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HIV and Viral Hepatitis Among Imprisoned Key Populations
Andrea L Wirtz1, Ping T Yeh2, Natalie L Flath3,4
1Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Epidemiologic Reviews
|April 25, 2018
Summary
Prisons increase the risk of HIV and viral hepatitis transmission. Key populations like people who inject drugs (PWID) and men who have sex with men (MSM) show significantly higher infection rates within correctional facilities.
Area of Science:
- Public Health
- Epidemiology
- Infectious Diseases
Background:
- Prisons and closed facilities are high-risk environments for HIV and viral hepatitis transmission.
- Key populations, including people who inject drugs (PWID), men who have sex with men (MSM), sex workers (SW), and transgender women, are disproportionately affected.
Purpose of the Study:
- To systematically review and meta-analyze the prevalence of HIV, hepatitis C virus (HCV), and hepatitis B virus (HBV) among key populations in prisons globally.
- To compare infection estimates within these key populations to general prison populations.
Main Methods:
- Systematic review and meta-analysis of peer-reviewed publications from 2005-2015.
- Included data from 29 countries, with a focus on PWID and MSM, and limited data on SW and transgender women.
- Analyzed pooled prevalence ratios (PPR) for HIV, HCV, and HBV.
Main Results:
- PWID had significantly higher prevalence of HIV (PPR=6.0), HCV (PPR=8.1), and HBV (PPR=2.0) compared to non-injecting prisoners.
- HIV prevalence was higher among SW (PPR=2.6) and MSM (PPR=5.3) than other prisoners.
- Limited data on prevention programs, with only a few studies reporting methadone therapy or needle exchange for PWID, and minimal HIV prevention coverage reported for SW and transgender women.
Conclusions:
- Key populations in prisons face substantially elevated risks for HIV and viral hepatitis.
- There is a critical need for targeted HIV and viral hepatitis prevention, testing, and treatment programs within correctional facilities, especially for criminalized and marginalized groups.
- Further research is needed to address data gaps for SW and transgender women in carceral settings.
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