Free Essay on Reducing HCV Prevalence in Incarcerated Population

Hepatitis C virus (HCV) infection is one of the main public health issues globally, with over 170 million infected individuals currently. Individuals detained in prisons and those in other disclosed settings are usually at a higher risk of infection with HCV because as an enclosed and crowded setting, prisons are characterized by high-risk behaviors such as drug use through injection, unprotected sexual intercourses, tattooing, or sharing syringes. The global incarcerated population exceeds 11 million individuals and has been growing at a rate that exceeds population growth (Behzadifar, Gorji, Rezapour, Bragazzi, 2018). With the widespread presence of blood-borne viruses (BBVs) such as HCV in prisons, the public health implication is clear. The implication is that prisons are a critical site for the identification and treatment of HCV and for minimizing the spread of infections through the implementation of evidence-based and infection control measures.

Is your time best spent reading someone else’s essay? Get a 100% original essay FROM A CERTIFIED WRITER!

Order now

Consistency with a widespread adoption of a comprehensive collection of interventions for HCV prevention in prisons can go a long way in being a commendable remedy. Assessing the uptake of such a package at a global level is necessary as a future research priority as well. Among the first steps that can be taken include noting the factors that lead to the high prevalence of HCV in prison. For instance, many prisoners have had a history of injection use while in prison (Behzadifar, et al., 2018).

This portion that continues doing so while in custody is small, but every inject poses a high risk due to the lack of access to clean equipment for injecting. There have been studies reviewing what is know on the impacts that come with prison needle and syringe programs (PNSPs) on the health outcomes for clients of such programs. Even with the widespread and sustained advocacy for PNSPs, there are only a few eligible studies, although they offer credible suggestions on the prevention of HCV. More importantly, the authors highlighted that even though evidence with respect to the safety of staff is limited, there are no reports of the needles being used as weapons against the staff members in prisons. With the strong evidence of benefits needle and syringe programs come with, the authors called for a wider adoption of PSNPs.

About 2-3% of individuals are infected with HCV globally, a rate way lower when compared to that in prisons. The main route of transmission, even in the public include injecting drug use (IDU) and, for developing countries, medical procedures through the use non-sterile needles and syringes (Puga, Pompilio, Croda, 2017). Prisons as well as other closed settings (such as jails, prisons, juvenile detention facilities, extra-judicial detention centers for persons using drugs, and pre-trial detention centers; immigration detention and psychiatric institutions may not be included as definition for the consider study purpose) are significantly important in understanding the HCV epidemic because of high prevalence in the risk behaviors of detainee population. The history of IDU is evident among prisoners, and injecting can continue while detained, with risks in attendant disease transmission (Puga, et al., 2017).

Additionally, most individuals in prison return to the community after a relatively short time. A lack of prevention measures for infectious disease transmission in prison has therefore proved to be coming with consequences that extend beyond the prison environment, thus the need of reducing HCV prevalence in prisons (Zampino, Coppola, Sagnelli, Caprio, Sagnelli, 2015). Incarceration also represents an important chance in identifying and initiating treatment for infectious diseases. Realization of this highly significant public health opportunity is contingent on the dependably identifying person with HCV infection.

The procedure for finding infectious diseases in prisons includes noting of evidence at prison reception as well as provider-initiated testing in prison as being associated with higher conducting of tests (Behzadifar, et al., 2018). Among those incarcerated, groups like those meant having sex with other men, those that inject drugs, transgender individuals, and sex workers are at a higher risk of poor health outcomes. Evidence in past studies confirms evidence-based prevention programs are specifically necessary for key incarcerated populations, in reducing their HCV prevalence rates to the one in the general population.

Despite the evidence of the risk of HCV infection in prison, there have been limited efforts in examining the extent of this issue. A better understanding of HCV epidemiology in closed settings is important in determining the extent of the problem, and this also proves a basis for public advocacy efforts as well as the development of treatment and prevention interventions. It is particularly so in terms of the recent advances in HCV therapies and the promise of interferon-free, all-oral treatments in the future (Larney Kopinski, Beckwith, Zaller, Jarlais, Hagan, Rich, Bergh, Degenhardt, 2012).

An example of an epidemiologic study design to use in assessing and addressing the prevalence of HCV in prison include first reviewing the results of the majority of performed studies globally on anti-HCV prevalence in prisons. These rates range from 3.1% to 3.8% over the years in relation to the endemicity of HCV infection in the prison's geographic location and in the states of origin of foreign prisoners (Behzadifar, et al., 2018). The study can be cross-sectional, conducted with differing aims, statistical analysis, and enrolment criteria. The information on the prisoners can be obtained with the use of a pre-coded questionnaire, or through an oral interview that must doctor to patient ones. Some questionnaires may not give any information on the necessary socioeconomic factors, as these may be indicators of the level of awareness of HCV infection.

Additionally, it is necessary to also consider the fact that some inmates can have lied with regards to certain questions, particularly those that concern needle use and sexual behavior. The reason behind this may be since these behaviors are considered socially immoral or are illegal. In getting more reliable information from the incarcerated individuals, peer-to-peer communication or educational programs can be organized to improve honest relations between the medical personnel and the patient prisoners. The study can also aim towards obtaining medical records, with a consistent lack of some data (Larney, et al., 2012). Different results can be obtained, thus the need to compare the different established prevalence of anti-HCV positive cases between members of staff and prisoners. A multicenter cross-sectional study can also be conducted to establish the existing difference in the anti-HCV rates between prison staff and the prisoners in several prisons.

The study can have an epidemiological impact on various risk factors in acquiring HCV infection, as established in several studies conducted in the past, on prisoners. One main risk factor related to HCV infection is the intravenous drug use (IVDU). Even though such a risky behavior may strictly be forbidden in prisons globally, nearly half of all illicit drug users continue to abuse these drugs following their imprisonment. Additionally, the challenge of getting sterile injecting equipment in prison results in widespread sharing of infected equipment as well as an increased risk of HCV transmission.

For instance, in some studies, observations included HCV infection being observed more frequently in female inmates when compared to the male one, and this reflected the higher rates of incarcerated females for drug-related offenses. Also, other risk factors in relation to HCV infection in incarcerated populations included an older age and previous imprisonments, factors that are probably related to an increased exposure over time to the major risk factors (Kinner & Young, 2018). There were significant associations established between the presence of HCV infection and ages over 30, as well as ages over 45 and a previous prison term being factors related to anti-HCV positivity for inmates. Previous imprisonments were also registered in the life history of much of the anti-HCV positive inmates in the main prison facilities.

Apart from using questionnaires and interviews used as data collection activities in the study, established literature can also be used. There several strategies that can be used in the identification of relevant literature. These include using databases of peer-reviewed literature, such as Embase, Medline, National Criminal Justice Reference Service, and Abstracts, can be searched. Another strategy in literature selection includes consideration of grey literature (Larney, et al., 2012). It refers to communications and publications not formally published by commercial publishers or peer-reviewed journals. Emails can also be sent the relevant contacts of authors, requesting data that can not have been identified in the search. The email can then be redistributed by the initial recipients as see appropriate.

Conclusively, high-risk activities such as IDU, IDVD, tattooing, and sexual activities are common practices carried out in prisons. Even with the prohibition, a few prisoners have access to tools used in injection drug use. The burden of HCV among prisoners, particularly in areas where drug abuse through injection is highly prevalent among detainees, is a crucial health concern. The lack of epidemiologic data is among the issues hindering a reducing of HCV infection rates in prisons to go down to that in the general population (Zampino, et al., 2015). The global response to HCV in prisons and other closed settings has essentially been limited, a few countries in the world have implemented the needed preventive interventions discussed in the paper, or lack providing treatment for detainees infected with HCV. There is a need for paying attention to HCV diagnosis, prevention, as well as ensuring effective delivery of treatments for incarcerated populations.

References

Behzadifar, M., Gorji, H. A., Rezapour, A. & Bragazzi, N. L. (2018). Prevalence of hepatitis C virus infection among prisoners in Iran: a systematic review and meta-analysis. Harm Reduction Journal, 9 May.15(24).

Kinner, S. A. & Young, J. T. (2018). Understanding and Improving the Health of People Who Experience Incarceration: An Overview and Synthesis. Epidemiologic Reviews, 1 June, 40(1), 4-11.

Larney, S. et al. (2012). The incidence and prevalence of hepatitis C in prisons and other closed settings: Results of a systematic review and meta-analysis. Hepatology, Oct, 58(4), 1215-1224.

Puga, M. A. M., Bandeira, L. M., Pompilio, M. A. & Croda, J. (2017). Prevalence and Incidence of HCV Infection among Prisoners in Central Brazil. PLoS ONE, 6 January.12(1).

Zampino, R. et al. (2015). Hepatitis C virus infection and prisoners: Epidemiology, outcome, and treatment. World Journal of Hepatology, 7(21), 2323-2330.