Surveillance and prevention of hepatitis C in Australian prisons

Hepatitis C (HCV) prevalence rates in prisons are even higher than HIV prevalence rates. Studies undertaken in the early and mid 1990s in Canadian prisons revealed rates of between 28 and 40 percent, and rates continue to rise. In one federal prison, 33 percent of study participants tested positive in 1998, compared to 27.9 percent in 1995; and at the Burnaby Correctional Centre for Women in British Columbia, over 78 percent of 69 inmates tested for HCV between 1 January 1996 and 8 August 1996 were seropositive. Similar figures are reported from other countries, including Australia. This raises many challenges for prison systems: how best to provide care and treatment to HCV-positive inmates; and how to prevent the further spread of HCV. Most HCV-positive inmates come to prison already infected, but the potential for further spread is high: HCV is much more easily transmitted than HIV, and transmission has been documented in prisons in several countries, including Canada. In Australia, an action plan for the surveillance and prevention of HCV in prisons has been developed as a result of meetings held in 1998 and 1999. We reproduce here the executive summary of the plan.