Seroprevalence and factors associated with hepatitis B virus exposure in the incarcerated population from southern Brazil.

Hepatitis B viral infection (HBV) in prisons poses serious public health challenges because it significantly contributes to the increase in both morbidity and mortality indicators worldwide. Research has shown high HBV prevalence among inmates when compared to the general population. In this study, we estimated the prevalence of HBV exposure and its risk factors among 1,132 inmates detained in high security institutions. A cross-sectional, epidemiological study was carried out in 11 male-only prisons in the State of Paraná, Brazil, between May 2015 to December 2016. HBV exposure was explored using a variety of methods, including HBsAg, anti-HBs, and total anti-HBc. Data were analyzed using univariate and multivariate techniques. The overall prevalence of HBV exposure was 11.9% (95% CI: 10.9-12.8), totaling 135 individuals. In the multivariate analyses, risk factors that remained statistically significant were related to the penitentiary location (Francisco Beltrão; OR = 5.59; 95% CI: 3.32-9.42), age (over 30 years; OR = 5.78; 95% CI: 3.58-9.34), undergoing tattooing procedures in prison (OR = 1.64; 95% CI: 1.03-2.60), self-reported sexual activities with a known drug user (OR = 1.67; 95% CI: 1.12-2.48) and having a history of previous history of hepatitis B or C infection (OR = 2.62; 95% CI: 1.48-4.64). The findings indicate that public policies-including vaccination, early diagnosis, harm reduction strategies, and adequate treatment-should be designed and delivered in the same way for both the incarcerated and the general population in order to reduce the prevalence of HBV and its associated consequences.

Condiciones de trabajo y salud de los funcionarios de prisiones en Paraná (Brasil) / Working conditions and health of prison officers in Paraná (Brazil)

Objetivos: Este estudio transversal fue realizado para identificar las asociaciones y las condiciones de trabajo y salud entre losagentes penitenciarios en una prisión estatal de Paraná, Brasil.Material y método: Se utilizó una muestra aleatoria proporcional y estratificada de 125 individuos. Los participantes respondieron, de forma anónima, un cuestionario autoadministrado.Resultados: Los resultados mostraron prevalencia de trastornos psiquiátricos menores (TPM) de 30,4% (intervalo de confianza[IC] del 95%: 22,4-39,2); el 17,9% presentaron estrés persistente (IC del 95%: 12,2-25,2); el 66,4% presentaron hasta cincoquejas relacionadas con la salud (IC del 95%: 58,4-75,2); y el 9,6% tenían un mayor riesgo de abuso y/o dependencia del alcohol (IC del 95%: 4,8-16,0). Los análisis multivariantes mostraron que, con el resultado de los TPM, los problemas de salud (p<0,01), el ambiente físico (p <0,013) y los riesgos organizacionales (p <0,01) fueron factores predictores significativos. El estréspersistente fue un predictor con la edad (p = 0,031), los problemas de salud (p <0,01) y los riesgos organizacionales (p = 0,023);mientras que las quejas de salud se asociaron con problemas de salud (p <0,01) y el entorno físico (p <0,01). No había predictores significativos para riesgos de abuso y/o dependencia del alcohol.Discusión: En general, los resultados demostraron la naturaleza precaria del trabajo del agente penitenciario, revelan la importancia de la realización de nuevos estudios para evaluar si se trata de una realidad específica de la unidad investigada o si estosresultados son comunes en otros entornos penitenciarios. (AU)

Objectives: This cross-sectional study was carried out to identify the associations between working and health conditionsamong prison officers at a state prison in Paraná, Brazil. Material and method: A proportional and stratified random sample of 125 individuals was used. The participants, who werenot identified, completed a self-administered questionnaire.Results: The results showed a prevalence of minor psychiatric disorders (MPD) of 30.4% (95%CI: 22.4-39.2). A total of 17.9%of the respondents had persistent stress (95%CI: 12.2-25.2), 66.4 had up to five health-related complaints (95%CI: 58.4-75.2)and 9.6% had scores that indicated higher risk for alcohol abuse and/or dependance (95%CI:4.8-16.0). Multivariate analyses showed that with an MPD outcome, health problems (p<0.01), physical environment (p=0.013) and organizational risks(p<0.01) were significant predictors. Persistent stress was predicted by age (p=0.031), health problems (p<0.01) and organizational risks (p=0.023), while health complaints were associated with health problems (p<0.01) and physical environment (p<0.01).There were no significant predictors for higher risk for alcohol abuse and/or dependance.Discussion: In general, the results demonstrate the precarious nature of the work of prison officers, and reveal the importanceof further studies to evaluate whether this is a specific reality of the unit that was investigated, or whether these results arecommon in other prison environments. (AU)

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

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.