ABSTRACT
More people with hepatitis C virus pass through incarcerated settings each year than any other venue. The goal of this study was to assess inmates' attitudes towards hepatitis C testing and treatment while incarcerated. We interviewed 153 male and female inmates at the Rhode Island Department of Corrections (RIDOC). Ninety-one per cent of inmates said they would agree to be tested for hepatitis C and 95% said that they would be willing to be treated for hepatitis C while incarcerated. Thirty-three per cent perceived themselves to be at risk for hepatitis C. Inmates were very interested in hepatitis C testing and, if indicated treatment. Inmates' attitudes towards hepatitis C testing and treatment do not pose a major obstacle to implementing comprehensive hepatitis C screening and treatment programme in correctional settings.
Subject(s)
Attitude to Health , Hepatitis C/diagnosis , Hepatitis C/drug therapy , Prisoners , Adult , Cross-Sectional Studies , Female , Humans , Male , Mass Screening , Patient ComplianceABSTRACT
Hepatitis C virus (HCV) and hepatitis B virus (HBV) are highly prevalent, often co-occurring infections among drug users. We examined HBV prevalence and risk behaviour patterns among a group of HCV-negative heroin and/or cocaine users in order to understand HBV risk and prevention opportunities among this unique group. Of 164 people enrolled, 44% had injected drugs. Overall, 24% of participants tested positive for exposure to HBV; drug injectors (28%) were only slightly and not significantly (P=0.287) more likely to test positive than those who had never injected drugs (21%). HBV exposure was significantly associated with multiple indicators of greater sex risk. HBV status was not associated with any demographic characteristic, but participants who reported longer duration of cocaine use were significantly less likely to test positive to exposure for HBV. It appears that HBV risk among HCV-negative drug users in this cohort is primarily due to sexual behaviour.
Subject(s)
Cocaine-Related Disorders/complications , Hepatitis B/etiology , Heroin Dependence/complications , Sexual Behavior , Adult , Female , Humans , Logistic Models , Male , Middle Aged , Risk-TakingABSTRACT
OBJECTIVE: Incarcerated populations are a group at high risk for hepatitis B. About 30% of people experiencing acute hepatitis B virus infection (HBV) have a history of incarceration. Offering routine HBV vaccinations to incarcerated individuals could have a significant effect on public health. The objective of this study is to identify current vaccine practices and the perceived feasibility of routine vaccinations for hepatitis B within correctional settings. METHOD: The authors surveyed the medical directors of state correctional facilities in all 50 states and the federal prison system regarding current HBV vaccine practices. Surveys were faxed or mailed between July 1 and September 1, 2000. RESULTS: Thirty-five states and the federal system responded (response rate = 70.6%). These systems account for 77% of all inmates in federal or state prisons and jails. Two states give hepatitis B vaccine routinely, nine states offer no hepatitis B vaccine, and 26 states and the Federal Bureau of Prisons offer hepatitis vaccine to some inmates. Most states do not spend enough money to vaccinate even those prisoners at highest risk. Under the Vaccine for Children program, 19,520 youths could receive vaccine immediately. According to the respondents, if vaccine were available at no-cost, 25 states and the Federal Bureau of Prisons would routinely offer vaccination to all inmates. CONCLUSIONS: Most correctional systems do not routinely offer vaccine to their incarcerated populations, but would if funds were available. There exists now a unique public health opportunity to prevent a significant proportion of new hepatitis B infections.
