Interventions to Increase Hepatitis B Testing Uptake Amongst Detained Populations: A Systematic Review.

Area of Science:

• Public Health
• Infectious Disease Epidemiology
• Health Services Research

Background:

• Detained populations exhibit higher hepatitis B virus (HBV) prevalence compared to the general population.
• Limited testing uptake in correctional facilities hinders progress towards the World Health Organization's 2030 HBV elimination targets.

Purpose of the Study:

• To systematically review interventions designed to enhance hepatitis B testing uptake among individuals in prison settings.
• To analyze factors influencing testing uptake, including screening approach, sex, and geographical region.

Main Methods:

• A systematic review of quantitative interventional studies published between January 2000 and April 2025, identified through searches of MEDLINE, EMBASE, CENTRAL, and CINAHL.
• Quality appraisal using the JBI critical appraisal tool and a random effects meta-analysis to estimate pooled testing uptake.
• Subgroup analyses were conducted to explore heterogeneity across different screening approaches, sex, and geographical regions.

Main Results:

• Sixteen papers representing 15 studies were included, with most conducted in Europe.
• The pooled hepatitis B testing uptake was 64%.
• Opt-in interventions demonstrated significantly higher testing uptake (77%) compared to opt-out interventions (33%), potentially due to associated counseling and tailored approaches.

Conclusions:

• Opt-in hepatitis B screening programs are associated with greater testing uptake in prisons than opt-out programs.
• Further research is necessary to evaluate enhanced screening approaches for cost-effectiveness and scalability in diverse settings.
• Robust studies are needed to identify the most effective and scalable screening programs to improve HBV testing in correctional facilities.