Hepatitis C Testing Protocols Across Massachusetts Jails, 2022-2023: An Opportunity for Intervention

Area of Science:

• Hepatology
• Infectious Diseases
• Public Health Policy

Background:

• Hepatitis C virus (HCV) is a leading cause of liver disease and disproportionately affects incarcerated populations.
• Current HCV testing and treatment policies within the criminal justice system are not standardized.
• Addressing HCV in jails is crucial for mitigating health disparities.

Purpose of the Study:

• To examine and compare Hepatitis C virus (HCV) testing and treatment protocols across Massachusetts county jails.
• To identify variations in current practices regarding HCV screening and management for incarcerated individuals.

Main Methods:

• A cross-sectional study was conducted examining HCV testing and treatment protocols.
• Data were collected from Massachusetts county jails between November 2022 and February 2023.
• Information was gathered through requests for information from jail facilities.

Main Results:

• Of 12 responding jails, 10 used opt-in HCV testing, 1 used opt-out, and 1 had no protocol.
• All jails inquired about HCV history, but only 3 asked about current treatment.
• Jails with treatment policies reported barriers like length-of-stay or sobriety requirements.

Conclusions:

• Policy changes are needed to implement universal opt-out HCV testing in county jails.
• Standardized HCV treatment protocols, including linkage to outpatient care and substance use disorder treatment, are essential.
• Adopting these changes can help address HCV in incarcerated populations and reduce health inequities.