Is prison tattooing a risk behaviour for HIV and other viruses? Results from a national survey of prisoners in England and Wales

Background Tattooing has, for more than a century, been recognized as a potential source of transmission of pathogens such as syphilis and hepatitis B. With the advent of HIV and other viruses such as hepatitis C, the extent and nature of tattooing warrants specific study. Tattoos are commonly found on prison inmates, including crude tattoos self‐applied or inflicted by others. The extent to which such prison tattoos might constitute a route of HIV transmission is not known and requires exploration. Method Confidential interviews with 1009 adult male prisoners in 13 prison establishments across England and Wales were conducted in 1994 by independent interviewers. Subjects were randomly selected through the LIDS (Local Inmate Data System), with stratification by prison wing, with a sampling fraction varying between one in four and one in six. An overall consent rate of 72% was achieved. Results A total of 53% (536) of the 1009 interviewees had been tattooed at least once in their lifetime, of whom 21% (111) had been tattooed whilst in prison. Of these, a third had never previously been tattooed. Half of these prison tattoos had been self‐administered, using a wide variety of instruments. However only 20 of the prison tattoos had been applied within the last year. For a quarter (26) of the 111 prison‐tattooed men, the tattoo had been applied at the same time as that of another prisoner. Crude attempts to sterilize the improvized tattooing equipment were commonly applied. Conclusions Despite a high lifetime prevalence of tattooing amongst this group, with a substantial proportion bearing prison‐applied tattoos, the more recent period‐prevalence of tattooing was low. The widely employed diverse cleaning methods suggest potential value in dissemination of advice about more effective hygiene and cleaning methods. Copyright © 2000 Whurr Publishers Ltd.