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Walker SJ, Shrestha LB, Lloyd AR, Dawson O, Sheehan Y, Sheehan J, Maduka NBC, Cabezas J, Akiyama MJ, Kronfli N. Barriers and advocacy needs for hepatitis C services in prisons: Informing the prisons hepatitis C advocacy toolkit. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2024; 126:104386. [PMID: 38492433 PMCID: PMC11106844 DOI: 10.1016/j.drugpo.2024.104386] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2023] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/18/2024]
Abstract
BACKGROUND Carceral settings are a key focus of the 2030 WHO global hepatitis C virus (HCV) elimination goals. Despite this, access to HCV testing and treatment services in prisons remains low globally, limiting opportunities to achieve these goals. Advocacy efforts are needed to address service inequities and mobilise support for enhanced HCV programs in prisons globally. INHSU Prisons, a special interest group of the International Network on Health and Hepatitis in Substance Users (INHSU) is developing a Prisons HCV Advocacy Toolkit to address this need. Here we present findings of a mixed study to inform the development of the Toolkit. METHODS The aim of this study was to inform the development of the Toolkit, including understanding barriers for scaling up prison-based HCV services globally and advocacy needs to address these. An online survey (n = 181) and in-depth interviews (n = 25) were conducted with key stakeholders from countries of different economic status globally. Quantitative data were statistically analysed using R Studio and qualitative data were analysed thematically. The data sets were merged using a convergent design. RESULTS Key barriers for enhanced prison-based HCV services included lack of political will and action, lack of prison-based healthcare resources, and poor awareness about HCV and the importance of prison-based HCV services. These findings underscore how advocacy efforts are needed to motivate policymakers to prioritise HCV healthcare in prisons and ensure funds are available for services (including diagnostic tools and treatment, healthcare teams to implement services, and systems to measure their success). Advocacy resources to raise the awareness of policy makers, people working in the prison sector, and incarcerated populations were also identified as key to increasing HCV service uptake. CONCLUSION The Toolkit has the potential to support advocacy efforts for reaching HCV elimination targets. By understanding the advocacy needs of potential Toolkit end-users, the findings can inform its development and increase its accessibility, acceptability, and uptake for a globally diverse audience.
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Affiliation(s)
- Shelley J Walker
- National Drug Research Institute, Curtin University, Perth, Australia; Burnet Institute, Melbourne, Australia; Public Health and Preventative Medicine, Monash University, Melbourne, Australia.
| | - Lok B Shrestha
- The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia; School of Biomedical Sciences, University of New South Wales (UNSW), Sydney, Australia
| | - Andrew R Lloyd
- The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia
| | - Olivia Dawson
- The International Network on Health and Hepatitis in Substance Users (INHSU)
| | - Yumi Sheehan
- The Kirby Institute, University of New South Wales (UNSW), Sydney, Australia
| | | | | | - Joaquin Cabezas
- Gastroenterology and Hepatology Department, University Hospital Marques de Valdecilla, Santander, Spain; Clinical and Translational Research in Digestive Diseases, Valdecilla Research Institute (IDIVAL), Santander, Spain
| | - Matthew J Akiyama
- Department of Medicine, Albert Einstein College of Medicine / Montefiore Medical Centre, New York, USA
| | - Nadine Kronfli
- Department of Medicine, Division of Infectious Diseases and Chronic Viral Illness Service, McGill University Health Centre, Montréal, Québec, Canada; Centre for Outcomes Research and Evaluation, Research Institute of the McGill University Health Centre, Montréal, Québec, Canada
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Mongale E, Allen S, Brew I, Ludlow-Rhodes A, Royal N, Waldron J, Alexander H, Christensen L, Dorrington K, Milner A, Missen L, Jones A, Troke PJ. Development and optimisation of a reception testing protocol designed to eliminate HCV in the UK prison population. JHEP Rep 2024; 6:100937. [PMID: 38169900 PMCID: PMC10758963 DOI: 10.1016/j.jhepr.2023.100937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2023] [Revised: 09/29/2023] [Accepted: 10/05/2023] [Indexed: 01/05/2024] Open
Abstract
Background & Aims Micro-elimination of hepatitis C virus (HCV) in high-risk populations is a feasible approach towards achieving the World Health Organization's targets for viral hepatitis elimination by 2030. Prisons represent an area of high HCV prevalence and so initiatives that improve testing and treatment of residents are needed to eliminate HCV from prisons. This initiative aimed to improve the HCV screening and treatment rates of new residents arriving at prisons in England. Methods A rapid test and treat pathway was developed and implemented in 47 prisons in England between May 2019 and October 2021 as a healthcare service improvement initiative. Prison healthcare staff performed opt-out HCV testing for all new residents at each prison within 7 days of arrival, and those who were positive for HCV RNA were offered treatment with direct-acting antivirals (DAAs). The Hepatitis C Trust provided peer support for all residents on treatment and those who were released into the community. Results Of 107,260 new arrivals, 98,882 (92.2%) were offered HCV antibody testing, 63,137 (63.9%) were tested and 1,848 were treated. Testing rates increased from 53.7% in Year 1 to 86.0% in Year 3. Between May 2020 and October 2021, 40,727 residents were tested, 2,286 residents were positive for HCV antibodies and 940 residents were HCV RNA positive, giving an antibody prevalence of 5.6% and an RNA prevalence of 2.3%. A total of 921 residents were referred for treatment and 915 initiated DAA treatment (97.3% of whom were HCV RNA positive). Conclusions This initiative showed that an opt-out HCV test and treat initiative in prison receptions is feasible and can be adapted to the needs of individual prisons as a viable way to achieve HCV micro-elimination. Impact and implications Prisons represent an area of high HCV prevalence and so initiatives that improve testing and treatment of residents are needed to eliminate HCV from prisons. The reception testing protocol improved HCV screening in new arrivals across 47 prisons in England and could be a viable way for countries to achieve HCV micro-elimination in their prison systems. The reception testing protocol presented here can be adapted to the individual needs of prisons, globally, to improve HCV screening and treatment in this setting.
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Affiliation(s)
- Emily Mongale
- Practice Plus Group, 5–6 Napier Court, Napier Road, Berkshire RG1 8BW, UK
| | - Samantha Allen
- Practice Plus Group, 5–6 Napier Court, Napier Road, Berkshire RG1 8BW, UK
| | - Iain Brew
- Practice Plus Group, 5–6 Napier Court, Napier Road, Berkshire RG1 8BW, UK
| | | | - Nichola Royal
- Practice Plus Group, 5–6 Napier Court, Napier Road, Berkshire RG1 8BW, UK
| | - Julia Waldron
- Practice Plus Group, 5–6 Napier Court, Napier Road, Berkshire RG1 8BW, UK
| | - Hannah Alexander
- Practice Plus Group, 5–6 Napier Court, Napier Road, Berkshire RG1 8BW, UK
- Defence Primary Healthcare, UK
| | | | | | - Andrew Milner
- Gilead Sciences Ltd, 280 High Holborn, London WC1V 7EE, UK
| | - Louise Missen
- Gilead Sciences Ltd, 280 High Holborn, London WC1V 7EE, UK
| | - Andy Jones
- Gilead Sciences Ltd, 280 High Holborn, London WC1V 7EE, UK
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Halford R, Christensen L, Cox S, Sheehan J, Brew I, Gillyon‐Powell M, Threadgold G, O'Moore É, Troke PJF, Jones A. Chronic hepatitis C elimination prison initiative: HCV-intensive test and treat, a whole prisoner population HCV test-and-treat program in England. Health Sci Rep 2023; 6:e1724. [PMID: 38125280 PMCID: PMC10730947 DOI: 10.1002/hsr2.1724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 10/11/2023] [Accepted: 11/03/2023] [Indexed: 12/23/2023] Open
Abstract
Background and Aim Prison residents are at high risk for hepatitis C virus (HCV) infection. HCV test-and-treat initiatives within prisons provide an opportunity to engage with prison residents and achieve HCV micro-elimination. The aim of the prison HCV-intensive test and treat initiative was to screen over 95% of all prison residents for HCV infection within a defined number of days determined by the size of the prison population and to initiate treatment within 7-14 days of a positive HCV RNA diagnosis. Methods An HCV-intensive test and treat toolkit was developed based on learnings from pilot HCV-intensive test and treat events. From January 2020 to September 2021, 13 HCV-intensive test and treat events took place at prisons in England selected based on high levels of reception blood-borne virus testing and good access to peers from The Hepatitis C Trust. Results Among a total of 8487 residents, 8139 (95.9%) underwent testing for HCV. Across the 13 prisons included, HCV antibody and RNA prevalence was 8.2% and 1.5%, respectively. The treatment initiation rate among HCV RNA-positive individuals (n = 124) was 79.0%. Conclusion The HCV-intensive test and treat initiative presented here provides a feasible and rapid test-and-treat process to achieve HCV elimination within individual prisons. The HCV-intensive test and treat toolkit can be adapted for rapid HCV testing and treatment events at other prisons in the United Kingdom and worldwide.
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Eisen L, Mor Z, Madar M, Rabinovitch R, Dadon Y, Sheffer R, Kaliner E, Goldstein L. Hepatitis C Virus Elimination Program among Prison Inmates, Israel. Emerg Infect Dis 2023; 29:2358-2361. [PMID: 37877627 PMCID: PMC10617329 DOI: 10.3201/eid2911.230728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2023] Open
Abstract
The Israeli Prison Services implemented a hepatitis C virus (HCV) elimination program in 2020. Inmates considered high risk for HCV were offered serology; HCV-seropositive participants were offered HCV RNA testing. Among participants, 7.0% had detectable HCV RNA and were offered antiviral drug therapy. This program reduced HCV burden among incarcerated persons.
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Affiliation(s)
| | | | - Miriam Madar
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Ron Rabinovitch
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Yuval Dadon
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Rivka Sheffer
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Ehud Kaliner
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
| | - Liav Goldstein
- Ministry of Health, Tel-Aviv Department of Health, Tel Aviv, Israel (L. Eisen, R. Sheffer)
- Ashkelon Academic College, Ashkelon, Israel (Z. Mor)
- Central Department of Health, Ministry of Health, Ramla, Israel (Z. Mor, E. Kaliner)
- Israel Prison Service, Israel (M. Madar, R. Rabinovitch, L. Goldstein)
- Deputy Director Office, Ministry of Health, Jerusalem, Israel (Y. Dadon)
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Van Hout MC, Fleißner S, Stöver H. # Me Too: Global Progress in Tackling Continued Custodial Violence Against Women: The 10-Year Anniversary of the Bangkok Rules. TRAUMA, VIOLENCE & ABUSE 2023; 24:515-529. [PMID: 34342249 PMCID: PMC10012393 DOI: 10.1177/15248380211036067] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Indexed: 05/03/2023]
Abstract
On any given day, almost 11 million people globally are deprived of their liberty. In 2020, the global female population was estimated to be 741,000, an increase of 105,000 since 2010. In order to investigate progress in the adoption of the Bangkok Rules since 2010, we conducted a legal realist assessment based on a global scoping exercise of empirical research and United Nations (UN) reporting, using detailed MESH terms across university and UN databases. We found evidences in 91 documents which directly relate to violations of the Bangkok Rules in 55 countries. By developing a realist account, we document the precarious situation of incarcerated women and continued evidence of systemic failures to protect them from custodial violence and other gender-sensitive human rights breaches worldwide. Despite prison violence constituting a complex and multifaceted phenomenon, very little research (from the United States, Canada, Brazil, Mexico, and Australia) has been conducted on custodial violence against women since 2010. Although standards of detention itself is a focus of UN universal periodic review, special procedures (violence against women) and concluding observations by the UN committees, very few explicitly mentioned women, and the implications of violence against them while incarcerated. We highlight three central aspects that hinder the full implementation of the Bangkok Rules; the past decade of a continued invisible nature of women as prisoners in the system; the continued legitimization, normalization, and trivialization of violence under the pretext of security within their daily lives; and the unawareness and disregard of international (Bangkok and others) rules.
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Affiliation(s)
- Marie Claire Van Hout
- Public Health Institute, Liverpool John Moores University, United Kingdom
- Marie Claire Van Hout, Public Health Institute, Liverpool John Moores University, United Kingdom.
| | - Simon Fleißner
- Faculty of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
| | - Heino Stöver
- Faculty of Health and Social Work, Frankfurt University of Applied Sciences, Frankfurt am Main, Germany
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Chen GJ, Sun HY, Chang SY, Su LH, Chen YT, Hsieh SM, Liu WD, Sheng WH, Huang YS, Lin KY, Su YC, Liu WC, Hung CC. Sexually-transmitted hepatitis C virus reinfections among people living with HIV in Taiwan: the emerging role of genotype 6. Emerg Microbes Infect 2022; 11:1227-1235. [PMID: 35412439 PMCID: PMC9067974 DOI: 10.1080/22221751.2022.2065933] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Abstract
Hepatitis C virus (HCV) reinfections after successful treatment with direct-acting antivirals (DAAs) pose a significant challenge to HCV elimination, especially among high-risk people living with HIV (PLWH). In this study, PLWH who had achieved HCV viral clearance with DAAs were included between January 2018 and June 2021. PLWH having acquired HCV infections after 2017 were classified as "recent-infection group," and those before 2017 as "remote-infection group," and the incidences of HCV reinfection were compared between two groups. Clinical and behavioural characteristics were evaluated to identify associated factors with HCV reinfection. A total of 284 PLWH were included: 179 in the recent-infection group and 105 in the remote-infection group. After a median follow-up of 2.32 years (interquartile range [IQR], 0.13-3.94), the overall incidence of HCV reinfection was 5.8 per 100 person-years of follow-up (PYFU). The incidence in the recent-infection group was significantly higher than that in the remote-infection group (9.8 vs. 0.4 per 100 PYFU, p < 0.001). The leading HCV genotypes before DAA treatment were genotypes 2 (31.0%), 1b (26.8%), and 6 (21.8%); however, genotype 6 (58.8%) became predominant upon reinfection. Younger age (adjusted odds ratio [aOR] per 1-year increase, 0.95; 95% CI, 0.90-0.99), condomless receptive anal sex (aOR, 14.5; 95% CI, 2.37-88.8), rimming (aOR, 3.87; 95% CI, 1.14-13.1), and recent syphilis (aOR, 2.73; 95% CI, 1.26-5.91) were linked to HCV reinfections. In conclusion, PLWH acquiring HCV after 2017 had a significantly higher risk for sexually-transmitted HCV reinfections. The predominance of HCV genotype 6 reinfections suggests possible on-going clustered HCV infections among at-risk PLWH.
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Affiliation(s)
- Guan-Jhou Chen
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Min-Sheng General Hospital, Taoyuan, Taiwan
| | - Hsin-Yun Sun
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sui-Yuan Chang
- Department of Clinical Laboratory Sciences and Medical Biotechnology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Laboratory Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Li-Hsin Su
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Ting Chen
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Szu-Min Hsieh
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wan-Da Liu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wang-Huei Sheng
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Shan Huang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Kuan-Yin Lin
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Ching Su
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Wen-Chun Liu
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Chien-Ching Hung
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Tropical Medicine and Parasitology, National Taiwan University College of Medicine, Taipei, Taiwan.,Department of Medical Research, China Medical University Hospital, Taichung, Taiwan.,China Medical University, Taichung, Taiwan
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Valentim JLRS, Dias-Trindade S, Oliveira ESG, Moreira JAM, Fernandes F, Romão MH, Morais PSG, Caitano AR, Dias AP, Oliveira CAP, Coutinho KD, Ceccim RB, Valentim RAM. The relevancy of massive health education in the Brazilian prison system: The course "health care for people deprived of freedom" and its impacts. Front Public Health 2022; 10:935389. [PMID: 36033741 PMCID: PMC9399509 DOI: 10.3389/fpubh.2022.935389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 07/26/2022] [Indexed: 01/25/2023] Open
Abstract
Introduction Brazil has one of the largest prison populations globally, with over 682,000 imprisoned people. Prison health is a public health emergency as it presents increasingly aggravating disease rates, mainly sexually transmitted infections (STI). And this problem already affects both developed and developing nations. Therefore, when thinking about intervention strategies to improve this scenario in Brazil, the course "Health Care for People Deprived of Freedom" (ASPPL), aimed at prison health, was developed. This course was implemented in the Virtual Learning Environment of the Brazilian Health System (AVASUS). Given this context, this study analyzed the aspects associated with massive training through technological mediation and its impacts on prison health. Methods This cross-sectional study analyzed data from 8,118 ASPPL course participants. The data analyzed were collected from six sources, namely: (i) AVASUS, (ii) National Registry of Health Care Facilities (CNES), (iii) Brazilian Occupational Classification (CBO), (iv) National Prison Department (DEPEN); (v) Brazilian Institute of Geography and Statistics (IBGE); and the (iv) Brazilian Ministry of Health (MoH), through the Outpatient Information System of the Brazilian National Health System (SIA/SUS). A data processing pipeline was conducted using Python 3.8.9. Results The ASPPL course had 8,118 participants distributed across the five Brazilian regions. The analysis of course evaluation by participants who completed it shows that 5,190 (63.93%) reported a significant level of satisfaction (arithmetic mean = 4.9, median = 5, and standard deviation = 0.35). The analysis revealed that 3,272 participants (40.31%) are health workers operating in distinct levels of care. The prison system epidemiological data shows an increase in syphilis diagnosis in correctional facilities. Conclusions The course enabled the development of a massive training model for various health professionals at all care levels and regions of Brazil. This is particularly important in a country with a continental size and a large health workforce like Brazil. As a result, social and prison health impacts were observed.
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Affiliation(s)
- Janaína L. R. S. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
| | - Sara Dias-Trindade
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
- Centre for Interdisciplinary Studies, Faculty of Arts and Humanities, University of Coimbra, Coimbra, Portugal
| | - Eloiza S. G. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
- Institute of Human Formation with Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Paraná, Brazil
| | - José A. M. Moreira
- Centre for Interdisciplinary Studies, University of Coimbra, Coimbra, Portugal
- Department of Education and Distance Learning (DEED), Open University (Universidade Aberta), Lisbon, Portugal
| | - Felipe Fernandes
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Manoel H. Romão
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Philippi S. G. Morais
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Alexandre R. Caitano
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Aline P. Dias
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Carlos A. P. Oliveira
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
- Institute of Human Formation with Technologies, State University of Rio de Janeiro (UERJ), Rio de Janeiro, Paraná, Brazil
- International Council for Open and Distance Education, Oslo, Norway
| | - Karilany D. Coutinho
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
| | - Ricardo B. Ceccim
- Postgraduate Program in Education, Federal University of Rio Grande do Sul (UFRGS), Porto Alegre, Rio Grande do Sul, Brazil
| | - Ricardo A. M. Valentim
- Laboratory of Technological Innovation in Health (LAIS), Federal University of Rio Grande do Norte (UFRN), Natal, Rio Grande do Norte, Brazil
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Tavoschi L. Treatment-as-prevention in prison settings: a growing evidence base for HCV elimination efforts. Lancet Gastroenterol Hepatol 2021; 6:512-513. [PMID: 33965005 DOI: 10.1016/s2468-1253(21)00133-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/26/2021] [Revised: 03/26/2021] [Accepted: 03/26/2021] [Indexed: 11/17/2022]
Affiliation(s)
- Lara Tavoschi
- Department of Translational Research and new Technologies in Medicine and Surgery, University of Pisa, Pisa, Italy.
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Abstract
People in prison are disproportionately affected by viral hepatitis. To examine the current epidemiology of and responses targeting hepatitis B virus (HBV) in prisons across the European Union, European Economic Area and United Kingdom, we analysed HBV-specific data from the World Health Organization's Health in Prisons European Database and the European Centre for Disease Prevention and Control's hepatitis B prevalence database. Hepatitis B surface antigen seroprevalence ranged from 0% in a maximum-security prison in United Kingdom to 25.2% in two Bulgarian juvenile detention centres. Universal HBV screening on opt-out basis and vaccination were reported available in 31% and 85% of 25 countries, respectively. Disinfectants, condoms and lubricants were offered free of charge in all prisons in the country by 26%, 46% and 15% of 26 countries, respectively. In 38% of reporting countries, unsupervised partner visits with the possibility for sexual intercourse was available in all prisons. The findings are suggestive of high HBV prevalence amidst suboptimal coverage of interventions in prisons. A harmonised monitoring system and robust data at national and regional levels are needed to better understand the HBV situation in prisons within the framework of the European action plan and Global Health Sector Strategy on viral hepatitis.
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