title: Community incidence of hepatitis B and C among reincarcerated women.
abstract: BACKGROUND
  The incarceration rate has increased 239% in the United States over the past 2 decades. This increase in incarceration has been fueled by the movement towards a criminal, rather than medical, response to the problem of drug dependence. For women in particular, incarceration and drug use are interdependent epidemics. Given that incarceration is common among drug-dependent persons, infectious diseases--including hepatitis B virus (HBV) and hepatitis C virus (HCV) infection--are prevalent among incarcerated persons. We sought to determine the incidence of HBV and HCV infection among recidivist women prisoners.
  
  
  METHODS
  From 1996 through 1997, excess from serum samples collected during HIV testing of female admittees to a state Department of Corrections facility were tested for HBV and HCV. Multiple samples obtained from women incarcerated multiple times during the study period were compared for incidence.
  
  
  RESULTS
  Baseline prevalences of markers of HBV and HCV were 36% and 34%, respectively. Incidence rates for HBV and HCV infection among reincarcerated women were 12.2 and 18.2 per 100 person-years, respectively. The majority of the time spent between serial intakes was not spent in the correctional facility; thus, incident infections likely occurred in the community.
  
  
  CONCLUSIONS
  Incidences of HBV and HCV infection among reincarcerated women were high. Prisons and jails can be efficient locations for the diagnosis, treatment, and prevention of hepatitis B and C through programs such as testing, counseling, education, vaccination, and linkage to medical and drug treatment services.
authors.affiliation: Department of Medicine, Tufts-New England Medical Center, Boston, MA, USA.
authors.forename: Grace E
authors.initials: GE
authors.lastname: Macalino
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
authors.forename: Brian P
authors.initials: BP
authors.lastname: Dickinson
authors.forename: Beth
authors.initials: B
authors.lastname: Schwartzapfel
authors.forename: Josiah D
authors.initials: JD
authors.lastname: Rich
mesh_terms: D000328:Adult; D017714:Community-Acquired Infections / Q000453:epidemiology; D005260:Female; D006509:Hepatitis B / Q000453:epidemiology*; D006526:Hepatitis C / Q000453:epidemiology*; D006801:Humans; D015994:Incidence; D015995:Prevalence; D011329:Prisoners; D012307:Risk Factors