title: HCV seropositivity in inmates and in the general population: an averaging approach to establish priority prevention interventions.
abstract: OBJECTIVE
  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.
  
  
  METHODS
  26 centres for HIV/HCV testing in southeastern France (23 in the general population and 3 in prison).
  
  
  METHODS
  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.
authors.affiliation: 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.
authors.forename: P
authors.initials: P
authors.lastname: Roux
authors.affiliation: 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.
authors.forename: L
authors.initials: L
authors.lastname: Sagaon-Teyssier
authors.affiliation: 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.
authors.forename: C
authors.initials: C
authors.lastname: Lions
authors.affiliation: 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.
authors.forename: L
authors.initials: L
authors.lastname: Fugon
authors.affiliation: 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.
authors.forename: P
authors.initials: P
authors.lastname: Verger
authors.affiliation: 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.
authors.forename: M P
authors.initials: MP
authors.lastname: Carrieri
mesh_terms: D000328:Adult; D046288:Body Piercing / Q000706:statistics & numerical data; D003430:Cross-Sectional Studies; D004797:Enzyme-Linked Immunosorbent Assay; D005260:Female; D005602:France / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D016036:Seroepidemiologic Studies; D015819:Substance Abuse, Intravenous / Q000453:epidemiology*; D013653:Tattooing / Q000706:statistics & numerical data; D055815:Young Adult
keywords: INFECTIOUS DISEASES