Seroprevalence and associated factors of HIV and Hepatitis C in Brazilian high-security prisons: A state-wide epidemiological study

Abstract

The prevalence of hepatitis C virus (HCV) and the acquired immunodeficiency virus (HIV) is much higher in prisons than in community settings. Some explanatory factors for this burden include putative aspects of the prison environment, such as unprotected sexual relations and sexual violence, use of injectable drugs and syringe sharing. Nonetheless, efforts in better understanding the dynamics of both HCV and HIV are scarce in developing countries such as Brazil, which poses a risk not only to the inmates but to the community as well. In this investigation, we sought to determine the seroprevalence and sociodemographic and behavioral risk factors associated with HIV and anti-HCV antibodies among men detained at high-security institutions. This is an epidemiological, proportionally stratified observational study including 1,132 inmates aged 18 to 79 years-old (Mage = 32.58±10.18) from eleven high-security prisons located in the State of Paraná, Brazil. We found that HIV and anti-HCV prevalence were 1.6% (95% CI: 1.0–2.5) and 2.7% (95% CI: 1.0–2.5), respectively. Risk factors associated with HIV included not receiving intimate visits (OR = 8.80, 95% CI: 1.15–66.88), already having another sexually transmitted infection (OR = 3.89, 95% CI: 1.47–10.29), and reporting attendance in HIV preventive campaigns (OR = 4.24, 95% CI: 1.58–11.36). Moreover, anti-HCV seroprevalence was associated with higher age (OR = 4.03, 95% CI: 1.61–10.07), criminal recidivism (OR = 2.58, 95% CI 1.02–6.52), and the use of injectable drugs (OR = 7.32, 95% CI 3.36–15.92). Although prisons might increase the risk for acquiring and transmitting HIV and HCV, the adoption of permanent epidemiological surveillance programs could help reducing the circulation of viruses, involving strategies focusing on screening, treating, and preventing infections to assure proper prisoner health. Moreover, these policies need to take place inside and outside the prison environment to offer continued assistance to former prisoners once they leave the institution.

Retracted: Prevalence of sexually transmitted infections and associated risk behaviors in prisoners: A systematic review

“…In our analysis of 32 publications, 23 papers evaluate the prisoners' educational levels. 3 , 14 , 15 , 16 , 17 , 18 , 19 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 30 , 34 , 35 , 39 , 40 , 42 , 43 , 44 , 50 Most papers had reported that the majority of their participants in the survey/research had low levels of education in comparison to the general population, and mostly only had completed some years of primary/elementary education. Prisoners with no history of institutional education (illiterate) were mentioned by nine articles, and the rate of complete illiteracy among participants ranged from 1.5% to 30.9%.…”

“…In total, 23 studies, reported alcohol or illicit drugs abuse in their study population. 3 , 14 , 15 , 16 , 17 , 19 , 20 , 21 , 23 , 25 , 26 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 39 , 41 , 42 , 50 In regard to alcohol, nine studies reported different rates of alcohol consumption among their incarcerated participants with rates ranging from 20.7% to 81.8%. 14 , 16 , 19 , 23 , 26 , 27 , 29 , 34 , 42 In addition, 22 studies indicated illicit drug abuse in their study population ranging from 6.3% to 78.3%, 3 , 14 , 15 , 16 , 17 , 19 , 20 , 21 , 23 , 25 , 27 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , …”

“…Fifteen studies assessed HIV prevalence among prisoners as follows; the most common laboratory diagnostic methods for HIV detection were HIV 1/2 specific antibodies and HIV Combo Ag/Ab ELISA tests. 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 25 , 28 , 29 , 33 , 40 , 50 The next common tests were the rapid HIV test 14 , 29 , 50 and Immunoblot or Western blot tests. 3 , 23 , 24 , 25 , 40 Some other tests were also used including; chemiluminescent magnetic microparticle immunoassay, enzyme‐linked fluorescence assay, 14 HIV RT1 and RT2‐enzyme immunoassay, 24 HIV viral load, 32 and CD4 lymphocyte counts.…”

“… 14 , 15 , 16 , 17 , 18 , 19 , 20 , 22 , 23 , 25 , 28 , 29 , 33 , 40 , 50 The next common tests were the rapid HIV test 14 , 29 , 50 and Immunoblot or Western blot tests. 3 , 23 , 24 , 25 , 40 Some other tests were also used including; chemiluminescent magnetic microparticle immunoassay, enzyme‐linked fluorescence assay, 14 HIV RT1 and RT2‐enzyme immunoassay, 24 HIV viral load, 32 and CD4 lymphocyte counts. 15 …”

The effect of a theory-based educational program on southern Iranian prisoners’ HIV preventive behaviors: a quasi-experimental research

“…. Prisoners are 7 to 12 times more likely to be infected with HIV than the public [ 4 ]. The outbreak of the disease in Kermanshah Prison in 1995 triggered a national response to HIV [ 2 ].…”