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Trends in HIV, hepatitis B and hepatitis C prevalence among Australian prisoners - 2004, 2007, 2010

Joanne M Reekie, Michael H Levy, Alun H Richards, Christopher J Wake, Deborah A Siddall, Holly M Beasley, Shalin Kumar and Tony G Butler
Med J Aust 2014; 200 (5): 277-280. || doi: 10.5694/mja13.11062

Summary

Objective: To report the prevalence of markers for HIV infection, hepatitis B and hepatitis C among Australian prison entrants.

Design: Cross-sectional survey conducted over 2-week periods in 2004, 2007 and 2010.

Setting: Reception prisons in New South Wales, Queensland, Tasmania and Western Australia.

Participants: Individuals entering prison from the community during the survey periods.

Main outcome measure: Prevalence of anti-HIV antibody (anti-HIV), hepatitis B surface antigen (HBsAg), anti-hepatitis B core antibody (anti-HBc) and anti-hepatitis C virus antibody (anti-HCV).

Results: The study included 1742 prison entrants: 588 (33.8%) in 2004, 536 (30.8%) in 2007 and 618 (35.5%) in 2010. The age-standardised prevalence estimates for anti-HIV, HBsAg and anti-HBc were 0.4%, 2.3% and 21.7% respectively, and remained stable over the three survey periods. The age-standardised prevalence estimate for anti-HCV was 29.0%; it decreased over time (33.3% in 2004 v 23.2% in 2010; P = 0.001), and this coincided with a decrease in prison entrants reporting injecting drug use (58.3% [343/588] in 2004 v 45.3% [280/618] in 2010; < 0.001). Among injecting drug users, the prevalence of anti-HCV was 57.2% and did not change significantly over time. Of those who were anti-HCV positive, 33.7% (140/415) were unaware of their infection status, and 74.3% (185/249) of those who tested positive for anti-HBc reported that they had never had hepatitis B.

Conclusions: HIV prevalence is low in the Australian prisoner population but transmission remains a risk. Despite a decrease in the proportion of prison entrants reporting injecting drug use, prevalence of hepatitis B and hepatitis C has remained high. Treatment and prevention initiatives should be prioritised for this population.

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  • Joanne M Reekie1
  • Michael H Levy2
  • Alun H Richards3
  • Christopher J Wake4
  • Deborah A Siddall5
  • Holly M Beasley6
  • Shalin Kumar7
  • Tony G Butler1

  • 1 Kirby Institute, University of New South Wales, Sydney, NSW.
  • 2 ANU College of Medicine, Biology and Environment, Australian National University, Canberra, ACT.
  • 3 Communicable Diseases Unit, Queensland Health, Queensland Government, Brisbane, QLD.
  • 4 Correctional Primary Health Service, Department of Health and Human Services, Tasmanian Government, Hobart, TAS.
  • 5 Forensic Health Services, Australasian Hepatology Association, Hobart, TAS.
  • 6 Department of Corrective Services, Government of Western Australia, Perth, WA.
  • 7 Justice Health and Forensic Mental Health Network, Sydney, NSW.

Correspondence: jreekie@kirby.unsw.edu.au

Acknowledgements: 

The cost of the data collection and screening was borne by the respective state and territory governments. Support for coordination of the study and report writing was provided by Justice Health (NSW), WA Department of Corrective Services, NT Department of Correctional Services, Queensland Health, South Australian Prison Health Service, Correctional Primary Health Services (Tas), Justice Health Services (ACT), and Justice Health (Vic). Tony Butler is supported by an Australian Research Council Future Fellowship (0991864). We are particularly grateful to the prisoners who participated in the survey and willingly provided the information necessary to make the survey a success.

Competing interests:

No relevant disclosures.

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