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Simpson PL, Gardoll B, White L, Butler T. HIV policies in Australian prisons: a structured review assessing compliance with international guidelines. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100813. [PMID: 38223398 PMCID: PMC10786648 DOI: 10.1016/j.lanwpc.2023.100813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 01/16/2024]
Abstract
Globally, people living with the Human Immunodeficiency Virus (HIV) are over-represented in incarcerated populations. The current study aimed to provide a national (Australian) snapshot of current HIV prison policies against the United Nations' (UN) 15 key HIV interventions for prisons. Publicly available policies, reports, and data were obtained, and interviews were conducted with prison health staff in five of eight Australian jurisdictions. We rated whether policies were compliant, partially compliant, or not compliant to the UN interventions and assigned an overall grade (A to E, where A = most compliant and E = least compliant) for each jurisdiction. Three jurisdictions received a B grade, three received a C grade, and two were not assessed due to insufficient data. In all jurisdictions HIV policies fell short of full compliance to most UN interventions. Prison-based needle and syringe programs and initiatives beyond education to reduce HIV transmission from body modification procedures (eg, tattooing) were absent in all jurisdictions. No condom programme existed in one jurisdiction and access issues were reported in others. Opioid substitution therapy, and peer-education access varied across and within most jurisdictions. Findings indicate that more action is required to meet the UN recommended interventions for HIV prevention in prisons.
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Affiliation(s)
- Paul L. Simpson
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bree Gardoll
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Luella White
- Faculty of Law and Justice, University of New South Wales, Sydney, New South Wales, Australia
| | - Tony Butler
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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Hibbert M, Simmons R, Harris H, Desai M, Sabin CA, Mandal S. Investigating rates and risk factors for hepatitis C virus reinfection in people receiving antiviral treatment in England. J Viral Hepat 2023; 30:646-655. [PMID: 36929670 DOI: 10.1111/jvh.13835] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2022] [Revised: 02/06/2023] [Accepted: 03/11/2023] [Indexed: 03/18/2023]
Abstract
England has committed to the World Health Organization target to eliminate hepatitis C virus (HCV) as a public threat by the year 2030. Given successful treatments for HCV in recent years, it is unclear whether HCV reinfection will impact England's ability to achieve HCV elimination. We aimed to estimate the HCV reinfection rate among a cohort of patients receiving antiviral treatment using available surveillance data. Linkage between a treatment dataset from 2015 to 2019 and an HCV RNA testing dataset were used to identify people who experienced reinfection using three criteria. A Cox proportional hazards model was used to determine risk factors associated with HCV reinfection among a cohort who received treatment and had follow-up HCV RNA testing. The reinfection rate among those receiving HCV treatment was 7.91 per 100 person-years (PYs, 95% confidence interval (CI) 7.37-8.49) and highest among current injecting drug users (22.55 per 100 PYs, 95% CI 19.98-25.46) and people who had been in prison (20.42 per 100 PYs, 95% CI 17.21-24.24). In the adjusted model, women had a significantly reduced risk of reinfection. Being of younger age, current injecting drug users, and receipt of first treatment in prison were each significantly associated with increased risk of reinfection. Two-fifths of those with reinfection (43%, n = 329/767) were linked to treatment after reinfection, and of those starting treatment, three quarters (75%, n = 222/296) achieved a sustained virologic response. Guidance for testing groups at risk of reinfection and harm reduction strategies to minimize transmission should be implemented if England is to achieve HCV elimination targets.
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Affiliation(s)
- Matthew Hibbert
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency (UKHSA), London, UK
- National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UKHSA, London, UK
| | - Ruth Simmons
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency (UKHSA), London, UK
- National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UKHSA, London, UK
| | - Helen Harris
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency (UKHSA), London, UK
| | - Monica Desai
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency (UKHSA), London, UK
- National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UKHSA, London, UK
| | - Caroline A Sabin
- National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UKHSA, London, UK
- Institute for Global Health, University College London, London, UK
| | - Sema Mandal
- Blood Safety, Hepatitis, Sexually Transmitted Infections and HIV Division, UK Health Security Agency (UKHSA), London, UK
- National Institute for Health and Care Research Health Protection Research Unit (NIHR HPRU) in Blood Borne and Sexually Transmitted Infections at University College London in partnership with UKHSA, London, UK
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3
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Busschots D, Kremer C, Bielen R, Koc ÖM, Heyens L, Nevens F, Hens N, Robaeys G. Hepatitis C prevalence in incarcerated settings between 2013–2021: a systematic review and meta-analysis. BMC Public Health 2022; 22:2159. [PMID: 36419013 PMCID: PMC9685883 DOI: 10.1186/s12889-022-14623-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Accepted: 11/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background The introduction of highly effective direct-acting antiviral therapy has changed the hepatitis C virus (HCV) treatment paradigm. However, a recent update on HCV epidemiology in incarcerated settings is necessary to accurately determine the extent of the problem, provide information to policymakers and public healthcare, and meet the World Health Organization's goals by 2030. This systematic review and meta-analysis were performed to determine the prevalence of HCV Ab and RNA in incarcerated settings. Methods For this systematic review and meta-analysis, we searched PubMed, Embase, Scopus, and Web of Science for papers published between January 2013 and August 2021. We included studies with information on the prevalence of HCV Ab or RNA in incarcerated settings. A random-effects meta-analysis was done to calculate the pooled prevalence and meta-regression to explore heterogeneity. Results Ninety-two unique sources reporting data for 36 countries were included. The estimated prevalence of HCV Ab ranged from 0.3% to 74.4%. HCV RNA prevalence (available in 46 sources) ranged from 0% to 56.3%. Genotypes (available in 19 sources) 1(a) and 3 were most frequently reported in incarcerated settings. HCV/HIV coinfection (available in 36 sources) was highest in Italy, Estonia, Pakistan, and Spain. Statistical analysis revealed that almost all observed heterogeneity reflects real differences in prevalence between studies, considering I2 was very high in the meta-analysis. Conclusions HCV in incarcerated settings is still a significant problem with a higher prevalence than in the general population. It is of utmost importance to start screening for HCV (Ab and RNA) in incarcerated settings to give clear, reliable and recent figures to plan further treatment. This is all in the context of meeting the 2030 WHO targets which are only less than a decade away. Trial registration PROSPERO: CRD42020162616 Supplementary Information The online version contains supplementary material available at 10.1186/s12889-022-14623-6.
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[Addiction management in prisons]. SOINS; LA REVUE DE REFERENCE INFIRMIERE 2022; 67:48-52. [PMID: 36681507 DOI: 10.1016/j.soin.2022.11.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
High levels of substance-related disorders among incarcerated people have been documented and there is a lot of drug users in French prisons. Several health and social workers are involved in the management of people dealing with addictions in prison. The coordination between substance use and mental health services in correctional settings and in the community is fundamental to ensure treatment continuity for these people.
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Georgieva E, Benkova K, Vlaeva N, Karamalakova Y, Miteva R, Abrashev H, Nikolova G. Is Illicit Substance Use Gender-Specific? The Basic Points of Mental and Health Disorders. TOXICS 2022; 10:toxics10070344. [PMID: 35878250 PMCID: PMC9323370 DOI: 10.3390/toxics10070344] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 05/16/2022] [Revised: 06/15/2022] [Accepted: 06/20/2022] [Indexed: 12/20/2022]
Abstract
Among the groups of users of illicit substances, a high percentage are persons deprived of their liberty; at the same time, each social and age group is also affected, to one degree or another. The purpose of this study is to provide general data on the relationship between different psychostimulants, clinical and socio-demographic studies, and gender, both among the general population and in one of the most at-risk groups. This review identifies the use of illicit substances as gender-specific in the general population. A detailed study of the causal relationship between the use of illicit substances and gender was carried out. Electronic databases Academic Search Complete, PubMed, HealthCare, Web of Science, and Google Scholar were searched for relevant studies up to 2022 associated with drug abuse and mental and health disorders. The analysis indicated that the human population showed significant differences between the sex of the consumer as to the type of drug consumers, development of addiction, and relapse. We focus on the pathological changes caused by drug use, the personal and physiological individual traits that influence drug choice, and the extent of use in one of the most affected groups of individuals. The study may provide some guidance in developing gender-specific treatment and prevention, including response to some pharmacological and behavioral therapies. The review is intended for a wide audience of social workers, toxicologists, and pharmacologists.
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Affiliation(s)
- Ekaterina Georgieva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Faculty of Medicine, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (E.G.); (R.M.)
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Krasimira Benkova
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
| | - Nadya Vlaeva
- Department of Medical Psychology, Social Activities and Foreign Languages, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (K.B.); (N.V.)
| | - Yanka Karamalakova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Radostina Miteva
- Department of General and Clinical Pathology, Forensic Medicine, Deontology and Dermatovenerology, Faculty of Medicine, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria; (E.G.); (R.M.)
| | - Hristo Abrashev
- Department of Vascular Surgery, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
| | - Galina Nikolova
- Department of Chemistry and Biochemistry, Medical Faculty, Trakia University, 11 Armeiska Str., 6000 Stara Zagora, Bulgaria;
- Correspondence: ; Tel.: +359-897-771-301
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Chandra Deb L, Hove H, Miller TK, Pinks K, Njau G, Hagan JJ, Jansen RJ. Epidemiology of Hepatitis C virus infection among incarcerated populations in North Dakota. PLoS One 2022; 17:e0266047. [PMID: 35349606 PMCID: PMC8963564 DOI: 10.1371/journal.pone.0266047] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2021] [Accepted: 03/12/2022] [Indexed: 12/09/2022] Open
Abstract
This retrospective cohort study was conducted to determine the prevalence of HCV infections among individuals incarcerated in a state prison system and identify potential contributing factors to HCV infection. North Dakota Department of Corrections and Rehabilitation (NDDOCR) data from 2009 to 2018 was used and period prevalence was calculated for this 10-year time period. The period prevalence of HCV infection was (15.13% (95% CI 14.39–15.90) with a marginally significant (p-value: 0.0542) increasing linear trend in annual prevalence over this period. Multivariate logistic regression analysis was used to identify risk factors associated with HCV infection. The main significant independent risk factors for HCV infection in this incarcerated population were age >40 years [OR: 1.78 (1.37–2.32)]; sex [OR: 1.21 (1.03–1.43)]; race/ethnicity [OR: 1.97 (1.69–2.29)]; history of intravenous drug use (IVDU) [OR: 7.36 (6.41–8.44)]; history of needle or syringe sharing [OR: 7.57 (6.62–8.67)]; and alcohol use [OR: 0.87 (0.77–0.99)]. Study limitations include uncollected information on sexual history, frequency or duration of injection drug use and blood transfusion history of the incarcerated population. Considering the high prevalence of HCV infection and its associated risk factors, it is important to implement prevention programs such as syringe/needle exchanges and counsel with imprisoned IVD users.
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Affiliation(s)
- Liton Chandra Deb
- Department of Public Health, North Dakota State University, Fargo, ND, United States of America
- Department of Population Health and Pathobiology, College of Veterinary Medicine, North Carolina State University, Raleigh, NC, United States of America
| | - Hannah Hove
- Department of Public Health, North Dakota State University, Fargo, ND, United States of America
- University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, United States of America
| | - Tracy K. Miller
- North Dakota Department of Health, Bismarck, ND, United States of America
| | - Kodi Pinks
- North Dakota Department of Health, Bismarck, ND, United States of America
| | - Grace Njau
- North Dakota Department of Health, Bismarck, ND, United States of America
| | - John J. Hagan
- North Dakota Department of Corrections and Rehabilitation, Bismarck, ND, United States of America
| | - Rick J. Jansen
- Department of Public Health, North Dakota State University, Fargo, ND, United States of America
- Genomics, Phenomics, and Bioinformatics Program, North Dakota State University, Fargo, ND, United States of America
- Center for Immunization Research and Education (CIRE), North Dakota State University, Fargo, ND, United States of America
- Center for Diagnostic and Therapeutic Strategies in Pancreatic Cancer, North Dakota State University, Fargo, ND, United States of America
- * E-mail:
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Wiessing L, Kalamara E, Stone J, Altan P, Van Baelen L, Fotiou A, Garcia D, Goulao J, Guarita B, Hope V, Jauffret-Roustide M, Jurgelaitienė L, Kåberg M, Kamarulzaman A, Lemsalu L, Kivite-Urtane A, Kolarić B, Montanari L, Rosińska M, Sava L, Horváth I, Seyler T, Sypsa V, Tarján A, Yiasemi I, Zimmermann R, Ferri M, Dolan K, Uusküla A, Vickerman P. Univariable associations between a history of incarceration and HIV and HCV prevalence among people who inject drugs across 17 countries in Europe 2006 to 2020 – is the precautionary principle applicable? Euro Surveill 2021; 26. [PMID: 34886941 PMCID: PMC8662800 DOI: 10.2807/1560-7917.es.2021.26.49.2002093] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2022] Open
Abstract
Background People who inject drugs (PWID) are frequently incarcerated, which is associated with multiple negative health outcomes. Aim We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe. Methods Aggregate data from PWID recruited in drug services (excluding prison services) or elsewhere in the community were reported by 17 of 30 countries (16 per virus) collaborating in a European drug monitoring system (2006–2020; n = 52,368 HIV+/−; n = 47,268 HCV+/−). Country-specific odds ratios (OR) and prevalence ratios (PR) were calculated from country totals of HIV and HCV antibody status and self-reported life-time incarceration history, and pooled using meta-analyses. Country-specific and overall population attributable risk (PAR) were estimated using pooled PR. Results Univariable HIV OR ranged between 0.73 and 6.37 (median: 2.1; pooled OR: 1.92; 95% CI: 1.52–2.42). Pooled PR was 1.66 (95% CI 1.38–1.98), giving a PAR of 25.8% (95% CI 16.7–34.0). Univariable anti-HCV OR ranged between 1.06 and 5.04 (median: 2.70; pooled OR: 2.51; 95% CI: 2.17–2.91). Pooled PR was 1.42 (95% CI: 1.28–1.58) and PAR 16.7% (95% CI: 11.8–21.7). Subgroup analyses showed differences in the OR for HCV by geographical region, with lower estimates in southern Europe. Conclusion In univariable analysis, a history of incarceration was associated with positive HIV and HCV serostatus among PWID in Europe. Applying the precautionary principle would suggest finding alternatives to incarceration of PWID and strengthening health and social services in prison and after release (‘throughcare’).
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Affiliation(s)
- Lucas Wiessing
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Eleni Kalamara
- EASO MTC Block A, Winemakers Wharf, Grand Harbour Valletta, Malta
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Jack Stone
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
| | - Peyman Altan
- Ministry of Health, Public Health General Directorate, Ankara, Turkey
| | - Luk Van Baelen
- Sciensano, Epidemiology and public health, Lifestyle and chronic diseases, Brussels, Belgium
| | - Anastasios Fotiou
- University Mental Health, Neurosciences, & Precision Medicine Research Institute, Athens, Greece
| | - D’Jamila Garcia
- NOVA FCSH – Universidade Nova de Lisboa, Lisbon, Portugal
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Joao Goulao
- General Director on Addictive Behaviours and Dependencies, Ministry of Health, Lisbon, Portugal
| | - Bruno Guarita
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Vivian Hope
- Public Health Institute, Liverpool John Moores University, Liverpool, United Kingdom
| | - Marie Jauffret-Roustide
- Santé Publique France, Saint-Maurice, France
- British Columbia Centre on Substance Use (BCCSU), Vancouver, Canada
- Centre d’Étude des Mouvements Sociaux (Inserm U1276/CNRS UMR8044/EHESS), Paris, France
- Baldy Center for Law and Social Policy, Buffalo University of Social Sciences, New York, United States
| | - Lina Jurgelaitienė
- Social Innovations and Science Centre, Vilnius, Lithuania
- Drug, Tobacco and Alcohol Control Department, Vilnius, Lithuania
| | - Martin Kåberg
- Department of Medicine Huddinge, Division of Infection and Dermatology, Karolinska Institutet, Karolinska University Hospital Huddinge, Stockholm, Sweden
- Stockholm Needle Exchange, Stockholm Centre for Dependency Disorders, Stockholm, Sweden
| | - Adeeba Kamarulzaman
- Department of Medicine, Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia
| | - Liis Lemsalu
- Centre for Prevention of Drug Addiction and Infectious Diseases, National Institute for Health Development, Tallinn, Estonia
| | | | - Branko Kolarić
- Medical Faculty, University of Rijeka, Rijeka, Croatia
- Andrija Stampar Teaching Institute of Public Health, Zagreb, Croatia
| | - Linda Montanari
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Magdalena Rosińska
- National Institute of Public Health NIH – National Research Institute, Warsaw, Poland
| | - Lavinius Sava
- National Antidrug Agency – Ministry of Internal Affairs, Bucharest, Romania
| | - Ilonka Horváth
- Gesundheit Österreich GmbH – Austrian National Public Health Institution, International Affairs and Consulting, Vienna, Austria
| | - Thomas Seyler
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Vana Sypsa
- Department of Hygiene, Epidemiology and Medical Statistics, Medical School, National and Kapodistrian University of Athens, Athens, Greece
| | - Anna Tarján
- Hungarian Reitox National Focal Point, Budapest, Hungary
| | - Ioanna Yiasemi
- Monitoring Department, Cyprus National Addictions Authority, Nicosia, Cyprus
| | - Ruth Zimmermann
- Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
| | - Marica Ferri
- European Monitoring Centre for Drugs and Drug Addiction (EMCDDA), Public Health Unit, Lisbon, Portugal
| | - Kate Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, Sydney, Australia
| | - Anneli Uusküla
- Department of Family Medicine and Public Health, University of Tartu, Tartu, Estonia
| | - Peter Vickerman
- Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, United Kingdom
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Stengaard AR, Combs L, Supervie V, Croxford S, Desai S, Sullivan AK, Jakobsen SF, Santos Q, Simões D, Casabona J, Lazarus JV, de Wit JBF, Amort FM, Pharris A, Nerlander L, Raben D. HIV seroprevalence in five key populations in Europe: a systematic literature review, 2009 to 2019. EURO SURVEILLANCE : BULLETIN EUROPEEN SUR LES MALADIES TRANSMISSIBLES = EUROPEAN COMMUNICABLE DISEASE BULLETIN 2021; 26. [PMID: 34823636 PMCID: PMC8619876 DOI: 10.2807/1560-7917.es.2021.26.47.2100044] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Abstract
Background In Europe, HIV disproportionately affects men who have sex with men (MSM), people who inject drugs (PWID), prisoners, sex workers, and transgender people. Epidemiological data are primarily available from national HIV case surveillance systems that rarely capture information on sex work, gender identity or imprisonment. Surveillance of HIV prevalence in key populations often occurs as independent studies with no established mechanism for collating such information at the European level. Aim We assessed HIV prevalence in MSM, PWID, prisoners, sex workers, and transgender people in the 30 European Union/European Economic Area countries and the United Kingdom. Methods We conducted a systematic literature review of peer-reviewed studies published during 2009–19, by searching PubMed, Embase and the Cochrane Library. Data are presented in forest plots by country, as simple prevalence or pooled across multiple studies. Results Eighty-seven country- and population-specific studies were identified from 23 countries. The highest number of studies, and the largest variation in HIV prevalence, were identified for MSM, ranging from 2.4–29.0% (19 countries) and PWID, from 0.0–59.5% (13 countries). Prevalence ranged from 0.0–15.6% in prisoners (nine countries), 1.1–8.5% in sex workers (five countries) and was 10.9% in transgender people (one country). Individuals belonging to several key population groups had higher prevalence. Conclusion This review demonstrates that HIV prevalence is highly diverse across population groups and countries. People belonging to multiple key population groups are particularly vulnerable; however, more studies are needed, particularly for sex workers, transgender people and people with multiple risks.
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Affiliation(s)
- Annemarie Rinder Stengaard
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Lauren Combs
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Virginie Supervie
- Sorbonne Université, INSERM, Institut Pierre Louis d'Epidémiologie et de Santé Publique, Paris, France
| | | | | | - Ann K Sullivan
- Directorate of HIV and Sexual Health, Chelsea and Westminster Hospital NHS Foundation Trust, London, United Kingdom
| | - Stine Finne Jakobsen
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Quenia Santos
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Daniel Simões
- EPIUnit-Instituto de Saúde Pública, Universidade do Porto, Rua das Taipas, n° 135, Porto, Portugal.,Grupo de Ativistas em Tratamentos (GAT), Lisboa, Portugal
| | - Jordi Casabona
- Centre d'Estudis Epidemiològics sobre les Infeccions de Transmissió Sexual i Sida de Catalunya (CEEISCAT), Barcelona, Spain.,Centro de Investigación Biomédica en Red de Epidemiología y Salud Pública (CIBERESP), Barcelona, Spain
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Barcelona, Spain
| | - John B F de Wit
- Department of Interdisciplinary Social Science, Utrecht University, Utrecht, Netherlands
| | - Frank M Amort
- FH JOANNEUM, University of Applied Sciences, Bad Gleichenberg, Austria
| | - Anastasia Pharris
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Lina Nerlander
- European Centre for Disease Prevention and Control (ECDC), Stockholm, Sweden
| | - Dorthe Raben
- Centre of Excellence for Health, Immunity and Infections (CHIP), Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
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9
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Saita NM, Andrade RLDP, Bossonario PA, Bonfim RO, Hino P, Monroe AA. Factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty: a systematic review. Rev Esc Enferm USP 2021; 55:e20200583. [PMID: 34605533 DOI: 10.1590/1980-220x-reeusp-2020-0583] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 07/06/2021] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE to analyze factors associated with unfavorable outcome of tuberculosis treatment in people deprived of liberty. METHOD systematic review, carried out in March 2021 in seven databases, with no delimitation of period of publication. The selection process of publications and data extraction was carried out by two independent reviewers. RESULTS a total of 1,448 publications was identified and nine were included in the study. Unfavorable outcome was higher among those who were men; had low level of education; were living in a rural area before detention; had longer prison time; received occasional visits; had been transferred between prisons; with no sputum smear microscopy or with a positive result at the diagnosis; with no follow-up sputum smear microscopy, previous history of tuberculosis; having both clinical forms of the disease, HIV/AIDS; alcoholics; smokers; low body weight; and self-administered treatment. Treatment default was associated with young people and death with older people. CONCLUSION prison health managers and professionals are expected to establish mechanisms of surveillance and health actions innovation aimed at the population deprived of liberty, making efforts to reduce the unfavorable outcomes of tuberculosis treatment.
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Affiliation(s)
- Nanci Michele Saita
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento Materno Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Rubia Laine de Paula Andrade
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento Materno Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Pedro Augusto Bossonario
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento Materno Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Rafaele Oliveira Bonfim
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento Materno Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
| | - Paula Hino
- Universidade Federal de São Paulo, Escola Paulista de Enfermagem, Departamento de Saúde Coletiva, São Paulo, SP, Brazil
| | - Aline Aparecida Monroe
- Universidade de São Paulo, Escola de Enfermagem de Ribeirão Preto, Departamento Materno Infantil e Saúde Pública, Ribeirão Preto, SP, Brazil
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Busschots D, Kremer C, Bielen R, Koc ÖM, Heyens L, Brixko C, Laukens P, Orlent H, Bilaey P, De Smet F, Hellemans G, Muyldermans G, Van Baelen L, Hens N, Van Vlierberghe H, Robaeys G. A multicentre interventional study to assess blood-borne viral infections in Belgian prisons. BMC Infect Dis 2021; 21:708. [PMID: 34315415 PMCID: PMC8314587 DOI: 10.1186/s12879-021-06405-z] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/30/2021] [Accepted: 07/18/2021] [Indexed: 02/08/2023] Open
Abstract
BACKGROUND Prevalence data on viral hepatitis B (HBV), hepatitis C (HCV), and HIV infection in prison are often scarce or outdated. There is currently no systematic screening for these blood-borne viral infections (BBV) in Belgian prisons. There is an urgency to assess the prevalence of these BBV to inform policymakers and public healthcare. METHODS This was a multicentre, interventional study to assess the prevalence of BBV using opt-in screening in prisons across Belgium, April 2019 - March 2020. Prisoners were tested using a finger prick and BBV risk factors were assessed using a questionnaire. A generalized linear mixed model was used to investigate the association between the various risk factors and HCV. RESULTS In total, 886 prisoners from 11 Belgian prisons were screened. Study uptake ranged from 16.9 to 35.4% in long-term facilities. The prevalence of HCV antibodies (Ab), hepatitis B surface antigen (Ag) and HIV Ab/Ag was 5.0% (44/886), 0.8% (7/886), and 0.2% (2/886). The adjusted odds for HCV Ab were highest in prisoners who ever injected (p < 0.001; AOR 24.6 CI 95% (5.5-215.2). The prevalence of detectable HCV RNA in the total cohort was 2.1% (19/886). Thirteen (68.4%) prisoners were redirected for follow-up of their HCV infection. CONCLUSIONS Opt-in testing for viral hepatitis B, C and HIV was relatively well-accepted in prisons. Compared with the general population, prisoners have a higher prevalence of infection with BBV, especially for HCV. Systematic screening for these BBV should be recommended in all prisons, preferably using opt-out to optimize screening uptake. TRIAL REGISTRATION Retrospectively registered at clinical trials NCT04366492 April 29, 2020.
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Affiliation(s)
- Dana Busschots
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium. .,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.
| | - Cécile Kremer
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-Biostat), Data Science Institute, Hasselt University, Diepenbeek, Belgium
| | - Rob Bielen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium
| | - Özgür M Koc
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,School of NUTRIM, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Leen Heyens
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,School of NUTRIM, Maastricht University Medical Centre, Maastricht, the Netherlands
| | - Christian Brixko
- Department of Gastroenterology and Hepatology, CHR Citadelle, Liège, Belgium.,Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium
| | - Pierre Laukens
- Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium
| | - Hans Orlent
- Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium.,Department of Gastroenterology and Hepatology, AZ St-Jan, Bruges, Belgium.,Department of Gastroenterology and Hepatology, UZ Gent, Ghent, Belgium
| | - Pascal Bilaey
- Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium
| | - Francis De Smet
- Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium
| | - Geert Hellemans
- Dienst Coördinatie Medische Zorg, Federale Overheidsdienst Justitie, Brussel, Belgium
| | | | - Luk Van Baelen
- Epidemiology and Public Health, Sciensano, Brussels, Belgium
| | - Niel Hens
- Interuniversity Institute for Biostatistics and statistical Bioinformatics (I-Biostat), Data Science Institute, Hasselt University, Diepenbeek, Belgium.,Centre for Health Economic Research and Modelling Infectious Diseases, Vaccine and Infectious Disease Institute, University of Antwerp, Antwerp, Belgium
| | | | - Geert Robaeys
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost-Limburg, Genk, Belgium.,Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
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11
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Patterns of Drug Use and Related Factors Among Prisoners in Iran: Results from the National Survey in 2015. J Prim Prev 2021; 41:29-38. [PMID: 31912408 DOI: 10.1007/s10935-019-00574-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Drug use by prisoners is one of the world's most important problems. We sought to determine the pattern of drug use behavior and related factors among prisoners of Iran in 2015. This cross-sectional study was part of the bio-behavioral surveillance survey conducted among 6200 prisoners in 26 prison sites in Iran who were selected through multi-stage sampling. Data were collected through questionnaires and interviews which inquired about participants' demographics and drug use behaviors. We analyzed study data using descriptive statistics, and crude and adjusted logistic regressions, in STATA-12. Of all prisoners, 74.0% had a history of lifetime drug use, and 16.6% of drug users had a history of lifetime injection drug use (IDU). According to the results of a multivariate logistic regression, male sex, being between the ages of 24 and 45, having a history of imprisonment, and having a history of lifetime high-risk sexual behavior were significant risk factors for lifetime drug use. Also, male sex, single status, and a history of previous imprisonment were significant risk factors for lifetime IDU. The prevalence of drug use in Iran's prison population is high and alarming. There is a continuing need for harm reduction programs, including the methadone maintenance treatment, among imprisoned drug users and IDUs.
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12
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Ahmadi Gharaei H, Fararouei M, Mirzazadeh A, Sharifnia G, Rohani-Rasaf M, Bastam D, Rahimi J, Kouhestani M, Rezaian S, Dianatinasab M. The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: a systematic review and meta-analysis. Infect Dis Poverty 2021; 10:93. [PMID: 34210349 PMCID: PMC8252262 DOI: 10.1186/s40249-021-00876-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/16/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common among individuals with human immune deficiency virus (HIV) infection worldwide. In this study, we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV, HBV and HIV coinfections among HIV-positive prisoners. METHODS We searched PubMed via MEDLINE, Embase, the Cochrane Library, SCOPUS, and Web of science (ISI) to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV. We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies. We used random-effect models and meta-regression for the meta-analysis of the results of the included studies. RESULTS The number of the included studies were 50 for HCV-HIV, and 23 for HBV-HIV co-infections. The pooled prevalence rates of the coinfections were 12% [95% confidence interval (CI) 9.0-16.0] for HBV-HIV and 62% (95% CI 53.0-71.0) for HCV-HIV. Among HIV-positive prisoners who reported drug injection, the prevalence of HBV increased to 15% (95% CI 5.0-23.0), and the HCV prevalence increased to 78% (95% CI 51.0-100). The prevalence of HBV-HIV coinfection among prisoners ranged from 3% in the East Mediterranean region to 27% in the American region. Also, the prevalence of HCV-HIV coinfections among prisoners ranged from 6% in Europe to 98% in the East Mediterranean regions. CONCLUSIONS Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners, particularly among those with a history of drug injection, varies significantly across the globe. The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades, rising a call for better screening and treatment programs targeting this high-risk population. To prevent the above coinfections among prisoners, aimed public health services (e.g. harm reduction via access to clean needles), human rights, equity, and ethics are to be seriously delivered or practiced in prisons. Protocol registration number: CRD42018115707 (in the PROSPERO international).
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Affiliation(s)
- Hasan Ahmadi Gharaei
- Department of Epidemiology, School of Public Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Health, Faculty of Public Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Public Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics and Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Golnaz Sharifnia
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Marzieh Rohani-Rasaf
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Dariush Bastam
- Medical School, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mostafa Kouhestani
- Department of Health, Faculty of Public Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Shahab Rezaian
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Dianatinasab
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40 (Room C5.570), 6229 ER, Maastricht, the Netherlands.
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Grammatikopoulou MG, Lampropoulou MΑ, Milapidou M, Goulis DG. At the heart of the matter: Cardiovascular health challenges among incarcerated women. Maturitas 2021; 149:16-25. [PMID: 34134886 DOI: 10.1016/j.maturitas.2021.05.002] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2021] [Revised: 05/12/2021] [Accepted: 05/15/2021] [Indexed: 12/17/2022]
Abstract
Many factors appear to contribute to an increased risk for cardiovascular disease (CVD) among incarcerated women. Imprisonment is associated with a bodyweight gain and an increased prevalence of overweight and obesity. Inadequate physical activity and unhealthy nutrition further contribute to this positive energy balance. Classical CVD risk factors are common, including hypertension, diabetes mellitus, metabolic syndrome, and smoking. Moreover, imprisonment is associated with an increased incidence of mental health issues, such as depression and anxiety, with coping mechanisms, including substance abuse, being frequently adopted. Specific attitudes in the correctional environment, including hunger strikes, bullying, abuse and solitary confinement, are effectors of cardiovascular and mental ill-health. Furthermore, the plethora of psychological stressors induces an accelerated aging process, paired with CVD risk. Communicable diseases, mainly human immunodeficiency virus, opportunistic infections and inadequate sunlight exposure increase cardiovascular dysregulation. Health care needs associated with the female sex are not always met, adding to the frustration and compromised well-being. All these factors act independently and cumulatively, increasing CVD risk among incarcerated women.
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Affiliation(s)
- Maria G Grammatikopoulou
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece; Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Maria Α Lampropoulou
- Department of Nutritional Sciences and Dietetics, Faculty of Health Sciences, Alexander Campus, International Hellenic University, Thessaloniki, Greece
| | - Maria Milapidou
- Dr. Juris, Post Doc Researcher, Faculty of Law, Aristotle University of Thessaloniki, Thessaloniki, Greece
| | - Dimitrios G Goulis
- Unit of Reproductive Endocrinology, 1st Department of Obstetrics and Gynecology, Medical School, Faculty of Health Sciences, Aristotle University of Thessaloniki, Thessaloniki, Greece.
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14
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Mendizabal M, Testa P, Rojas M, Colaci CS, Elías S, Nicolini P, Olguín S, Dunn C, Ronchi C, Barreiro M, Zirpoli M, Piñero F, Arora S, O Flaherty M, Rubinstein F, Silva MO. Pilot study using the ECHO model to enhance linkage to care for patients with hepatitis C in the custodial setting. J Viral Hepat 2020; 27:1430-1436. [PMID: 32813904 DOI: 10.1111/jvh.13374] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2020] [Revised: 08/10/2020] [Accepted: 08/11/2020] [Indexed: 12/14/2022]
Abstract
Prisoners in most countries have a higher prevalence of HCV than the general population, but their access to treatment is very limited. Our aim was to evaluate a pilot programme using the ECHO model to enhance linkage to care in patients with HCV in 3 Argentinean prisons between October 2018 and January 2020. All inmates were invited to participate, and data were collected through a personal interview. We then estimated HCV prevalence with dried blood spot and performed a logistic regression analysis to identify risk behaviours associated with HCV infection. Finally, HCV management was assessed and monitored through ECHO. Overall, 1141 inmates agreed to participate, representing 39.7% of the total prison population. Anti-HCV prevalence was estimated at 1.58% (CI 0.93; 2.48), being significantly higher in women 2.98% (CI 1.4;5.6) than in men 1.07% (CI 0.5; 2.0); P = .03. Patients with anti-HCV were significantly older than those who tested negative, 42.3 years (CI 37.6;47.1) vs 30.1 years (CI 30.6;31.2), P < .001, respectively. Multiple logistic regression analysis, identified age OR 1.07 (CI 1.03;1.12, P = .001), history of sexually transmitted disease OR 3.08 (CI 0.97;9.82, P = .057) and intravenous drug use OR 12.6 (CI 3.31;48.53, P < .001) as risk factors associated with anti-HCV. Treatment was initiated in all the patients with specialist physician support utilizing ECHO model. In conclusion, our pilot study reported a low prevalence of anti-HCV in the studied population. Incarceration provides an ideal opportunity for testing and treating HCV. ECHO model arises as a useful tool to support assessment and treatment for inmates with chronic HCV.
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Affiliation(s)
- Manuel Mendizabal
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Pablo Testa
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Mercedes Rojas
- Virology laboratory, Hospital Universitario Austral, Pilar, Argentina
| | - Carla S Colaci
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Solana Elías
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Paula Nicolini
- Servicio Penitenciario Bonaerense, Buenos Aires, Argentina
| | - Soledad Olguín
- Servicio Penitenciario Bonaerense, Buenos Aires, Argentina
| | | | | | - Mariano Barreiro
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Mercedes Zirpoli
- Virology laboratory, Hospital Universitario Austral, Pilar, Argentina
| | - Federico Piñero
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
| | - Sanjeev Arora
- Department of Internal Medicine, University of New Mexico, NM, USA
| | - Martín O Flaherty
- Department of Public Health and Policy, University of Liverpool, Liverpool, UK
| | | | - Marcelo O Silva
- Hepatology and Liver Transplant Unit, Hospital Universitario Austral, Pilar, Argentina
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15
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Okafor IM, Ugwu SO, Okoroiwu HU. Hepatitis C virus infection and its associated factors among prisoners in a Nigerian prison. BMC Gastroenterol 2020; 20:360. [PMID: 33126856 PMCID: PMC7602341 DOI: 10.1186/s12876-020-01504-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Accepted: 10/15/2020] [Indexed: 11/17/2022] Open
Abstract
Background The prison population is considered at high risk of acquiring infectious diseases due to confined conditions, behavioral factors, injection drug use, unprotected sexual activity, non-professional tattooing and scarification, and needle sharing. Hepatitis C virus (HCV) is a blood borne pathogen mostly transmitted via percutaneous exposure that results in inflammation of the liver. It is one of the public health problem worldwide and is the principal cause of parenterally transmitted non-A, non-B hepatitis. The study was aimed at evaluating the prevalence of HCV among prison inmates in Calabar, Cross River State, Nigeria and the associated factors. Methods The study took a descriptive cross sectional approach using multi-stage sampling technique. One hundred and forty-two (142) prison inmates within the age range of 18–50 years and above were recruited for this study. Result Forty two (42); [29.6%] of the participating prison inmates were seropositive for HCV. Gender stratification showed that 31.0% of the males were seropositive for HCV while 15.4% of the females were seropositive for HCV. Fisher exact test showed that gender, age, marital status, occupation and level of education had no association in distribution of seroprevalence of HCV (p > 0.05) but the duration in prison was significantly associated with distribution of seropositivity of HCV in the studied population (p < 0.05). Bivariate logistic regression showed that tattoo/scarification, injection drug use, history of blood transfusion, sexual experience, shaving equipment sharing and multiple sexual partners were not risk factor for distribution of HCV prevalence in the studied population (p > 0.05). However, 23.5% who had tattoo/scarification, 29.6% who used injection drug, 33.3% who had history of blood transfusion, 29.8% who had sexual experience, 21.2% who shared shaving equipment, and 28.3% who had multiple sex partners were seropositive for HCV. Conclusion Approximately 29.6% prevalence of Hepatitis C virus infection observed among inmates studied is high and calls for concern. Attitude and behaviors by inmates such as tattooing/scarification, injection drugs use, sharing of shaving equipment, multiple sexual partners should be discouraged.
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Affiliation(s)
- Ifeyinwa M Okafor
- Haematology Unit, Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria.
| | - Solomon O Ugwu
- Haematology Unit, Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria
| | - Henshaw U Okoroiwu
- Haematology Unit, Department of Medical Laboratory Science, College of Medical Sciences, University of Calabar, Calabar, Nigeria
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16
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Prevalence of Hepatitis C Virus in Iranian Prisoners: An Updated Systematic Review and Multilevel Meta-Analysis Study. HEPATITIS MONTHLY 2020. [DOI: 10.5812/hepatmon.102004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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17
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Rousselet M, Guerlais M, Caillet P, Le Geay B, Mauillon D, Serre P, Chameau PY, Bleher Y, Mounsande S, Jolliet P, Victorri-Vigneau C. Consumption of psychoactive substances in prison: Between initiation and improvement, what trajectories occur after incarceration? COSMOS study data. PLoS One 2019; 14:e0225189. [PMID: 31800580 PMCID: PMC6892542 DOI: 10.1371/journal.pone.0225189] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 10/30/2019] [Indexed: 11/27/2022] Open
Abstract
Background Few studies have examined the consumption trajectories of inmates after entry to prison. The aim of this study was to assess the changes in the consumption of psychoactive substance between the period before detention and during incarceration and to characterize the profiles of prisoners with similar consumption trajectories during incarceration. Methods and findings A multicenter, cross-sectional study was performed in all of the prisons from one region of France. All prisoners incarcerated during their 3rd months, over 18 years old, and with a sufficient level of French fluency to participate in the study were recruited over a period of 12 months. A total of 800 prisoners were recruited. All prisoners were interviewed face-to-face by a trained interviewer. A majority of prisoners had used at least one psychoactive substance in the weeks prior to incarceration. During incarceration, a substantial reduction in alcohol and illicit drug consumption was observed. The initiation of consumption and an increase in consumption were primarily related to medications. Five different profiles of consumption before incarceration were identified. These profiles all had a high probability of migrating to a similar profile during detention, characterized by less severe consumption of psychoactive substances. Conclusions Based on their consumption profile prior to incarceration, most prisoners would benefit from a specific medical evaluation as soon as possible following entry into detention. Prison could be an opportunity for reduced consumption and/or the initiation of treatment for the majority of prisoners, despite the pejorative development observed for a minority of prisoners during incarceration.
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Affiliation(s)
- Morgane Rousselet
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, France
- INSERM U1246 SPHERE “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes and Tours University, Nantes, France
- Addictology and Psychiatry Department, University Hospital, Nantes, France
| | - Marylène Guerlais
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, France
| | - Pascal Caillet
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, France
- INSERM U1246 SPHERE “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes and Tours University, Nantes, France
| | - Bertrand Le Geay
- Department of Prison Psychiatry, Nantes University Hospital, France
| | - Damien Mauillon
- Medical department of prison, Angers University Hospital, France
| | - Patrick Serre
- Medical department of prison, Le Mans HospitalFrance
| | | | - Yves Bleher
- Medical department of prison, La Roche sur Yon Departemental Hospital, Boulevard Stéphane Moreau, France
| | - Serge Mounsande
- Medical department of prison, Fontenay-Le-Comte Hospital, France
| | - Pascale Jolliet
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, France
- INSERM U1246 SPHERE “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes and Tours University, Nantes, France
| | - Caroline Victorri-Vigneau
- Centre for Evaluation and Information on Pharmacodependence, Clinical Pharmacology Department, Nantes University Hospital, France
- INSERM U1246 SPHERE “methodS in Patient-centered outcomes and HEalth ResEarch”, Nantes and Tours University, Nantes, France
- * E-mail:
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Søholm J, Holm DK, Mössner B, Madsen LW, Hansen JF, Weis N, Sauer AP, Awad T, Christensen PB. Incidence, prevalence and risk factors for hepatitis C in Danish prisons. PLoS One 2019; 14:e0220297. [PMID: 31348813 PMCID: PMC6660074 DOI: 10.1371/journal.pone.0220297] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2019] [Accepted: 07/12/2019] [Indexed: 12/17/2022] Open
Abstract
Hepatitis C virus (HCV) infection is prevalent among people in prison and prisons could therefore represent a unique opportunity to test risk groups for HCV. The aim of this sero-epidemiological study was to determine the incidence and prevalence of HCV infection and the corresponding risk factors in Danish prisons. Participants, recruited from eight Danish prisons, were tested for HCV using dried blood spots and filled out a questionaire with demographic data and risk factors for HCV infection. In total, 76.9% (801/1041) of all eligible prisoners consented to participate. The prevalence of HCV RNA positive prisoners was 4.2% (34/801) and the in-prison incidence rate was 0.7–1.0 per 100PY overall and 18-24/100PY among PWIDs. Infected prisoners were older than the overall population with a mean age of 42 years and only 17.6% (6/34) were younger than 35 years. The prevalence of PWID was 8.5% (68/801) and only 3% (2/68) of PWID were younger than 25 years. Among the PWID, 85.3% (58/68) had ever received opioid substitution therapy (OST) and 47.1% (32/68) were currently receiving OST. Risk factors associated with HCV infection were intravenous drug use, age ≥ 40 years, and being incarcerated ≥ 10 years. In conclusion, the prevalence of PWID in Danish prisons is low, possibly reflecting a decrease in injecting among the younger generation. This together with OST coverage could explain the low prevalence of HCV infection. However among PWIDs in prison the incidence remains high, suggesting a need for improved HCV prevention in prison.
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Affiliation(s)
- Jacob Søholm
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
- * E-mail:
| | | | - Belinda Mössner
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Lone Wulff Madsen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- OPEN, Odense Patient data Explorative Network, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Janne Fuglsang Hansen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
| | - Nina Weis
- Department of Infectious Diseases, Copenhagen University Hospital, Hvidovre, Denmark
- Department of Clinical Medicine, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | | | - Tahany Awad
- Medical Affairs, AbbVie A/S, Copenhagen, Denmark
| | - Peer Brehm Christensen
- Department of Infectious Diseases, Odense University Hospital, Odense, Denmark
- Clinical Institute, University of Southern Denmark, Odense, Denmark
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Prevalence and Risk Factors for Hepatitis B and Hepatitis C Exposure in Iranian Prisoners: A National Study in 2016. HEPATITIS MONTHLY 2019. [DOI: 10.5812/hepatmon.91129] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/13/2023]
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Parriault MC, Chaponnay A, Cropet C, About V, Pastre A, Perusseau-Lambert R, Nacher M, Huber F. Penile implants and other high risk practices in French Guiana's correctional facility: A cause for concern. PLoS One 2019; 14:e0218992. [PMID: 31251774 PMCID: PMC6599133 DOI: 10.1371/journal.pone.0218992] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/30/2018] [Accepted: 06/13/2019] [Indexed: 11/19/2022] Open
Abstract
Background Prisoners in French Guiana, a French territory located in South America, have a HIV and hepatitis B prevalence of 4%. Body modifications such as penile implants, tattoos, and body piercings are common among detainees, increasing the risk of blood-borne virus transmission. Methods We conducted a cross-sectional randomised survey in which the primary objective was to estimate the prevalence of high risk ‘bloody practices’ (penile implants, tattoos, body piercings) in French Guiana’s only correctional facility. The secondary objective was to describe the risk factors for penile implants, the procedures and motivations for insertion, the reported complications, their risk factors and adverse impact on condom use. Results Of the 221 male inmates interviewed, 19% had tattoos or body piercings while incarcerated, and 68% had penile implants, of which, 85% had been inserted inside the correctional facility. Addictive behaviors such as cannabis use and alcohol addiction (positive AUDIT-C score), early age at first sexual intercourse, and the number of incarcerations correlated positively with having inserted one or more penile implants while incarcerated. In contrast, having reported previous psychiatric hospitalizations and having a high knowledge score for HIV/AIDS and sexually transmitted infections (STIs) were negatively correlated with the insertion of penile implants while incarcerated. Penile implants were inserted in poor hygienic conditions, usually using the sharp lid of a canned food container, with 18% of early complications, mostly haemorrhage and edema. Condom use was negatively impacted for 52% of men with penile implants. Conclusions Our results highlight the need for prevention interventions which should aim at increasing knowledge levels and at implementing comprehensive risk-reduction measures.
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Affiliation(s)
- Marie-Claire Parriault
- Centre d’Investigation Clinique Antilles Guyane, CIC INSERM, Cayenne General Hospital, Cayenne, French Guiana, France
- * E-mail:
| | | | - Claire Cropet
- Centre d’Investigation Clinique Antilles Guyane, CIC INSERM, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Vincent About
- UCSA, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Agathe Pastre
- UCSA, Cayenne General Hospital, Cayenne, French Guiana, France
| | | | - Mathieu Nacher
- Centre d’Investigation Clinique Antilles Guyane, CIC INSERM, Cayenne General Hospital, Cayenne, French Guiana, France
- COREVIH, Cayenne General Hospital, Cayenne, French Guiana, France
- University of French Guiana, Cayenne, French Guiana, France
| | - Florence Huber
- COREVIH, Cayenne General Hospital, Cayenne, French Guiana, France
- Réseau Kikiwi, Cayenne, French Guiana, France
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21
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Izquierdo L, Mellon G, Buchaillet C, Fac C, Soutière MP, Pallier C, Dulioust A, Roque-Afonso AM. Prevalence of hepatitis E virus and reassessment of HIV and other hepatitis virus seroprevalences among French prison inmates. PLoS One 2019; 14:e0218482. [PMID: 31242210 PMCID: PMC6594613 DOI: 10.1371/journal.pone.0218482] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2019] [Accepted: 06/03/2019] [Indexed: 12/28/2022] Open
Abstract
Background Prison inmates are considered a high-risk population for blood-borne and enterically transmitted infections before and during their imprisonment. Hepatitis E virus (HEV) prevalence is unknown among French inmates, whereas a reassessment of human immunodeficiency virus (HIV), hepatitis A virus (HAV), hepatitis B virus (HBV) and hepatitis C virus (HCV) prevalences is required to describe the epidemiologic evolution in this high-risk population. Methods A prospective survey was conducted from June to December 2017 in Fresnes prison, a penitentiary center with 2,581 inmates. In addition to HIV, HAV, HBV and HCV testing, which is offered to all patients at admission, we systematically offered HEV screening. Retrospective serological data for HIV, HBV and HCV, collected annually from 2014 to 2017, were also used to assess evolution. Results In 2017, 1,093 inmates were screened for HEV, HIV, HAV, HBV and HCV. Prevalences in this population were 8.2%, 1.3%, 62.7%, 1.9% and 2.9%, respectively. HEV seroprevalence increased with age (p<0.0001) and was higher among Eastern Europe born inmates (p<0.0001). Between 2014 and 2017, HIV seroprevalence remained steady, while a decrease in HBV and HCV seroprevalence was observed. Conclusions Compared to the reported prevalence in French blood donors, HEV seroprevalence was remarkably low in French inmates. HIV, HAV, HBV and HCV prevalences among prisoners were higher than reported in the general population.
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Affiliation(s)
- Laure Izquierdo
- Virologie, Hôpital Paul Brousse, AP-HP, Villejuif, France
- INSERM U1193, Villejuif, France
- Université Paris-Sud, Bicêtre, France
| | - Guillaume Mellon
- Médecine, Etablissement Public National de Santé de Fresnes (EPSNF), Fresnes, France
- Maladies Infectieuses et Tropicales, Hôpital Saint Louis, AP-HP, Paris, France
- * E-mail:
| | - Céline Buchaillet
- Unité de Consultations et de Soins en Ambulatoire (UCSA), Centre Pénitentiaire de Fresnes, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
| | - Catherine Fac
- Unité de Consultations et de Soins en Ambulatoire (UCSA), Centre Pénitentiaire de Fresnes, Centre Hospitalier Universitaire de Bicêtre, Le Kremlin-Bicêtre, France
| | | | | | - Anne Dulioust
- Médecine, Etablissement Public National de Santé de Fresnes (EPSNF), Fresnes, France
| | - Anne-Marie Roque-Afonso
- Virologie, Hôpital Paul Brousse, AP-HP, Villejuif, France
- INSERM U1193, Villejuif, France
- Université Paris-Sud, Bicêtre, France
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22
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Strickland JC, Staton M, Leukefeld CG, Oser CB, Webster JM. Hepatitis C antibody reactivity among high-risk rural women: opportunities for services and treatment in the criminal justice system. Int J Prison Health 2019; 14:89-100. [PMID: 29869584 DOI: 10.1108/ijph-03-2017-0012] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Purpose The purpose of this paper is to examine the drug use and criminal justice factors related to hepatitis C virus (HCV) antibody reactivity among rural women in the USA recruited from local jails. Design/methodology/approach Analyses included 277 women with a history of injection drug use from three rural jails in Kentucky. Participants completed health and drug use questionnaires and received antibody testing for HCV. Findings The majority of women tested reactive to the HCV antibody (69 percent). Reactivity was associated with risk factors, such as unsterile needle use. Criminal justice variables, including an increased likelihood of prison incarceration, an earlier age of first arrest, and a longer incarceration history, were associated with HCV reactive tests. Participants also endorsed several barriers to seeking healthcare before entering jail that were more prevalent in women testing HCV reactive regardless of HCV status awareness before entering jail. Originality/value Injection and high-risk sharing practices as well as criminal justice factors were significantly associated with HCV reactivity. Future research and practice could focus on opportunities for linkages to HCV treatment during incarceration as well as during community re-entry to help overcome real or perceived treatment barriers. The current study highlights the importance of the criminal justice system as a non-traditional, real-world setting to examine drug use and related health consequences such as HCV by describing the association of high-risk drug use and criminal justice consequences with HCV among rural women recruited from local jails.
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Affiliation(s)
- Justin C Strickland
- Department of Psychology, College of Arts and Sciences, University of Kentucky , Lexington, Kentucky, USA
| | - Michele Staton
- Department of Behavioral Science, College of Medicine, University of Kentucky , Lexington, Kentucky, USA.,Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA
| | - Carl G Leukefeld
- Department of Behavioral Science, College of Medicine, University of Kentucky , Lexington, Kentucky, USA.,Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA
| | - Carrie B Oser
- Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA.,Department of Sociology, College of Arts and Sciences, University of Kentucky , Lexington, Kentucky, USA
| | - J Matthew Webster
- Department of Behavioral Science, College of Medicine, University of Kentucky , Lexington, Kentucky, USA.,Center on Drug and Alcohol Research, University of Kentucky , Lexington, Kentucky, USA
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23
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Stöver H, Meroueh F, Marco A, Keppler K, Saiz de la Hoya P, Littlewood R, Wright N, Nava F, Alam F, Walcher S, Somaini L. Offering HCV treatment to prisoners is an important opportunity: key principles based on policy and practice assessment in Europe. BMC Public Health 2019; 19:30. [PMID: 30621658 PMCID: PMC6323720 DOI: 10.1186/s12889-018-6357-x] [Citation(s) in RCA: 28] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/10/2018] [Accepted: 12/21/2018] [Indexed: 02/07/2023] Open
Abstract
Background Prisoners have a high prevalence of hepatitis C virus (HCV) infection but may find it difficult to access healthcare services. This may be related to risk behaviour including history of injecting drugs and marginalisation related to problem drug use/ opioid use disorder (OUD). Direct-acting antiviral products with superior efficacy and safety compared to interferon-based regimens offer HCV cure. Many citizens in Europe have been treated, although few received therapy in prisons. Methods Analysis of prisoner HCV treatment need and policy determinants of clinical practice was completed for 5 EU countries. Evidence was collected from national statistical sources and peer-reviewed publications to describe prison populations and HCV prevalence, to map national prison/ HCV health policy or guidance. A consensus of important principles for prisoner HCV care was developed. Results Data from published sources describing prisoner HCV prevalence is limited. Prisoner population requiring HCV treatment is not known; estimated numbers based on analysis of evidence: England and Wales, 9000, France, 8000, Spain, 6000, Italy, 6000, Germany, 6000. Treatment access: national law defines right to equivalent care in all countries implying access to HCV therapy in prison similar to community; useful prisoner HCV guidance facilitating treatment decisions present in: 4 of 5 national/ regional HCV policy documents, 4 of 5 national prison healthcare policies. Four of five had practical prison HCV clinical guidelines. Despite existence of policy, implementation of guidance, and so HCV treatment, is suboptimal in many locations. Conclusions Prison is an important location to detect, address and treat HCV infection in people who may be underserved for healthcare and find it difficult to navigate community treatment pathways. This is often related to problems with OUD and resulting social inequity. HCV management in prisons must be improved. Policy and clinical practice guidance must be set to promote treatment, and practical steps to make treatment easy should be followed including education to promote engagement, set-up of optimal screening and work up processes with modern tools to reduce time needed/ achieve efficiency; programs to make it easier to get specialists’ input include remote working and nurse-led services.
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Affiliation(s)
- H Stöver
- Institute of Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany.
| | - F Meroueh
- Health Unit, Villeneuve les Maguelone, France
| | - A Marco
- Penitentiary Program, Catalan Health Institute, Barcelona, Spain
| | | | | | | | - N Wright
- Spectrum Community Health CIC, Wakefield, UK
| | - F Nava
- University of Modena and Reggio Emilia, University Hospital Policlinico of Modena, Modena, Italy
| | - F Alam
- Divisional Medical Director, Central and North West London NHS Foundation Trust, London, UK
| | - S Walcher
- CONCEPT, Addiction Medicine, Munich, Germany
| | - L Somaini
- Addiction Treatment Centre, Biella, Italy
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24
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Loustaud-Ratti V, Debette-Gratien M, Carrier P. European Association for the Study of the Liver and French hepatitis C recent guidelines: The paradigm shift. World J Hepatol 2018; 10:639-644. [PMID: 30386457 PMCID: PMC6206148 DOI: 10.4254/wjh.v10.i10.639] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2018] [Revised: 07/17/2018] [Accepted: 08/04/2018] [Indexed: 02/06/2023] Open
Abstract
The latest Association Française pour l'Etude du Foie - French Association for Study of the Liver (AFEF) and European Association for the Study of the Liver (EASL) recommendations announce a change of paradigm, for the management of patients infected with hepatitis C virus (HCV). The AFEF recommendations focus on the elimination of HCV infection on a national level by preventing reinfection, in less than ten years. This goal involves the facilitation of patients' management in a simplified pathway by increasing screening procedures and access to pangenotypic treatments mainly in the "reservoir" population of people who inject drugs and migrants. Even in the complex pathway of patients with previous comorbidities, AFEF takes the option of a therapeutic simplification. The EASL guidelines position themselves on the state of the art with a precise description of all therapeutic options available, without separating simplified and complex pathways even if they take into account the epidemiological evolution of difficult-to-treat populations.
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Affiliation(s)
- Véronique Loustaud-Ratti
- Fédération d'Hépatologie, Service d'Hépato-gastroentérologie, CHU Limoges, Limoges 87042, France.
| | - Marilyne Debette-Gratien
- Fédération d'Hépatologie, Service d'Hépato-gastroentérologie, CHU Limoges, Limoges 87042, France
| | - Paul Carrier
- Fédération d'Hépatologie, Service d'Hépato-gastroentérologie, CHU Limoges, Limoges 87042, France
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25
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Golrokhi R, Farhoudi B, Taj L, Pahlaviani FG, Mazaheri-Tehrani E, Cossarizza A, SeyedAlinaghi S, Mohraz M, Voltarelli FA. HIV Prevalence and Correlations in Prisons in Different Regions of the World: A Review Article. Open AIDS J 2018; 12:81-92. [PMID: 30369993 PMCID: PMC6176549 DOI: 10.2174/1874613601812010081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 02/08/2023] Open
Abstract
The prevalence of HIV is substantially higher among prisoners than the general population, while the incidence varies considerably in different regions around the world. If we consider Sub-Saharan Africa as one region with the highest prevalence of HIV, data on African prisoners would be limited. Despite the low prevalence of HIV in the Middle East and North Africa, its incidence is rising in these regions with a few exceptions; there are insufficient data on HIV prevalence in prisons. A similar situation is present in both Pacific and Central Asia as well as in Eastern Europe. A high rate of infection is mainly observed among prisoners in Western and Central parts of Europe, since the data from these are more available than other parts. Nowadays, the sexual transmission mode and tattooing are important ways in HIV risks among prisoners after injecting drug use as the most common route of HIV transmission in all regions. However, it is difficult to compare and analyze the prevalence of HIV among prisoners in different regions regarding the limited data and different methods which they used in collecting data. Eventually, it can certainly be said that prisons are one of the high-risk places for HIV transmission; on the other hand, can be a suitable place for implementing HIV case-finding, linkage to treatment and harm reduction programs.
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Affiliation(s)
- Raheleh Golrokhi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Farhoudi
- Clinical Research Development Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Leila Taj
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Golsoorat Pahlaviani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mazaheri-Tehrani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Andrea Cossarizza
- University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabrício Azevedo Voltarelli
- Federal University of Mato Grosso, Graduation Program in Health Sciences, Faculty of Medicine, Cuiabá, Brazil
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26
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Abel S, Cuzin L, Da Cunha S, Bolivard JM, Fagour L, Miossec C, Pircher M, Thioune M, Césaire R, Cabié A. Reaching the WHO target of testing persons in jails in prisons will need diverse efforts and resources. PLoS One 2018; 13:e0202985. [PMID: 30161176 PMCID: PMC6116985 DOI: 10.1371/journal.pone.0202985] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2018] [Accepted: 08/12/2018] [Indexed: 12/03/2022] Open
Abstract
Background The Caribbean is the second most affected region in the world by human immunodeficiency virus (HIV), and HIV prevalence is significantly higher among persons in jails and prisons than in the free population. The aim of our study was to assess the screening rates of HIV, hepatitis B and C, syphilis and human T cell leukaemia virus type 1 among newly-arrived persons in 2014, at Ducos facility in Martinique and the testing process performance. Methods This is an observational monocentric study conducted within the prison’s health unit. The study population consisted of all individuals incarcerated between 01/01/14 and 31/12/14. At the initial medical visit, HIV and STI testing were proposed to every newcomer. The rate of acceptance was calculated, as well as the screening process performance. Results In 2014 778 new persons were incarcerated, among those, 461 (59.3%) were tested. The main reasons for missing the testing opportunity were due to organization of the judiciary system (persons on electronic monitoring or day parole, transferred or quickly released before completion of the process) or to individual refusal. Finally, 75 persons did not get their results (all of them negative), 41 of them due to the medical staff work overload. Conclusions HIV and STI testing rates among newcomers at Ducos have notable room for improvement. The future availability of combined (HIV, HBV, HCV and syphilis) rapid tests may be very useful in case of short term incarceration, if their cost is not prohibitive. Reaching higher levels of testing will also require more resources.
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Affiliation(s)
- Sylvie Abel
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
| | - Lise Cuzin
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
- INSERM, UMR 1027, Toulouse, France
- * E-mail:
| | - Séverine Da Cunha
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
| | | | - Laurence Fagour
- Virology Laboratory, Martinique University Hospital, Fort de France, France
| | - Charline Miossec
- Parasitology Laboratory, Martinique University Hospital, Fort de France, France
| | - Mathilde Pircher
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
| | - Marême Thioune
- Prison Medical Unit, Martinique University Hospital, Fort de France, France
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
| | - Raymond Césaire
- Virology Laboratory, Martinique University Hospital, Fort de France, France
- Antilles University, EA4537, Fort de France, France
| | - André Cabié
- Infectious and Tropical Diseases Unit, Martinique University Hospital, Fort de France, France
- Antilles University, EA4537, Fort de France, France
- Inserm CIC1424, Martinique University Hospital, Fort de France, France
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27
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Moradi G, Gouya MM, Azimizan Zavareh F, Mohamadi Bolbanabad A, Darvishi S, Aghasadeghi MR, Nabavi M, Alasvand R, Tashakorian M, Nouri B, Rahmani K, Molaei L. Prevalence and risk factors for HBV and HCV in prisoners in Iran: a national bio-behavioural surveillance survey in 2015. Trop Med Int Health 2018; 23:641-649. [PMID: 29698576 DOI: 10.1111/tmi.13065] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
OBJECTIVES To provide more accurate estimates of the prevalence of Hepatitis B (HBV) and Hepatitis C (HCV) and their contributing factors among prisoners in Iran. METHODS Cross-sectional study of 6200 Iranian prisoners in 2015. Data were collected through questionnaires and interviews. HBV infection and HCV exposure status of the participants was determined by HBsAg and HCV antibodies blood tests using enzyme-linked immunosorbent assay (ELISA). Data were analysed in STATA-12. RESULT Prevalence of HCV exposure was 9.48% (95% CI: 8.73-10.27), and prevalence of HBV was 2.48% (95% CI: 2.07-2.89) in the general prison population. In multivariate analysis, the most important risk factor for HBV was a history of drug use in lifetime (adjusted odds ratio, AOR: 1.8, 95% CI: 1.17-3.02). The main risk factors for HCV exposure were a history of drug use in lifetime (AOR: 4.08, CI: 2.56-6.27), age over 30 (AOR: 2.68, CI: 2.01-3.56), and having tattoos (AOR = 1.67, CI: 1.35-2.07). CONCLUSION Although vaccination is used to control HBV among prisoners, prevalence of HCV exposure is alarming in the prison population of Iran, especially among people who inject drugs. Eliminating viral hepatitis in Iran by 2030 requires a national commitment and rapid measures for targeting this high-risk group. Given the increased efficiency of HCV treatment in recent years, prisons provide an opportunity to access patients for treatment.
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Affiliation(s)
- Ghobad Moradi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Mohammad-Mehdi Gouya
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Fatemeh Azimizan Zavareh
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Amjad Mohamadi Bolbanabad
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Sonia Darvishi
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | | | - Mahmood Nabavi
- Iranian Center for Communicable Diseases Control, Ministry of Health & Medical Education, Tehran, Iran
| | - Ramin Alasvand
- Health and Treatment Directorate of Prisons and Security and Corrective Measures Organization, Tehran, Iran
| | - Mehrzad Tashakorian
- Health and Treatment Directorate of Prisons and Security and Corrective Measures Organization, Tehran, Iran
| | - Bijan Nouri
- Social Determinants of Health Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Khaled Rahmani
- Liver and Digestive Research Center, Research Institute for Health Development, Kurdistan University of Medical Sciences, Sanandaj, Iran
| | - Leila Molaei
- Iran University of Medical Sciences, Tehran, Iran
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28
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Prevalence of hepatitis C virus infection among prisoners in Iran: a systematic review and meta-analysis. Harm Reduct J 2018; 15:24. [PMID: 29739400 PMCID: PMC5941323 DOI: 10.1186/s12954-018-0231-0] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/06/2018] [Accepted: 04/17/2018] [Indexed: 02/06/2023] Open
Abstract
Background Hepatitis C virus (HCV) is one of the major public health problems both in developed and developing countries. Prison represents a high-risk environment for prisoners, in that it is characterized by high-risk behaviors such as injecting drug use (IDU), tattooing, unprotected sexual intercourses, or sharing syringes. The aim of this study was to quantitatively evaluate the prevalence of HCV among Iranian prisoners conducting a systematic review and meta-analysis. Methods We searched different scholarly databases including Embase, PubMed/MEDLINE, ISI/Web of Sciences, the Cochrane library, Scopus, CINAHL, and PsycINFO as well as Iranian bibliographic thesauri (namely, Barakatns, MagIran, and SID) up to December 2017. The Newcastle Ottawa Scale (NOS) was used to assess the quality of the studies included. HCV prevalence rate with its 95% confidence interval (CI) was estimated using the DerSimonian-Laird random-effects model, with Freeman-Tukey double arcsine transformation. Egger’s regression test was used to evaluate publication bias. Results Finally, 17 articles were selected based on inclusion and exclusion criteria. Overall, 18,693 prisoners were tested. Based on the random-effects model, the prevalence of HCV among Iranian prisoners was 28% (CI 95% 21–36) with heterogeneity of I2 = 99.3% (p = 0.00). All studies used an ELISA test for the evaluation of HCV antibodies. The findings of this study showed that the highest prevalence rate (53%) was among prisoners who inject drugs. Conclusion The findings of our study showed that the prevalence of HCV among Iranian prisoners is dramatically high. Managing this issue in Iran’s prisons requires careful attention to the availability of health facilities and instruments, such as screening, and harm reduction policies, such as giving sterile syringes and needles to prisoners. An integrated program of training for prisoners, prison personnel and medical staff is also needed to improve the level of health condition in prisons.
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29
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Pazart L, Godard-Marceau A, Chassagne A, Vivot-Pugin A, Cretin E, Amzallag E, Aubry R. Prevalence and characteristics of prisoners requiring end-of-life care: A prospective national survey. Palliat Med 2018; 32:6-16. [PMID: 28786339 PMCID: PMC5758925 DOI: 10.1177/0269216317721816] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
BACKGROUND Ensuring adequate end-of-life care for prisoners is a critical issue. In France, data investigating the impact of laws allowing release of seriously ill prisoners are lacking. AIM To assess the number and characteristics of prisoners requiring palliative care in French prisons. DESIGN A prospective, national survey collecting data over a 3-month period. SETTING/PARTICIPANTS All healthcare units ( n = 190) providing care for prisoners in France. The prison population was 66,698 during the study period. Data collection concerned prisoners requiring end-of-life care, that is, with serious, advanced, progressive, or terminal illness and life expectancy <1 year. RESULTS Estimated annual prevalence of ill prisoners requiring end-of-life care was 15.2 (confidence interval: 12.5-18.3) per 10,000 prisoners. The observed number of prisoners requiring palliative care ( n = 50) was twice as high as the expected age- and sex-standardized number based on the general population and similar to the expected number among persons 10 years older in the free community. In all, 41 of 44 (93%) of identified ill prisoners were eligible for temporary or permanent compassionate release, according to their practitioner. Only 33 of 48 (68%) of ill prisoners requested suspension or reduction in their sentence on medical grounds; half (16/33) received a positive answer. CONCLUSION The proportion of prisoners requiring palliative care is higher than expected in the general population. The general frailty and co-existing conditions of prisoners before incarceration and the acceleration of these phenomena in prison could explain this increase in end-of-life situations among prisoners.
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Affiliation(s)
- Lionel Pazart
- Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France
- EA 481, Université de Bourgogne Franche-Comté, Besançon, France
| | - Aurélie Godard-Marceau
- Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France
- EA 481, Université de Bourgogne Franche-Comté, Besançon, France
- Département douleur-Soins palliatifs, CHRU de Besançon, Besançon, France
| | - Aline Chassagne
- Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France
- Département douleur-Soins palliatifs, CHRU de Besançon, Besançon, France
| | - Aurore Vivot-Pugin
- Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France
| | - Elodie Cretin
- Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France
- EA 481, Université de Bourgogne Franche-Comté, Besançon, France
- Département douleur-Soins palliatifs, CHRU de Besançon, Besançon, France
- L’Espace de Réflexion Ethique Bourgogne Franche-Comté, Besançon, France
| | - Edouard Amzallag
- L’Unité Hospitalière Sécurisée Interrégionale (UHSI), Centre Hospitalier Lyon-Sud, Lyon, France
| | - Regis Aubry
- Inserm CIC 1431, University Hospital Besançon, CHRU de Besançon, Besançon, France
- EA 481, Université de Bourgogne Franche-Comté, Besançon, France
- Département douleur-Soins palliatifs, CHRU de Besançon, Besançon, France
- L’Espace de Réflexion Ethique Bourgogne Franche-Comté, Besançon, France
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Brouard C, Boussac-Zarebska M, Silvain C, Durand J, de Lédinghen V, Pillonel J, Delarocque-Astagneau E. Rapid and large-scale implementation of HCV treatment advances in France, 2007-2015. BMC Infect Dis 2017; 17:784. [PMID: 29262788 PMCID: PMC5738822 DOI: 10.1186/s12879-017-2889-4] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2017] [Accepted: 12/06/2017] [Indexed: 01/03/2023] Open
Abstract
BACKGROUND The last decade was marked by major advances in HCV treatment with the introduction of first wave protease inhibitors (1st-wave PIs, telaprevir or boceprevir) in 2011 and second direct-acting antivirals (2nd-wave DAAs) in 2014, that followed low effective pegylated interferon α / ribavirin bitherapy. We estimated the number of patients initiating HCV treatment in France between 2007 and 2015 according to the type of therapy, described their demographical characteristics, and estimated how many were cured with 2nd-wave DAAs in 2014-2015. METHODS Individual data from the national health insurance information system were analysed. HCV treatment initiation was defined as a drug reimbursement in the absence of any reimbursement for the same drug in the previous six weeks. RESULTS Between 2007 and 2015, 72,277 patients initiated at least one HCV treatment. The annual number of patients initiating treatment decreased from 2007 (~13,300) to 2010 (~10,000). It then increased with the introduction of 1st-wave PIs (~12,500 in 2012), before decreasing again in 2013 (~8400). A marked increase followed upon the approval of 2nd-wave DAAs in 2014 (~11,600). Approximately, 8700 and 14,700 patients initiated 2nd-wave DAAs in 2014 and 2015, respectively, corresponding to an estimated 20,300 cured patients in 2014-2015. Patients initiating HCV treatment were mostly male (~65% throughout the 9-year period). Women were older than men (mean age: 55.0 vs. 48.9). Increasing age was associated with more advanced treatment. Among patients initiating 2nd-wave DAAs, the proportions of those under 40 and over 79 years old increased between 2014 and 2015, whereas the proportion of those previously treated for HCV 2007 onwards declined. CONCLUSIONS Successive advances in HCV treatment have been rapidly and widely implemented in France. With the announcement of universal access to DAAs in mid-2016 and price reductions, access to 2nd-wave DAAs is expected to expand even more.
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Affiliation(s)
- Cécile Brouard
- Santé publique France, the national public health agency, Saint-Maurice, France
| | | | | | - Julien Durand
- Santé publique France, the national public health agency, Saint-Maurice, France
| | - Victor de Lédinghen
- Investigation Centre of Liver Fibrosis, Haut-Lévêque Hospital, Bordeaux University Hospital, Pessac, France
| | - Josiane Pillonel
- Santé publique France, the national public health agency, Saint-Maurice, France
| | - Elisabeth Delarocque-Astagneau
- INSERM 1181, Biostatistics, Biomathematics, Pharmacoepidemiology, and Infectious Diseases (B2PHI), Paris, France
- Institut Pasteur, B2PHI, Paris, France
- Versailles Saint-Quentin University, UMR 1181, B2PHI, Montigny-le-Bretonneux, France
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Stasi C, Silvestri C, Voller F. Emerging Trends in Epidemiology of Hepatitis B Virus Infection. J Clin Transl Hepatol 2017; 5:272-276. [PMID: 28936408 PMCID: PMC5606973 DOI: 10.14218/jcth.2017.00010] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/14/2017] [Revised: 04/15/2017] [Accepted: 04/21/2017] [Indexed: 12/16/2022] Open
Abstract
Although a vaccine against hepatitis B virus (HBV) has been available since 1982, the prevalence of adults with chronic HBV infection in sub-Saharan Africa and East Asia is still estimated at 5-10%. A high rate of chronic infections is also found in the Amazon and the southern parts of eastern and central Europe. In the Middle East and the Indian subcontinent, the prevalence is 2-5%. Less than 1% of the population of Western Europe and North America is chronically infected. Given the high prevalence of infections (such as hepatitis) among inmates, prison is considered a reservoir for facilitating such infections. Based on these premises, this current review examines and discusses emerging trends in the epidemiology of HBV infection, with particular attention to HBV infection in prison. The hepatitis B surface antigen (HBsAg) prevalence in prisoners in west and central Africa is very high (23.5%). The Centers for Disease Control and Prevention has highlighted the importance of HBV blood screening and subsequent anti-HBV vaccination in the prison population. The vaccination was recommended for all inmates, representing an opportunity to prevent HBV infection in a high-risk population. In these subjects, an accelerated hepatitis B immunisation schedule may result in rapid seroconversion for early short-term protection. Therefore, it is necessary to seek collaboration among public health officials, clinicians and correctional authorities to implement a vaccination programme.
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Affiliation(s)
- Cristina Stasi
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
- Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy
- *Correspondence to: Cristina Stasi, Observatory of Epidemiology, Regional Health Agency of Tuscany, 50141 Florence, Italy. Tel: +39-55-4624385, Fax: +39-55-4624330, E-mail:
| | - Caterina Silvestri
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
| | - Fabio Voller
- Observatory of Epidemiology, Regional Health Agency of Tuscany, Florence, Italy
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Huber F, Merceron A, Madec Y, Gadio G, About V, Pastre A, Coupez I, Adenis A, Adriouch L, Nacher M. High mortality among male HIV-infected patients after prison release: ART is not enough after incarceration with HIV. PLoS One 2017; 12:e0175740. [PMID: 28453525 PMCID: PMC5409162 DOI: 10.1371/journal.pone.0175740] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2016] [Accepted: 03/30/2017] [Indexed: 12/01/2022] Open
Abstract
Context French Guiana is a South American French territory, where HIV prevalence consistently exceeds 1% in the adult population. In the only correctional facility, HIV prevalence fluctuates at around 4%. Aims After describing the population of HIV-positive inmates, we aimed to evaluate mortality after release from the correctional facility, and to identify its predictive factors. Rationale Outside North American settings, data on treatment outcome and vital status of HIV-positive former inmates are scarce. There were no data in French Guiana. Filling this gap represents a basis for potential improvements. Methods All HIV-infected adults released from an incarceration of 30 days or more, between 2007 and 2013, were enrolled in a retrospective cohort study. Mortality was described over time, one to seven years following release, using Kaplan-Meier estimates. Factors associated with mortality were identified through a non-parametric survival regression model. Results 147 former inmates were included. The male to female ratio was 4.4. The median age was 37.3 years. The majority were migrants, 25.8% were homeless, 70.1% suffered from substance abuse, with 34.0% of crack-cocaine users. On admission, 78.1% had an early HIV-stage infection (CDC-stage A), with a median CD4 count of 397.5/mm3, 34.0% had one comorbidity, mainly hypertension. Upon release, 50.3% were on ART. Reasons for not being treated were not fulfilling the criteria for 74.6%, and refusing for 15.1%. Before release, 84.5% of the patients on ART had a viral load≤200cp/ml. After release, 8.2% of the cohort had died, with a crude incidence of 33.8/1000 person-years. All recorded deaths were males, with an incidence of 42.2/1000 person-years. Comparing with the age-specific mortality rates for males in French Guiana, the standardized mortality ratio was 14.8. In multivariate analysis, factors associated with death were age and CD4 count before release. Conclusion Despite access to ART while incarcerated, with good virological outcome, the post-release mortality was very high for males, almost 15 times what is observed in the general male population living in French Guiana, after age standardization. Access to ART in correctional facilities may be a necessary, but not sufficient condition to protect male inmates from death after release.
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Affiliation(s)
- Florence Huber
- COREVIH, Cayenne General Hospital, Cayenne, French Guiana, France
- Day Hospital, Cayenne General Hospital, Cayenne, French Guiana, France
- Reseau Kikiwi, Cayenne, French Guiana, France
- * E-mail:
| | - Alice Merceron
- Faculty of Medecine Hyacinthe Basturaud, University of French Guiana, Cayenne, French Guiana, France
| | - Yoann Madec
- Emerging Diseases Epidemiology Unit, Pasteur Institute, Paris, France
| | - Gueda Gadio
- Centre d’Investigation Clinique Epidemiologie Clinique Antilles Guyane, INSERM CIC 1424, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Vincent About
- UCSA, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Agathe Pastre
- UCSA, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Isabelle Coupez
- UCSA, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Antoine Adenis
- Centre d’Investigation Clinique Epidemiologie Clinique Antilles Guyane, INSERM CIC 1424, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Leila Adriouch
- COREVIH, Cayenne General Hospital, Cayenne, French Guiana, France
| | - Mathieu Nacher
- COREVIH, Cayenne General Hospital, Cayenne, French Guiana, France
- Faculty of Medecine Hyacinthe Basturaud, University of French Guiana, Cayenne, French Guiana, France
- Centre d’Investigation Clinique Epidemiologie Clinique Antilles Guyane, INSERM CIC 1424, Cayenne General Hospital, Cayenne, French Guiana, France
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Ranieri R, Starnini G, Carbonara S, Pontali E, Leo G, Romano A, Panese S, Monarca R, Prestileo T, Barbarini G, Babudieri S. Management of HCV infection in the penitentiary setting in the direct-acting antivirals era: practical recommendations from an expert panel. Infection 2016; 45:131-138. [PMID: 28025726 DOI: 10.1007/s15010-016-0973-0] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2016] [Accepted: 12/06/2016] [Indexed: 01/15/2023]
Abstract
BACKGROUND The prevalence of HCV infection is higher among prisoners than in the general population. The introduction of HCV direct-acting antivirals (DAA) holds the potential to improve clinical outcomes also in inmates. However, treatment of hepatitis C in inmates has to face several clinical and logistical issues which are peculiar of prison environment. Recommendations on the management of HCV infection specific for the penitentiary setting in the DAA era remain scant. The Italian Society for Penitentiary Medicine and Healthcare has, therefore, issued these recommendations, to provide clinicians with a guide for the comprehensive management of HCV infection in the restriction setting, taking into account its peculiar characteristics. RESULTS Dedicated diagnostic and treatment procedures should be established in each prison. In particular, the use of DAAs appears crucial to provide patients with an effective therapeutic option, able to overcome the limitations of IFN-based regimens with a short period of treatment. DAA treatment should be initiated as soon as possible in all eligible subjects with the aim to cure the patient, as well as to limit the transmission of HCV infection both inside the penitentiary system and to the free community, once the inmates ends his/her release. Importantly, efforts should be made to open a discussion with regulatory bodies, to define specific regulations aimed to guarantee wide access to effective therapies of all eligible patients, to optimize the management of and the adherence to the HCV treatment, and to ensure the therapeutic continuity after discharge from prison.
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Affiliation(s)
- Roberto Ranieri
- Azienda Ospedaliera Santi Paolo e Carlo Penitentiary Infectious Diseases Unit, University of Milan, Milan, Italy
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy
| | - Giulio Starnini
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy
- U.O.C. Medicina protetta-Malattie infettive, Viterbo, Italy
| | - Sergio Carbonara
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy
- Clinic of Infectious Diseases, University of Bari, Bari, Italy
| | - Emanuele Pontali
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy
- Infectious Disease Unit, Ospedale Galliera, Genoa, Italy
| | - Guido Leo
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy
- Infectious Disease Unit, Ospedale Amedeo di Savoia, Turin, Italy
| | | | - Sandro Panese
- Ospedale dell'Angelo Malattie infettive e Tropicali, Venice, Italy
| | - Roberto Monarca
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy
- Ospedale Belcolle, Viterbo, Italy
| | | | - Giorgio Barbarini
- Malattie Infettive e Tropicali IRCCS San Matteo, Università di Pavia, Pavia, Italy
- Case Circondariali di Pavia, Voghera e Vigevano, Italy
| | - Sergio Babudieri
- SIMSPe-Italian Society for Penitentiary Medicine and Healthcare, v.le San Pietro35/b, 07100, Sassari, Italy.
- Infectious Disease Unit, University of Sassari, Sassari, Italy.
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Sánchez Recio R, Alonso Pérez de Ágreda JP, Santabárbara Serrano J. [Sexually transmitted infections in male prison inmates: risk of development of new diseases]. GACETA SANITARIA 2016; 30:208-14. [PMID: 26987281 DOI: 10.1016/j.gaceta.2016.01.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/01/2015] [Revised: 01/25/2016] [Accepted: 01/26/2016] [Indexed: 10/22/2022]
Abstract
OBJECTIVE To measure incidence and main risk factors related to sexually transmitted infections (STIs) in Daroca Prison (Zaragoza, Spain). METHOD A retrospective cohort study (2005-2013) to measure the incidence of STI and a cross-sectional study to measure risk factors. RESULTS Of the 203 inmates, 79 developed an STI, 37 had a previous STI, 55.2% lacked knowledge on STI prevention, and 28.9% showed behaviours unfavourable for STI prevention. The incidence rate was 6.5 STIs per 1,000 inmates-year. The most frequent STIs were hepatitis B (39.7%), Ureaplasma urealyticum (19.1%), herpes simplex (16.2%) and HIV (8.8%). The risk (hazard ratio, HR) of acquiring a new STI was significantly higher in inmates with a history of previous STI (HR=2.61; 95%CI: 1.01 to 6.69), and was at the limit of significance for non-preventive behaviour (HR=2.10; 95%CI: 0.98 to 4.53), but not in knowledge related to STIs (HR=1.33; 95%CI: 0.58 to 3.07). CONCLUSION The most important risk factors in prison are behaviours related to STIs and previous history of STIs. Other factors are being a repeat offender, injecting drug use, or being in a methadone programme. Health personnel and peer education can facilitate prevention and control.
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Affiliation(s)
- Raquel Sánchez Recio
- Centro Penitenciario de Daroca, Secretaría General de Instituciones Penitenciarias, Ministerio del Interior, Zaragoza, España.
| | | | - Javier Santabárbara Serrano
- Departamento de Microbiología, Medicina Preventiva y Salud Pública, Universidad de Zaragoza, Zaragoza, España
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Monarca R, Madeddu G, Ranieri R, Carbonara S, Leo G, Sardo M, Choroma F, Casari S, Marri D, Muredda AA, Nava FA, Babudieri S. HIV treatment and care among Italian inmates: a one-month point survey. BMC Infect Dis 2015; 15:562. [PMID: 26653247 PMCID: PMC4676105 DOI: 10.1186/s12879-015-1301-5] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2015] [Accepted: 11/30/2015] [Indexed: 01/14/2023] Open
Abstract
Background HIV infection, with an estimated prevalence be between 2 and 50 times those of the general adult population is a major health challenge for prison authorities worldwide. Since no nationwide surveillance system is present in Italy, data on HIV prevalence and treatment in prisons are limited to only a few and small observational studies. We aimed to estimate HIV prevalence and obtain an overview on diagnostic and therapeutic activities concerning HIV infection in the Italian penitentiary system. Methods We piloted a multi-centre cross-sectional study investigating the prevalence of HIV infection and assessing HIV-related medical activities in Italian correctional institutions. Results A total of 15,675 prisoners from 25 institutions, accounting for approximately one-fourth of the prison inmates in Italy, were included in the study, of whom, 97.7 % were males, 37.1 % foreigners and 27 % had a history of intravenous drug addiction. HIV-tests were available in 42.3 % of the total population, with a known HIV Infection proportion of 5.1 %. In the month prior to the study, 604 of the 1,764 subjects who entered prison were tested for HIV, with a HIV-positive prevalence of 3.3 %. Among the 338 HIV-positive prisoners, 81.4 % were under antiretroviral treatment and 73.5 % showed undetectable HIV-RNA. In 23/338 (6.8 %) a coinfection with HBV and in 189/338 (55.9 %) with HCV was also present. Among the 67 (19.8 %) inmates with HIV who did not receive HIV treatment, 13 (19.5 %) had T-CD4+ count <350 cells/mm3 and 9 (69.2 %) of these had refused the treatment. The majority of the inmates with HIV-infection were on a PI-based (62.5 %) or on NNRTIs-based (24.4 %) regimen. Only a minority of patients received once daily regimens (17.2 %). Conclusions Although clinical and therapeutic management of HIV infection remains difficult in Italian prisons, diagnostics, treatment and care were offered to the majority of HIV-infected inmates. Specific programs should be directed towards the prison population and strict cooperation between prison and health institutions is needed to increase HIV treatment.
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Affiliation(s)
- R Monarca
- Infectious Diseases Unit, Belcolle Hospital, Viterbo, Italy.
| | - G Madeddu
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
| | - R Ranieri
- Infectious Diseases Unit, A.O. San Paolo, Milan, Italy.
| | - S Carbonara
- Institute of Infectious Diseases, University of Bari, Bari, Italy.
| | - G Leo
- Infectious Diseases Unit, Amedeo di Savoia Hospital, Torino, Italy.
| | - M Sardo
- Cotugno Hospital, Infectious Diseases Unit, Naples, Italy.
| | - F Choroma
- Infectious Diseases Unit, AUSL, Parma, Italy.
| | - S Casari
- Institute of Infectious Diseases, University of Brescia, Brescia, Italy.
| | - D Marri
- Infectious Diseases Unit, A.O. Santa Maria alle Scotte, Siena, Italy.
| | - A A Muredda
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
| | - F A Nava
- Penitentiary Medicine, Padova, Italy.
| | - S Babudieri
- Infectious Diseases Unit, Department of Clinical and Experimental Medicine, University of Sassari, Viale San Pietro 35b, 07100, Sassari, Italy.
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Sgarbi RVE, Carbone ADSS, Paião DSG, Lemos EF, Simionatto S, Puga MAM, Motta-Castro ARC, Pompilio MA, Urrego J, Ko AI, Andrews JR, Croda J. A Cross-Sectional Survey of HIV Testing and Prevalence in Twelve Brazilian Correctional Facilities. PLoS One 2015; 10:e0139487. [PMID: 26466312 PMCID: PMC4605759 DOI: 10.1371/journal.pone.0139487] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2015] [Accepted: 09/13/2015] [Indexed: 11/20/2022] Open
Abstract
BACKGROUND Prior studies have reported higher HIV prevalence among prisoners than the general population in Brazil, but data have been derived from single prisons. The aim of this study was to evaluate HIV testing practices, prevalence and linkage to care among inmates in a network of 12 prisons. METHODS We administered a questionnaire to a population-based sample of inmates from 12 prisons in Central-West Brazil and collected sera for HIV and syphilis testing from January to December 2013. We evaluated factors associated with HIV testing and infection using multivariable logistic regression models. Six months after HIV testing, we assessed whether each HIV-infected prisoner was engaged in clinical care and whether they had started antiretroviral therapy. RESULTS We recruited 3,362 inmates, of whom 2,843 (85%) were men from 8 prisons, and 519 (15%) were women from 4 prisons. Forty-five percent of participants reported never having been tested for HIV previously. In multivariable analysis, the variables associated with previous HIV testing were lack of a stable partner (adjusted odds ratio [AOR]: 1.38; 95% CI: 1.18-1.60), completed more than four years of schooling (AOR 1.40; 95% CI: 1.20-1.64), history of previous incarceration (AOR: 1.68; 95% CI: 1.43-1.98), history of mental illness (AOR 1.52; 95% CI: 1.31-1.78) and previous surgery (AOR 1.31; 95% CI: 1.12-1.52). Fifty-four (1.6%) of all participants tested positive for HIV; this included 44 (1.54%) men and 10 (1.92%) women. Among male inmates, HIV infection was associated with homosexuality (AOR 6.20, 95% CI: 1.73-22.22), self-report of mental illness (AOR 2.18, 95% CI: 1.13-4.18), history of sexually transmitted infections (AOR 3.28, 95% CI: 1.64-6.56), and syphilis sero-positivity (AOR 2.54, 95% CI: 1.20-5.39). Among HIV-infected individuals, 34 (63%) were unaware of their HIV status; only 23 of these 34 (68%) newly diagnosed participants could be reached at six month follow-up, and 21 of 23 (91%) were engaged in HIV care. CONCLUSIONS HIV testing rates among prison inmates are low, and the majority of HIV-infected inmates were unaware of their HIV diagnosis. Incarceration can be an opportunity for diagnosis and treatment of HIV among vulnerable populations who have poor access to health services, but further work is needed on transitional HIV care for released inmates.
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Affiliation(s)
| | | | | | | | - Simone Simionatto
- Faculty of Ambiental and Biological Sciences, Federal University of Grande Dourados, Brazil
| | | | - Ana Rita Coimbra Motta-Castro
- Department of Biochemical Pharmacy, Federal University of Mato Grosso do Sul, Campo Grande, Brazil
- Oswaldo Cruz Foundation, Campo Grande, Brazil
| | | | - Juliana Urrego
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
| | - Albert I. Ko
- Department of Epidemiology of Microbial Disease, Yale School of Public Health, New Haven, Connecticut, United States of America
- Gonçalo Moniz Institute, Oswaldo Cruz Foundation, Salvador, Brazil
| | - Jason R. Andrews
- Division of Infectious Diseases and Geographic Medicine, Stanford University School of Medicine, Stanford, California, United States of America
| | - Julio Croda
- Faculty of Health Sciences, Federal University of Grande Dourados, Dourados, Brazil
- Oswaldo Cruz Foundation, Campo Grande, Brazil
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Moschetti K, Stadelmann P, Wangmo T, Holly A, Bodenmann P, Wasserfallen JB, Elger BS, Gravier B. Disease profiles of detainees in the Canton of Vaud in Switzerland: gender and age differences in substance abuse, mental health and chronic health conditions. BMC Public Health 2015; 15:872. [PMID: 26358116 PMCID: PMC4566300 DOI: 10.1186/s12889-015-2211-6] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2014] [Accepted: 09/02/2015] [Indexed: 12/21/2022] Open
Abstract
BACKGROUND Literature on the disease profile of prisoners that differentiates by age and gender remains sparse. This study aimed to describe the health of correctional inmates in terms of substance abuse problems and mental and somatic health conditions, and compare it by gender and age. METHODS This study examined cross-sectional data from the Canton of Vaud in Switzerland on the health conditions of detainees who were in prison on January 1, 2011 or entered prison in 2011. Health conditions validated by physician examination were reported using the International Classification of Diseases (ICD) version 10. The analyses were descriptive by groups of prisoners: the entire sample (All), Men, Older adults and Women. RESULTS A total of 1,664 individuals were included in the analysis. Men comprised 91.5 % of the sample and had a mean age of 33 years. The other 8.5 % were women and had an average age of 39. Older adults (i.e., age 50 and older) represented 7 % of the total sample. Overall, 80 % of inmates were non-Swiss citizens, but the proportion of Swiss prisoners was higher among the older adults (51 %) and women (29 %). Overall, 41 % of inmates self-reported substance abuse problems. Of those, 27 % were being treated by psychiatrists for behavioral disorders related to substance abuse. Chronic infectious diseases were found in 9 % of the prison population. In addition, 27 % of detainees suffered from serious mental health conditions. Gender and age had an influence on the disease profile of this sample: compared to the entire prison population, the older inmates were less likely to misuse illegal drugs and to suffer from communicable infections but exhibited more problems with alcohol and a higher burden of chronic health conditions. Female prisoners were more disposed to mental health problems (including drug abuse) and infectious diseases. In terms of chronic diseases, women suffered from the same conditions as men, but the diseases were more prevalent in women. CONCLUSION It is important to understand the different disease profiles of prisoners by gender and age, as it helps identify the needs of different groups and tailor age-and gender-specific interventions.
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Affiliation(s)
- Karine Moschetti
- Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV), Route de la Corniche 10, 1010, Lausanne, Switzerland.
- Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV), Lausanne, 1011, Switzerland.
- IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH, Internef Building, Lausanne, 1015, Switzerland.
| | - Pierre Stadelmann
- Institut universitaire de médecine sociale et préventive, Unité d'evaluation des soins, University Hospital of Lausanne (CHUV), Route de la Corniche 10, 1010, Lausanne, Switzerland.
- IEMS - Plateforme interfacultaire en économie et management de la santé, University of Lausanne CH, Internef Building, Lausanne, 1015, Switzerland.
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland.
| | - Alberto Holly
- Institut d'économie et management de la santé (IEMS), HEC Lausanne and Département d'économétrie et d'économie politique (DEEP), University of Lausanne, Internef Building, Lausanne, 1015, Switzerland.
| | - Patrick Bodenmann
- Vulnerable Population Center, Department of Ambulatory Care and Community Medicine, University of Lausanne, Lausanne, 1011, Switzerland.
| | - Jean-Blaise Wasserfallen
- Technology Assessment Unit (UET), University Hospital of Lausanne (CHUV), Lausanne, 1011, Switzerland.
| | - Bernice S Elger
- Institute for Biomedical Ethics, Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, Basel, 4056, Switzerland.
- Centre universitaire romand de médecine légale, University of Geneva, Geneva, Switzerland.
| | - Bruno Gravier
- Service of Correctional Medicine and Psychiatry (SMPP), University Hospital of Lausanne (CHUV), Prilly-Lausanne, 1008, Switzerland.
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HIV/AIDS prevalence in Israeli prisons: Is there a need for universal screening? J Public Health Policy 2015. [PMID: 26202863 DOI: 10.1057/jphp.2015.21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
This study aimed to assess HIV/AIDS point-prevalence among inmates and evaluate costs related to universal screening as currently practiced and appraise its necessity. All inmates newly incarcerated in Israel (2003-2010) underwent HIV tests and their medical files were cross-matched the with the national HIV/AIDS registry to who had been newly infected and detected on prison entry. They were classified by key risk-groups. Of 108,866 new inmates during the period, 215 (0.2 per cent) were diagnosed with HIV/AIDS, 44 of those (0.04 per cent) were not aware of their infection. A large majority (94.2 per cent) of the infected inmates were members of a key-risk group: drug-users, homosexuals, or originating from a high-HIV prevalence country. The direct cost of detecting a single HIV-infected inmate who was not previously recorded was [euro ]12,386. The HIV/AIDS-screening process can be improved by interviewing the new inmates and performing targeted HIV-testing for those who are members of a known risk-group. These data from Israel are pertinent to developed countries with low HIV prevalence, because they present a picture of all newly infected inmates over an 8-year period within the paradigm of a fully functional HIV surveillance system.
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García Comas L, Ordobás Gavín M, Sanz Moreno JC, Ramos Blázquez B, Gutiérrez Rodríguez A, Astray Mochales J, Moreno Guillén S. Prevalence of hepatitis C antibodies in the population aged 16-80 years in the Community of Madrid 2008-2009. J Med Virol 2015; 87:1697-701. [PMID: 25989026 DOI: 10.1002/jmv.24219] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/23/2015] [Indexed: 12/18/2022]
Abstract
Together with AIDS, the burden of hepatitis C virus (HCV) in Spain heads the list of communicable diseases in terms of impact on public health. The aim of this study was to estimate the prevalence of HCV antibodies in the Community of Madrid, assess changes in recent years and analyse associated risk factors. Descriptive cross-sectional study of a target population consisting of Community of Madrid residents aged 16-80 years old. Two-stage cluster sampling was performed, with stratification by socioeconomic status and percentage immigrant population. The sampling frame consisted of public blood extraction centers attached to the Madrid Health Service. Seroprevalence of HCV antibodies, prevalence ratios by age groups in comparison with 1999 survey data and prevalence association with risk factors were assessed using a logistic regression model. Prevalence of HCV antibodies for the age group 16-80 years was 1.8% (95% CI: 1.3-2.5). The age group with the highest prevalence was 41-60 years. In comparison with the 1999 survey, prevalence fell for the age groups 21-30 and 31-40 years and increased for the age group 41-60. Statistically significant associations were found for age, education, history of hepatitis C and consultation regarding liver problems. Seroprevalence of HCV antibodies in the Community of Madrid is similar to that shown in other regions of Spain. It is increasing in older age groups as the population at risk ages. Incidence of hepatitis C may be decreasing considering the decrease in the seroprevalence in the population younger than 40 related to the previous serosurvey.
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Affiliation(s)
- Luis García Comas
- Subdirectorate of Health Promotion and Prevention, Health Department of the Community of Madrid (institution at which the work was performed), Madrid, Spain
| | - María Ordobás Gavín
- Subdirectorate of Health Promotion and Prevention, Health Department of the Community of Madrid (institution at which the work was performed), Madrid, Spain
| | - Juan Carlos Sanz Moreno
- Health Department of the Community of Madrid, Regional Public Health Laboratory, Madrid, Spain
| | - Belén Ramos Blázquez
- Health Department of the Community of Madrid, Regional Public Health Laboratory, Madrid, Spain
| | - Angeles Gutiérrez Rodríguez
- Subdirectorate of Health Promotion and Prevention, Health Department of the Community of Madrid (institution at which the work was performed), Madrid, Spain
| | - Jenaro Astray Mochales
- Subdirectorate of Health Promotion and Prevention, Health Department of the Community of Madrid (institution at which the work was performed), Madrid, Spain
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40
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Milloy MJ, Montaner JSG, Wood E. Incarceration of people living with HIV/AIDS: implications for treatment-as-prevention. Curr HIV/AIDS Rep 2015; 11:308-16. [PMID: 24962285 DOI: 10.1007/s11904-014-0214-z] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Contact with the criminal justice system, including incarceration, is a common experience for many people living with HIV/AIDS. Optimism has recently been expressed that correctional facilities could be important locations for treatment-as-prevention (TasP)-based initiatives. We review recent findings regarding the effect of incarceration on patterns of HIV transmission, testing, treatment initiation and retention. We found that the prevalence of HIV infection among incarcerated individuals remains higher than analogous non-incarcerated populations. Recent studies have shown that voluntary HIV/AIDS testing is feasible in many correctional facilities, although the number of previously undiagnosed individuals identified has been modest. Studies have implied enhanced linkage to HIV/AIDS treatment and care in jails in the United States was associated with improvements in the HIV cascade of care. However, for many individuals living with HIV/AIDS, exposure to the correctional system remains an important barrier to retention in HIV/AIDS treatment and care. Future research should evaluate structural interventions to address these barriers and facilitate the scale-up of TasP-based efforts among individuals living in correctional settings.
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Affiliation(s)
- M-J Milloy
- British Columbia Centre for Excellence in HIV/AIDS, 608-1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada,
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41
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Roux P, Sagaon-Teyssier L, Lions C, Fugon L, Verger P, Carrieri MP. HCV seropositivity in inmates and in the general population: an averaging approach to establish priority prevention interventions. BMJ Open 2014; 4:e005694. [PMID: 25331969 PMCID: PMC4202016 DOI: 10.1136/bmjopen-2014-005694] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
Abstract
OBJECTIVES Despite the fact that a considerable portion of hepatitis C virus (HCV) positive individuals are viraemic, the risk of transmitting HCV to others is context dependent. Prison is a particularly risky environment as HCV prevention tools are often unavailable. Using data from a cross-sectional study conducted in centres for HCV testing in southeastern France, we aimed to compare the patterns of risk factors in HCV-positive inmates with those in the general population. SETTING 26 centres for HIV/HCV testing in southeastern France (23 in the general population and 3 in prison). PRIMARY OUTCOME MEASURE HCV seropositivity measured with ELISA test. METHODS A propensity score method to ensure that the general and inmate populations could be compared and a multimodel averaging to estimate the degree (strong, weak, none) of the association of a number of specific factors with HCV seropositivity in each group. RESULTS Among the 52,082 participants, HCV infection prevalence was 1.5% and 5.2% in the general (n=46,125) and inmate (n=5957) populations, respectively. In both populations, 'drug injection without snorting' and 'drug injection with snorting' were very strongly associated with HCV seropositivity. Among inmates, 'drug snorting alone' (OR (95% CI) 2.21 (1.39 to 3.52) was also a strong correlate while tattoos, piercings (OR (95% CI) 1.22 (0.92 to 1.61)) and the sharing of toiletry items (OR (95% CI) 1.44 (0.84 to 2.47)) were weak correlates. CONCLUSIONS The pattern of risk factors associated with HCV seropositivity is different between the general and prison populations, injection and snorting practices being more prevalent in the latter. Access to prevention measures in prisons is not only a public health issue but also a human right for inmates who deserve equity of care and prevention.
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Affiliation(s)
- P Roux
- INSERM UMR912 (SESSTIM), Marseille, France
- Université Aix Marseille, IRD, UMR-S912, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - L Sagaon-Teyssier
- INSERM UMR912 (SESSTIM), Marseille, France
- Université Aix Marseille, IRD, UMR-S912, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - C Lions
- INSERM UMR912 (SESSTIM), Marseille, France
- Université Aix Marseille, IRD, UMR-S912, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - L Fugon
- INSERM UMR912 (SESSTIM), Marseille, France
- Université Aix Marseille, IRD, UMR-S912, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
- AIDES, Tour Essor, Pantin, France
| | - P Verger
- INSERM UMR912 (SESSTIM), Marseille, France
- Université Aix Marseille, IRD, UMR-S912, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
| | - M P Carrieri
- INSERM UMR912 (SESSTIM), Marseille, France
- Université Aix Marseille, IRD, UMR-S912, Marseille, France
- ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d'Azur, Marseille, France
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Darvishi M, Noori A, Assari S, Moazen B. Do the rates we report misinform the local programs? Pak J Med Sci 2014; 30:682-3. [PMID: 24949005 PMCID: PMC4048532 DOI: 10.12669/pjms.303.4912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2014] [Accepted: 04/20/2014] [Indexed: 11/15/2022] Open
Affiliation(s)
- Mohammad Darvishi
- Mohammad Darvishi, Assistant Professor, Infectious Diseases and Tropical Medicine Research Center (IDTMRC), AJA University of Medical Sciences, Tehran, Iran
| | - Atefeh Noori
- Atefeh Noori, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | - Shervin Assari
- ShervinAssari, Center for Research on Ethnicity, Culture, and Health (CRECH), Department of Health Behavior and Health Education, University of Michigan School of Public Health, Ann Arbor, USA
| | - Babak Moazen
- Babak Moazen, Non-communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
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