Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners

Kamarulzaman, Adeeba; Reid, Stewart E.; Schwitters, Amee; Wiessing, Lucas; El‐Bassel, Nabila; Dolan, Kate; Moazen, Babak; Wirtz, Andrea L.; Verster, Annette; Altice, Frederick L.

doi:10.1016/s0140-6736(16)30769-3

Cited by 165 publications

(182 citation statements)

References 86 publications

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“…International surveys have shown that a small portion of the world imprisoned population has consistent access to measures for prevention of STIs, highlighting the low frequency of condom use in the prison environment, which, among other factors, has the existence of imposed sexual relations as determinant. (26,27) Condom use is an important measure for the prevention of new cases of hepatitis B, because its efficacy is proven as a physical barrier in the transmission of particles with size similar to that of small STI-causing viruses. In addition, if used correctly, it reduces the risks of slides or ruptures.…”

Section: Discussionmentioning

confidence: 99%

Prevalência de hepatite B e fatores associados em internos de sistema prisional

et al. 2017

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Objective: To estimate the prevalence of HBsAg marker in prisoners of the Brazilian prison system, correlating it to associated factors. Methods: An epidemiological, cross-sectional study was conducted in prison units with closed or semi-open regime (n=12), totaling 2,131 participant prisoners. Data were collected in an interview, followed by rapid testing for Hepatitis B (HBsAg). Simple, bivariate and multivariate descriptive analyses were carried out, with the use of logistic regression with the p value settled at 0.05. Results: The prevalence of positive HBsAg was 0.5%, with a statistically significant association with the variables "does not like to wear condoms" (ORa=3.63) and "does not know how to prevent sexually transmissible diseases" (ORa=5.02). Conclusion: The estimated prevalence was equal to or lower than that found in the general population of the country and the results proved that there are factors statistically associated with the prevalence of HBsAg positivity in the studied population. ResumoObjetivo: Estimar a prevalência do marcador HBsAg em internos de sistema prisional brasileiro, correlacionando-a a fatores associados. Métodos: Pesquisa epidemiológica, transversal, realizada nas unidades prisionais com regime fechado ou semiaberto (n=12), totalizando 2.131 internos participantes. A coleta de dados ocorreu por meio da realização de entrevista, seguida de testagem rápida para Hepatite B (HBsAg). Foram realizadas análises descritivas simples, bivariadas e multivariadas, utilizando-se a Regressão Logística com o valor de p fixado em 0,05. Resultados: A prevalência de HBsAg positivo foi de 0,5%, com associação estatisticamente significativa com as variáveis "não gostar de utilizar preservativo" (ORa=3,63) e "não saber como prevenir infecções sexualmente transmissíveis" (ORa=5,02). Conclusão: A prevalência estimada esteve igual ou menor que a encontrada na população geral do país e comprovou-se que existem fatores estatisticamente associados à prevalência de positividade do HBsAg na população estudada.

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Section: Discussionmentioning

confidence: 99%

Prevalência de hepatite B e fatores associados em internos de sistema prisional

et al. 2017

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“…Prison could be an important setting to deliver HCV prevention interventions, although few countries currently do this(4, 11, 12). In Spanish prisons, PWID experience five-fold lower incidence if on OST(13).…”

Section: Introductionmentioning

confidence: 99%

Modelling the impact of incarceration and prison-based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland

Martin²,

et al. 2017

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Background and AimsPeople who inject drugs (PWID) experience high incarceration rates, and previous incarceration is associated with elevated hepatitis C virus (HCV) transmission risk. In Scotland, national survey data indicate lower HCV incidence in prison than the community (4.3 versus 7.3 per 100 person‐years), but a 2.3‐fold elevated transmission risk among recently released (< 6 months) PWID. We evaluated the contribution of incarceration to HCV transmission among PWID and the impact of prison‐related prevention interventions, including scaling‐up direct‐acting antivirals (DAAs) in prison.DesignDynamic mathematical modelling of incarceration and HCV transmission, using approximate Bayesian computation for model calibration.SettingScotland, UK.ParticipantsA simulated population of PWID.MeasurementsPopulation‐attributable fraction (PAF) of incarceration to HCV transmission among PWID. Decrease in HCV incidence and chronic prevalence due to current levels of prison opiate substitution therapy (OST; 57% coverage) and HCV treatment, as well as scaling‐up DAAs in prison and/or preventing the elevated risk associated with prison release.FindingsIncarceration contributes 27.7% [PAF; 95% credible interval (CrI) –3.1 to 51.1%] of HCV transmission among PWID in Scotland. During the next 15 years, current HCV treatment rates (10.4/6.8 per 1000 incarcerated/community PWID annually), with existing prison OST, could reduce incidence and chronic prevalence among all PWID by a relative 10.7% (95% CrI = 8.4–13.3%) and 9.7% (95% CrI = 7.7–12.1%), respectively. Conversely, without prison OST, HCV incidence and chronic prevalence would decrease by 3.1% (95% CrI = –28.5 to 18.0%) and 4.7% (95% CrI = –11.3 to 14.5%). Additionally, preventing the heightened risk among recently released PWID could reduce incidence and chronic prevalence by 45.0% (95% CrI = 19.7–57.5%) and 33.3% (95% CrI = 15.6–43.6%) or scaling‐up prison HCV treatments to 80% of chronic PWID prison entrants with sufficient sentences (>16 weeks) could reduce incidence and prevalence by 45.6% (95% CrI = 38.0–51.3%) and 45.5% (95% CrI = 39.3–51.0%), respectively.ConclusionsIncarceration and the elevated transmission risk following prison release can contribute significantly to hepatitis C virus transmission among people who inject drugs. Scaling‐up hepatitis C virus treatment in prison can provide important prevention benefits.

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“…Investment in HIV prevention programmes in the community can be made redundant by a complete lack of services within prisons: while community-based NSPs are available in 90 countries, only eight countries provide prison NSPs. Condom programmes, available almost universally in community settings, are only provided in prisons in 28 countries [23]. …”

Section: Discussionmentioning

confidence: 99%

Beyond the 90‐90‐90: refocusing HIV prevention as part of the global HIV response

Baggaley

Dalal

Johnson

et al. 2016

Journal of the International AIDS Society

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IntroductionThe remarkable expansion in availability of antiretroviral therapy (ART) over the past two decades has transformed HIV infection into a manageable chronic condition. People with HIV infection now live long and healthy lives on treatment that is simpler, safer and cheaper. According to UNAIDS estimates, the global coverage of ART reached 46% in 2015, resulting in a 26% decrease in annual HIV-related deaths since 2010. Such success has positioned treatment access at the centre of the global HIV response as a way to prevent mortality, morbidity and HIV transmission through a “Treat All” approach. Continuing expansion of treatment is needed to further reduce HIV-related mortality. This progress with treatment, however, masks a stagnation in the estimated annual number of new HIV infections. Continuing levels of HIV incidence despite treatment scale-up stem from several factors, which should be addressed in order to prevent new infections and decrease the numbers of people requiring treatment in the future.DiscussionART can only reach those already diagnosed, and although it is unclear what proportion of new infections occur during acute and early infection prior to treatment initiation, phylogenetic studies suggest that it might be substantial. Thus, better testing approaches to reach the 40% of people with undiagnosed HIV infection as early as possible are critical. New approaches to reach men, young people and key populations, where HIV risk is highest and HIV prevention, testing and treatment coverage is lowest, are also needed. Overall coverage of effective prevention interventions remains low, enabling HIV transmission to occur, or time is required to show population-level effects. For example, the full impact of the medical male circumcision intervention will be seen once a larger proportion of men in age cohorts with high incidence are circumcised. Finally, strategically focused pre-exposure prophylaxis interventions have the potential to prevent HIV acquisition among populations at substantial risk, averting treatment costs in coming years.ConclusionsThe United Nations (UN) targets to end AIDS include the “90-90-90” targets for HIV diagnosis, treatment and viral suppression. While 90-90-90 has been widely emphasized and adopted by countries and international funders, the focus thus far has largely been on increasing access to ART – the second “90.” A similar emphasis on achieving UN HIV prevention targets and adequate funding for meeting these is essential, alongside treatment, in order to reduce population-level incidence and change the trajectory of the HIV epidemic over the long term.

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Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners

Cited by 165 publications

References 86 publications

Prevalência de hepatite B e fatores associados em internos de sistema prisional

Prevalência de hepatite B e fatores associados em internos de sistema prisional

Modelling the impact of incarceration and prison-based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland

Beyond the 90‐90‐90: refocusing HIV prevention as part of the global HIV response

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