in hepatitis C and HIV infection among inmates entering
prisons in California, 1994 versus 1999
AIDS November 2002; 16(16):2236-2238
The prevalences of hepatitis C virus (HCV) and HIV are much higher among incarcerated populations than the general public. For example, the incidence of HCV in the
Between 1995 and 2001, the incarcerated population in the
The California Department of Corrections has 13 reception centers in which male and female inmates are processed separately for entrance into the prison system. Four of the 10 male centers and two of the three female centers were selected for inclusion in the surveys. The same centers were selected in 1994 and 1999. A sample from each prison was selected based on the proportion of inmates processed at the center on a weekly basis. All incoming inmates to the California Department of Corrections receive a physical examination shortly after arrival at a reception center. During the physical examination, a blood sample is obtained for syphilis serology. Inmates cannot refuse to provide a blood sample; leftover blood was used for blinded testing of HCV and HIV antibodies. Blood specimens were collected between August and September 1994 (men) and August and October 1994 (women). Samples for 1999 were collected between January and March for both men and women. The same laboratory methods were used in 1994 and 1999. HCV antibodies were detected using the hepatitis C virus encoded antigen (recombinant c 100-3, HC-31 and HC-34) Abbott HCV enzyme-linked immunosorbent assay (EIA) 2.0 (Abbott Laboratories,
using the Abbott EIA. Those specimens repeatedly reactive to EIA were confirmed by immunofluorescence assay, and any discrepancy was resolved using Western blot. Unlinked survey data were used to estimate the seroprevalence of HCV and HIV antibodies; each correctional facility provided demographic information. The California Health and Welfare Agency Committee for the Protection of Human Subjects approved the study protocols for both the 1994 and 1999 studies.
A total of 4140 male and 624 female inmates were tested in 1994, and a total of 4876 male and 719 female inmates were tested in 1999. Less than 3% of the samples in both surveys (n = 137 in 1994 and n = 135 in 1999) could not be tested, either because no blood was drawn, the quantity of the sample was too small, or the specimen was not saved.
In 1999, men entering
HIV seroprevalence decreased from 1994 to 1999 by 42% for men and 47% for women. Compared with white and Latino inmates, African American male and female inmates were more likely to be infected with HIV in 1999.
The decline in HCV and HIV prevalences demonstrate a possible reduction in injection drug use or an increase in safer injecting practices within
Although rates of HCV and HIV among
Juan D. Ruiza; Fred Molitorb; Julie A. Plagenhoefc
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Available at http://www.adp.cahwnet.gov/RC/rc_comm.shtml. Accessed
Available at http://caag.state.ca.us/cjsc/publications/misc/drugarrests/drugs2.pdf. Accessed
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