title: Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees.
abstract: The prison setting presents not only challenges, but also opportunities, for the prevention and treatment of HIV, viral hepatitis, and tuberculosis. We did a comprehensive literature search of data published between 2005 and 2015 to understand the global epidemiology of HIV, hepatitis C virus (HCV), hepatitis B virus (HBV), and tuberculosis in prisoners. We further modelled the contribution of imprisonment and the potential impact of prevention interventions on HIV transmission in this population. Of the estimated 10·2 million people incarcerated worldwide on any given day in 2014, we estimated that 3·8% have HIV (389 000 living with HIV), 15·1% have HCV (1 546 500), 4·8% have chronic HBV (491 500), and 2·8% have active tuberculosis (286 000). The few studies on incidence suggest that intraprison transmission is generally low, except for large-scale outbreaks. Our model indicates that decreasing the incarceration rate in people who inject drugs and providing opioid agonist therapy could reduce the burden of HIV in this population. The prevalence of HIV, HCV, HBV, and tuberculosis is higher in prison populations than in the general population, mainly because of the criminalisation of drug use and the detention of people who use drugs. The most effective way of controlling these infections in prisoners and the broader community is to reduce the incarceration of people who inject drugs.
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia. Electronic address: k.dolan@unsw.edu.au.
authors.forename: Kate
authors.initials: K
authors.lastname: Dolan
authors.affiliation: Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors.forename: Andrea L
authors.initials: AL
authors.lastname: Wirtz
authors.affiliation: Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.
authors.forename: Babak
authors.initials: B
authors.lastname: Moazen
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, CT, USA.
authors.forename: Martial
authors.initials: M
authors.lastname: Ndeffo-Mbah
authors.affiliation: Center for Infectious Disease Modeling and Analysis, Yale University, New Haven, CT, USA.
authors.forename: Alison
authors.initials: A
authors.lastname: Galvani
authors.affiliation: Griffith Criminology Institute & Menzies Health Institute Queensland, Griffith University, Brisbane, QLD, Australia.
authors.forename: Stuart A
authors.initials: SA
authors.lastname: Kinner
authors.affiliation: National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Ryan
authors.initials: R
authors.lastname: Courtney
authors.affiliation: Department of Health Services Research and Policy, London School of Hygiene & Tropical Medicine, London, UK.
authors.forename: Martin
authors.initials: M
authors.lastname: McKee
authors.affiliation: Health and Human Rights Division, Human Rights Watch, New York, NY, USA.
authors.forename: Joseph J
authors.initials: JJ
authors.lastname: Amon
authors.affiliation: Kirby Institute, University of New South Wales, Sydney, NSW, Australia.
authors.forename: Lisa
authors.initials: L
authors.lastname: Maher
authors.affiliation: Centre for Population Health, Burnet Institute, Melbourne, VIC, Australia.
authors.forename: Margaret
authors.initials: M
authors.lastname: Hellard
authors.affiliation: Center for Public Health and Human Rights, Johns Hopkins School of Public Health, Baltimore, MD, USA; Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, MD, USA.
authors.forename: Chris
authors.initials: C
authors.lastname: Beyrer
authors.affiliation: Epidemiology and Public Health, Yale University, New Haven, CT, USA.
authors.forename: Fredrick L
authors.initials: FL
authors.lastname: Altice
mesh_terms: D060085:Coinfection / Q000453:epidemiology; D017281:Cost of Illness; D004196:Disease Outbreaks / Q000517:prevention & control; D055030:Drug Users / Q000331:legislation & jurisprudence; D014943:Global Health / Q000706:statistics & numerical data / Q000639:trends; D015658:HIV Infections / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control / Q000635:transmission; D006509:Hepatitis B / Q000453:epidemiology; D006526:Hepatitis C / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006525:Hepatitis, Viral, Human / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data*; D015819:Substance Abuse, Intravenous / Q000150:complications; D014376:Tuberculosis / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology