TY - JOUR
T1 - HIV and Viral Hepatitis among Imprisoned Key Populations
AU - Wirtz, Andrea L.
AU - Yeh, Ping T.
AU - Flath, Natalie L.
AU - Beyrer, Chris
AU - Dolan, Kate
N1 - Funding Information:
Author affiliations: Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Andrea L. Wirtz, Chris Beyrer); Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Ping T. Yeh); Department of Health Behavior and Society, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland (Natalie L. Flath); Baltimore City Health Department, Baltimore, Maryland (Natalie L. Flath); and University of New South Wales, Sydney, New South Wales, Australia (Kate Dolan). This study was supported by grants to the Center for Public Health and Human Rights at Johns Hopkins Bloomberg School of Public Health from the National Institute on Drug Abuse; the Open Society Foundations; the United Nations Population Fund; MACAIDS; the Bill and Melinda Gates Foundation; and the Johns Hopkins University Center for AIDS Research, a National Institute of Health–funded program 1P30AI094189. Conflict of interest: none declared.
Funding Information:
This study was supported by grants to the Center for Public Health and Human Rights at Johns Hopkins Bloomberg School of Public Health from the National Institute on Drug Abuse; the Open Society Foundations; the United Nations Population Fund; MACAIDS; the Bill and Melinda Gates Foundation; and the Johns Hopkins University Center for AIDS Research, a National Institute of Health-funded program 1P30AI094189.
Publisher Copyright:
© 2018 The Author(s). Published by Oxford University Press on behalf of the Johns Hopkins Bloomberg School of Public Health.
PY - 2018/6/1
Y1 - 2018/6/1
N2 - Prisons and other closed facilities create opportunities for transmission of human immunodeficiency virus (HIV) and viral hepatitis during detention and after release. We conducted a systematic review and meta-analysis of peer-reviewed publications (2005-2015) to describe the prevalence of HIV, hepatitis C virus, and hepatitis B virus among key populations in prisons worldwide and to compare estimates of infection with those of other prison populations. Most data were reported for people who inject drugs (PWID; n = 72) and for men who have sex with men (MSM; n = 21); few data were reported on sex workers (SW; n = 6), or transgender women (n = 2). Publications were identified from 29 countries, predominantly middle-and high-income countries. Globally, PWID had 6 times the prevalence of HIV (pooled prevalence ratio (PPR) = 6.0, 95% CI: 3.8, 9.4), 8 times the prevalence of hepatitis C virus (PPR = 8.1, 95% CI: 6.4, 10.4), and 2 times the prevalence of hepatitis B virus (PPR = 2.0, 95% CI: 1.5, 2.7) compared with noninjecting prisoner populations. Among these articles, only those from Iran, Scotland, Spain, and Italy included the availability of methadone therapy; 2 articles included information on access to needle exchange programs by PWID detainees. HIV prevalence was more than 2 times higher among SW (PPR = 2.6, 95% CI: 2.2, 3.1) and 5 times higher among MSM (PPR = 5.3, 95% CI: 3.5, 7.9) compared with other prisoners. None of these articles reported HIV prevention coverage among SW or transgender women; 1 described HIV and sexually transmitted infection screening for MSM in prison. Prevention programs specific to key populations are important, particularly for populations that are criminalized and/or may cycle in and out of prison.
AB - Prisons and other closed facilities create opportunities for transmission of human immunodeficiency virus (HIV) and viral hepatitis during detention and after release. We conducted a systematic review and meta-analysis of peer-reviewed publications (2005-2015) to describe the prevalence of HIV, hepatitis C virus, and hepatitis B virus among key populations in prisons worldwide and to compare estimates of infection with those of other prison populations. Most data were reported for people who inject drugs (PWID; n = 72) and for men who have sex with men (MSM; n = 21); few data were reported on sex workers (SW; n = 6), or transgender women (n = 2). Publications were identified from 29 countries, predominantly middle-and high-income countries. Globally, PWID had 6 times the prevalence of HIV (pooled prevalence ratio (PPR) = 6.0, 95% CI: 3.8, 9.4), 8 times the prevalence of hepatitis C virus (PPR = 8.1, 95% CI: 6.4, 10.4), and 2 times the prevalence of hepatitis B virus (PPR = 2.0, 95% CI: 1.5, 2.7) compared with noninjecting prisoner populations. Among these articles, only those from Iran, Scotland, Spain, and Italy included the availability of methadone therapy; 2 articles included information on access to needle exchange programs by PWID detainees. HIV prevalence was more than 2 times higher among SW (PPR = 2.6, 95% CI: 2.2, 3.1) and 5 times higher among MSM (PPR = 5.3, 95% CI: 3.5, 7.9) compared with other prisoners. None of these articles reported HIV prevention coverage among SW or transgender women; 1 described HIV and sexually transmitted infection screening for MSM in prison. Prevention programs specific to key populations are important, particularly for populations that are criminalized and/or may cycle in and out of prison.
KW - HIV
KW - drug use
KW - men who have sex with men
KW - prison
KW - sex work
KW - transgender persons
KW - viral hepatitis
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U2 - 10.1093/epirev/mxy003
DO - 10.1093/epirev/mxy003
M3 - Article
C2 - 29688317
AN - SCOPUS:85048692424
SN - 0193-936X
VL - 40
SP - 12
EP - 26
JO - Epidemiologic reviews
JF - Epidemiologic reviews
IS - 1
ER -