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Recent incarceration associated with increased risk for HIV, HCV

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November 11, 2018

Recent incarceration is associated with an 81% increased risk for HIV and a 62% increased risk for hepatitis C virus acquisition, according to a systematic review and meta-analysis of dozens of studies from five continents.

“HCV and HIV are leading causes of morbidity and mortality and continue to represent major global public health concerns,” Jack Stone, PhD, an infectious disease mathematical modeler in the department of population health sciences at the University of Bristol in England, and colleagues wrote. “Injecting drug use is associated with two-fifths of the global HCV disease burden, while outside sub-Saharan Africa, an estimated one-fifth of new HIV infections occur among people who inject drugs (PWID).”

Studies have showed the benefits of HCV and HIV treatment in prisons. Although there is evidence that reinfection and transmission of HCV is common in prisoners who inject drugs, and that PWID have a higher prevalence of incarceration, little is known about the link between incarceration history and HCV and HIV risk, according to Stone and colleagues.

To assess the potential of elevated HIV or HCV acquisition risk among PWID, Stone and colleagues analyzed studies found in MEDLINE, Embase and PsycINFO databases that were published between Jan. 1, 2000, and June 13, 2017.

In total, they identified 25,434 unique records and ultimately included results from 20 published studies and 21 unpublished studies. The results showed that incarceration within the past 3, 6 or 12 months was associated with an 81% increase in HIV acquisition risk and a 62% increase in HCV acquisition risk. According to the researchers, past incarceration also showed increases in HIV and HCV acquisition risk of 25% and 21%, respectively.

The authors said further research is required to better understand how incarceration elevates HIV and HCV risk to guide intervention developments.

“Our study provides strong evidence that recent incarceration is associated with substantial increases in HIV and HCV acquisition risk among PWID. Owing to the high prevalences of incarceration among PWID, incarceration is likely to be an important driver of HCV and HIC transmission and transmission among PWID,” they concluded. “Our findings add to the growing body of evidence for the harms associated with international drug policy, which result in many people who use drugs being incarcerated, and support calls for decriminalization of illicit drug use and greater access to prison-based harm reduction, with linkage following release.” – by Caitlyn Stulpin

Disclosures: Stone reports non-financial support from Gilead Sciences outside of the study. Please see the study for all other authors’ relevant financial disclosures.

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