Hepatitis C prevention, control efforts should focus on incarcerated individuals

More than one in nine people with hepatitis C in Canada spend time in a correctional facility each year and researchers said this presents a unique opportunity to focus hepatitis C prevention and control efforts in incarcerated populations.

People who have spent time in correctional facilities have higher risk factors for hepatitis C, including injection drug use and needle sharing, both in custody and in the community, according to the paper published online today in the Canadian Journal of Public Health.

"Incarcerated individuals are more likely to be infected with hepatitis C and more likely to continue the transmission cycle because of their involvement in risky behaviours such as sharing needles," said Dr. Fiona Kouyoumdjian, a post-doctoral fellow with the Centre for Research on Inner City Health of St. Michael's Hospital. "Time in custody is a unique opportunity for health-care workers to offer prevention activities to people who may otherwise be difficult to reach."

The paper outlined various strategies to address hepatitis C in individuals in custody, including:

• Introducing needle exchange programs in correctional facilities.
• Improving access to opioid substitution therapy and other drug treatments, which previous research has shown to prevent hepatitis C infection in injection drug users.
• Offering screening for hepatitis C in all correctional facilities.
• Expanding access to hepatitis C treatment in correctional facilities, when feasible and appropriate.
• Linking individuals to community-based programs upon their release.

Dr. Kouyoumdjian said health-care and public services in correctional facilities should be equivalent to those available in the community, and that individuals in custody should have access to the tools they need to improve their health.

"Any strategy addressing hepatitis C in Canada should include a focus on people who experience incarceration," said Dr. Kouyoumdjian. "Identifying and managing hepatitis C in incarcerated individuals can prevent the progression of the disease in infected individuals, and can have a positive effect in society, by reducing transmission rates and health care costs."