious diet
  • Get vaccinated for hepatitis A & B
  • Do not put others at risk
  • Stay physically active
  • Get regular bloodwork (to monitor the progress of your disease)
  • Ask about treatment

What Hepatitis C services will I receive in Manitoba jails?

Within the Federal institutions, HCV testing is available and encouraged on admission and at any time during custody upon request by an inmate.  Pre and post test counselling is offered by health staff, and HAV/HBV immunization programs are also available.  A mandatory component of the prison admission process is the dissemination of information on HCV, drug use, and harm reduction.  Health education is available in programs such as Choosing Health in Prison (CHIPS), wherein presentations are delivered by a nurse and an inmate every two weeks.  In addition to this, the Inmate Health Awareness groups meet once a week to share health information via guest presenters, inmates, or an in-house nurse.  A number of peer counsellors are also available for one-to-one support and information sharing with inmates.  Condoms and bleach kits are available and accessible in various locations in all institutions. 

Treatment and qualifications for treatment are the same inside prison as they are in the community. Your doctor will order more tests to see you if you qualify.  You will NOT be considered for treatment if you continue:

  • Drinking alcohol
  • Taking IV drugs or snorting cocaine
  • Getting tattoos and body piercings

You must attend all appointments with health services to remain in the treatment program.

How can I protect myself in jail?

Avoid the following:

  • Sharing IV drug needles, rigs, fits, works, filters, cottons, water or cookers
  • Sharing tubes or straws
  • Sharing tattooing equipment like needles, ink or caps
  • Body piercing if sharing needles, pins, rings or studs
  • Sharing personal hygiene items like toothbrushes, razors, nail clippers, or scissors
  • Having unprotected sex
  • Getting in fistfights

How can I protect my loved ones?

The risk of spreading hepatitis C through normal household contact is very low.  But certain safeguards nevertheless need to be taken:

  • Do not share razors, toothbrushes, or any other personal hygiene instrument that could contain blood particles and infect another.
  • Body piercings, snorting drugs, and contaminated intravenous needles can spread hepatitis C.
  • Never have unprotected sex.  Always use a condom.
  • You must not give blood.
  • Menstrual blood is known to carry hepatitis C – women should avoid sex at this time.
  • There is a small chance that the virus can be passed to your newborn during childbirth.

Links of Interest

1Manitoba/Saskatewan Region Hepatitis C Prevention and Community – Based Support Funds: Five Years of Work – 1999-2004.  Migiliardi, Chorney, Majano and Saxena.(2005) Public Health Agency of Canada

 

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Phone: (204) 775-1514
Fax: (204) 775-1670
office@johnhoward.mb.ca