Prisoners doing time in the jails, detention centres and youth centres of Quebec and Ontario have startlingly high rates of hepatitis C and HIV, find two new studies that suggest the need for better efforts to prevent inmates from spreading their illnesses.
Dr. Liviana Calzavara, public health scientist at the University of Toronto and colleagues looked at the health information of 1,877 adult and young offenders admitted to 13 Ontario remand facilities between Feb. 1, 2003, and June 20, 2004.
Among the adult offenders, they found that the rate of hepatitis C infection was 22 times higher than that of the general population, and the rate of HIV infection was 11 times higher.
- 2.1 per cent of the adults tested positive for HIV
- 17.6 per cent tested positive for hepatitis C
- None of the young offenders tested positive for HIV
- One (0.4 per cent) tested positive for hepatitis C.
Based on these results, the researchers estimate that 1,079 HIV-positive adults and 9,208 hepatitis C virus carriers were admitted to Ontario remand facilities from Apr. 1, 2003, to Mar. 31, 2004.
Rates were highest among inmates who reported a history of injection drug use. The authors note that 30.3 per cent of all the adults surveyed and 4.7 per cent of the young offenders reported a history of injection drug use.
"This shows the importance of education, because in some cases, there were people who knew they were infected and still were engaging in behaviours that would transmit the infection," said Liviana Calzavara, one of the study authors.
"This study draws attention to issues around education for individuals in terms of how to avoid it, how to avoid transmitting it to others and treatment that is available that would limit the health effects.
A study conducted in Quebec by Celine Poulin found similar results.
- The rate of hep C infection was 16.6 per cent among male prisoners studied
- The rate of hep C infection was 29.2 per cent among females
- The rate of HIV infection was 2.3 per cent among male prisoners
- The rate of HIV infection was 8.8 per cent among females.
In both studies, injection drug use was the most important risk factor, and the prevalence of hepatitis C virus infection was much higher than that of HIV infection.
Both studies are published in the Canadian Medical Association Journal.
The studies suggest the real the possibility that inmates are spreading these diseases within the correctional system. The authors say that given the fact that many offenders are likely to offend again and return repeatedly to provincial prisons and jails for short stays, the results of their studies have important public health implications.
In a related commentary, Richard Elliott, deputy director of the Canadian HIV/AIDS Legal Network, comments on the continued refusal by federal and provincial governments to bring in measures to prevent HIV and HCV infections in prisons.
For example, he notes that Correctional Services Canada has noted the widespread practice of unsafe tattooing in prisons. As well, many have called for needle-exchange programs in prisons, but notes that no prison system in Canada currently provides access to sterile injection equipment.
He suggests it may be time to put "the evidence of this ongoing denial of human rights" before the courts.
