HIV/AIDS, hepatitis and tuberculosis-related mortality among incarcerated people: a global scoping review

People in prison are at a higher risk of preventable mortality from infectious disease such as HIV/AIDS, HBV, HCV and TB than those in the community. The extent of infectious disease-related mortality within the prison setting remains unclear. Our aim was to collate available information on infectious disease-related mortality, including the number of deaths and calculate the person-time death rate.

We searched databases between 1 Jan 2000 and 18 Nov 2020 for studies reporting HIV, HBV, HCV, TB and/or HIV/TB-related deaths among people in prison.

We identified 78 publications drawn from seven UNAIDS regions encompassing 33 countries and reporting on 6,568 deaths in prison over a 20-year period. HIV/AIDS (n=3,305) was associated with the highest number of deaths, followed by TB (n=2,892), HCV (n=189), HIV/TB (n=173), and HBV (n=9). Due to the limitations of the available published data, it was not possible to meta-analyse or in any other way synthesise the available evidence.

To our best knowledge, this is the first scoping review focused on deaths due to these infections among people in prison internationally. The gaps identified form recommendations to improve the future collection and reporting of prison mortality data.

To inform targeted efforts to reduce mortality, there is a need for more, better quality data to understand infectious disease-related mortality in custodial settings. Increased investment in the prevention and management of infectious diseases in custodial settings, and in documenting infectious disease-related deaths in prison, is warranted and will yield public health benefits.