[HIVAb, HCVAb and HBsAg seroprevalence among inmates of the prison of Bologna and the effect of counselling on the compliance of proposed tests].
OBJECTIVE
The aims of the study were to evaluate the HIVAb, HCVAb and HBsAg seroprevalence among Italian and foreign inmates of the prison of Bologna, to evaluate if the extensive counselling of "new" inmates has significantly enhanced adherence to laboratory tests.


METHODS
The serological status was determined by a blood withdraw following the informed consent. Before asking their consent, patients were informed by cultural mediators who had been instructed about the aims of the study/exam during introductory meetings. The initial step managed by mediators was followed by further individual counselling interventions, carried out by hospital infective disease unit, prison and prison drug abuse service physicians. The laboratory tests were performed in an external structure.


METHODS
Prison of Bologna.


METHODS
The study was conducted on 433 subjects among a whole population of 900 inmates in the local prison: 390 subjects were males (90.1%) and 43 were females (9.9%). The median age of the whole population was 34.86 years (+/- 9.9). The studied population counted 147 (33.9%) intravenous drug users (IDU) and 286 not addicts (66.1%). As regards nationality, 212 subjects were Italian (48.9%) and 221 (51.1%) foreigners. Among the total 433 inmates considered, 78 (18%) were known as previous IDU with conviction history or condemned to long term sentences, while 59 (13.6%) were inmates recently convicted active IDU assisted by the internal drug abusers service. The third group was composed by 296 inmates imprisoned during the summer (103 Italians and 193 foreigners) self declared not IDU.


RESULTS
A. 12.5% of inmates were HIV positive, 8.1% HBV positive and 31.1% HCV positive. 25 subjects were found positive both to HIV and HCV; 1 both to HIV and HBV and 5 to HIV, HBV and HCV. HIV positivity is more common among Italian vs. foreigners inmates, among IDU vs. not IDU. HCV positivity is more common among Italian vs. foreigners inmates, and among IDU vs. not IDU. The distribution of HBV seropositivity among the different groups shows no statistically significant differences. All subjects receiving multi-focal counselling reached better compliance levels: 10% vs. 1% for HIV, 16% vs. 1% for HBV and 35% vs. 0.3% for HCV, with statistically significant coefficients of contingency.


CONCLUSIONS
In the prison of Bologna drug addiction is prevalent in italian seropositive personers and it is often associated with HIV and HCV positivity. Foreign inmates, mostly in the not-IDU group, show a lower prevalence of these two infections. Multi-focal counselling before test increased significantly the adherence of inmates to the study.
Sabbatani
Sergio
S
UO malattie infettive, Policlinico S. Orsola di Bologna. sabbatani@med.unibo.it
Giuliani
Ruggero
R
Fulgaro
Ciro
C
Paolillo
Pasquale
P
Baldi
Elena
E
Chiodo
Francesco
F
D000328:Adult; D003955:Diagnostic Tests, Routine; D037001:Directive Counseling; D005260:Female; D015483:HIV Antibodies / Q000097:blood*; D015658:HIV Infections / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D006509:Hepatitis B / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D006514:Hepatitis B Surface Antigens / Q000097:blood*; D006526:Hepatitis C / Q000097:blood* / Q000175:diagnosis / Q000453:epidemiology*; D018937:Hepatitis C Antibodies / Q000097:blood*; D006801:Humans; D007558:Italy; D008297:Male; D010349:Patient Compliance; D015995:Prevalence; D011330:Prisons; D016036:Seroepidemiologic Studies
D015483:HIV Antibodies; D006514:Hepatitis B Surface Antigens; D018937:Hepatitis C Antibodies