Archival Content: 1999-2005
The unique circumstances of the criminal justice environment create opportunities to reach an underserved population with viral hepatitis prevention and treatment services. However, correctional facilities must grapple with several issues, including uncertainty about who will pay for these services, a lack of screening and treatment guidelines, and a need for staff training.
Viral Hepatitis is an Important Issue Facing the Criminal Justice System
Hepatitis B and C are highly prevalent in correctional facilities.
Although the prevalence of hepatitis B virus (HBV) and hepatitis C virus (HCV) infections in correctional facilities is not known with certainty, a number of indications point to their being very common:
Transmission can occur within and beyond the corrections setting.
Many inmates already have chronic HBV or HCV infection when they enter prison or jail. Because symptoms are often mild or nonexistent, inmates may not know they are infected and can unwittingly transmit the virus to others through injection drug use, consensual sex, rape, and tattooing with contaminated equipment. Transmission can also occur as a result of sharing personal items, such as razors or toothbrushes. There is also a high risk of transmission to the larger community outside of the facility if an inmate continues to practice high-risk drug use and sexual behaviors after release.
The Criminal Justice System Faces Particular Challenges in Responding to Hepatitis B and Hepatitis C
Awareness of viral hepatitis as an important public health issue is growing, but correctional facilities face a number of unique issues as they try to respond:
Despite these challenges, the unique circumstances of the correctional environment create an unparalleled opportunity to reach a population that has been resistant to or unreached by education and interventions and to provide them with beneficial prevention and treatment services:
To Learn More About This Topic
Read the overview fact sheet in this series on drug users and hepatitis –“Viral Hepatitis and IDUs.” It provides basic information, links to the other fact sheets in this series, and links to other useful information (both print and Internet).
Visit these other websites:
Check out these sources of information:
Advisory Committee on Immunization Practices, CDC. Protection against viral hepatitis: recommendations of the Immunization Practices Advisory Committee (ACIP). Morbidity and Mortality Weekly Report 1990;39(RR-2):1-26.
Association of State and Territorial Health Officials (ASTHO). Hepatitis C and incarcerated populations: the next wave for correctional health initiatives. Washington (DC): ASTHO; November 2000.
Centers for Disease Control and Prevention (CDC). Hepatitis B outbreak in a state correctional facility, 2000. Morbidity and Mortality Weekly Report 2001;50(25):529-532.
Centers for Disease Control and Prevention (CDC). Decrease in AIDS related mortality in a state correctional system – New York, 1995-1998. Morbidity and Mortality Weekly Report 1999;47(51):1115-1117.
Centers for Disease Control and Prevention (CDC). Recommendations for prevention and control of hepatitis C virus (HCV) infection and HCV-related chronic disease. Morbidity and Mortality Weekly Report 1998;47(RR19):1-39.
Advisory Committee on Immunization Practices, CDC. Hepatitis B virus: a comprehensive strategy for eliminating transmission in the United States through universal childhood vaccination: Recommendations of the Immunization Practices Advisory Committee (ACIP). Morbidity and Mortality Weekly Report 1991;40(RR13):1-39.
National Commission on Correctional Health Care. Position statement on management of hepatitis B virus in correctional facilities. April 13, 1997.
National Commission on Correctional Health Care and Society of Correctional Physicians. Joint position statement on management of hepatitis C in correctional institutions. November 7, 1999.
National Institutes of Health. Management of hepatitis C: 2002. Consensus Development Statement #116. June, 10-12, 2002.
Reindollar RW. Hepatitis C and the correctional population. American Journal of Medicine 1999;107(6B):100S-103S. Spaulding A, Greene C, Davidson K, et al. Hepatitis C in state correctional facilities. Preventive Medicine 1999;28(1):92-100.
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