Table 4 Links between key areas of safer tattooing interventions, review findings, gaps in knowledge, and recommended focus for research
From: Safer tattooing interventions in prisons: a systematic review and call to action
Key areas of safer tattooing interventions | Promising strategies based on findings | Gaps in knowledge | Areas for further research |
|---|---|---|---|
Approachability (information provision) | Information and education materials given to all incarcerated people vs. only to tattooists and tattoo recipients. | Effect of information strategies over time on populations, including prison staff. | What information programs best increase awareness of both people in prison and prison staff and increase demand for safer tattooing services? |
Information on safer tattooing as part of an information package on blood-borne infection prevention, treatment, and care. | How to best integrate safer tattooing into a comprehensive infectious disease information package to increase demand for testing and counseling on HIV, HBV, HCV and other key infections? | ||
Are stand-alone information programs on unsafe tattooing risks as effective as providing information combined with safe tattoo room in reducing risks of blood-borne infection transmission through tattooing? | |||
Acceptability | Supervision of a tattoo room by prison staff or by health staff. | Implementation of a tattoo room in prison health clinics (where such clinics are available) vs. in prison workshops. | Which implementation setting and supervision strategy are the most acceptable to people in prison, in addition to being cost-effective and feasible for the detention facility and the health services? |
Implementation of a stepwise model to safer tattooing that considers available resources and acceptability thresholds. | What is the effectiveness, feasibility, acceptability, and sustainability of each of the interventions outlined in a stepwise approach to safer tattooing (information, education and communication; standard precautions and effective sterilization techniques, such as bleach; sterile ink; single-use needles and safe disposal of used needles; tattoo machines; dedicated and supervised tattoo room; and vocational training)? | ||
Availability of safer tattooing services | During non-working hours. | Availability limitations of the tattoo room when managed by health staff vs. prison staff. | How to best professionalize safer tattooing services into an official prison vocational workshop (thus guaranteeing quality services that are available during business hours)? |
Affordability | Below-market costs or free-of-charge tattooing services. | Influence of direct costs borne by recipients on uptake of safer tattooing. | What is the willingness-to-pay of prospective recipients? |
Appropriateness | Provision by people in prison trained to be tattooists. | Provision by trained detainee-tattooists vs. external professional tattooists vs. a combination of both? | What are the feasibility, sustainability, and acceptability of a private-public partnership between the detention center and private professional tattooist? |
Inclusion of other related services. | In addition to safer tattooing services, what are the other services to be offered, including non-health services (e.g. skin piercing), and health services (provision of health information on blood-borne infection prevention and screening)? |