Equivalence of care? A scoping review of prison healthcare experiences of women and non-binary people who use drugs.

BACKGROUND

'Equivalence of care' refers to the principle that imprisoned people should receive healthcare services that are equivalent in quality and accessibility to those available in the community, including drug related healthcare. We aimed to examine existing evidence about women and non-binary peoples' experiences of prison-based drug-related healthcare, how this relates to the equivalence of care principle, and how researchers have conceptualised this topic.

METHODS

We conducted a scoping review by searching Scopus and Web of Science databases to identify qualitative research articles published between 1995 and 2023. Articles were subject to a thematic analysis to identify common themes in study findings and the researcher approaches used to address the topic.

RESULTS

A total of 2414 articles were identified; 40 articles met inclusion criteria and were included in this review. The findings are separated into: i) study characteristics and evidence gaps; ii) characteristics of prison experiences; and iii) research approaches to the topic. Themes pertaining to prison experiences include inequivalent 'care', relative relief, and unsupported withdrawal, while researcher approaches were found to include individualising tendencies, variable conceptions of gender, and limited intersectional analyses.

CONCLUSION

While our review found no studies that explicitly used the 'equivalence of care' framework to examine women and non-binary peoples' experiences of prison-based drug healthcare, it identified research that speaks to the harms of incarceration and the poor quality of prison healthcare for this cohort. The implications of this review include the need for researchers to adopt more refined, context-sensitive conceptual tools that can account for the compounded effects of systemic marginalisation in carceral health settings.