Abstract
Objectives
To compare the prevalence of HIV, hepatitis C virus (HCV) infections, and related risky behaviours among inmates in Quebec’s provincial prisons between 2003 and 2014–2015.
Methods
Cross-sectional data were anonymously collected from May 2014 to March 2015 for men (n = 1315) and women (n = 250) and combined with data collected in 2003 to evaluate trends in the last decade. Participants completed a questionnaire and provided saliva samples. The data from the 2003 and 2014–2015 surveys were merged for statistical analysis.
Results
HIV prevalence was stable between 2003 and 2014–2015 for men (2.4% vs. 1.8%, p = 0.4), whereas it decreased for women (8.8% vs. 0.8%, p < 0.001). HCV prevalence decreased between 2003 and 2014–2015 for both men (16.6% vs. 11.9%, p < 0.001) and women (29.2% vs. 19.2%, p = 0.02). HIV and HCV prevalence were higher among people who inject drugs (PWID), for both sexes and both studies. PWID-specific prevalence did not change between 2003 and 2014–2015, except for a decrease in HIV prevalence in PWID women. However, the proportion of prisoners reporting a history of injection drug use outside prison was lower in 2014–2015 than in 2003 for men (19.8% vs. 27.7%, p < 0.0001) and women (28.6% vs. 42.6%, p = 0.002).
Conclusion
The lower proportion of PWID inmates in 2014–2015 compared to 2003 explained in large part the decrease in HIV and HCV prevalence. Despite the decrease in prevalence, HIV and HCV infections among incarcerated individuals still represent a major public health problem due to the sizable increase of individuals in Quebec’s correctional system over the same period.
Résumé
Objectif
Comparer la prévalence des infections au VIH, l’hépatite C (VHC) et les comportements à risque chez les individus incarcérés dans les prisons provinciales du Québec en 2003 et 2014–2015.
Méthodes
Les données transversales ont été collectées entre mai 2014 et mars 2015 chez les hommes (n = 1315) et les femmes (n = 250). Un questionnaire a été administré et un échantillon de salive recueilli. Les données recueillies ont ensuite été combinées aux données de 2003 pour les analyses statistiques.
Résultats
La prévalence du VIH a été stable entre 2003 et 2014–15 pour les hommes (2,4% c. 1,8%, p = 0,4), mais a diminué pour les femmes (8,8% c. 0,8%, p < 0,001). La prévalence du VHC a diminué entre 2003 et 2014–2015 chez les hommes (16,6% c. 11,9%, p < 0,001) et les femmes (29,2% c. 19,2%, p = 0,02). Les prévalences du VIH et VHC étaient plus élevées chez les utilisateurs de drogues par injection (UDI) pour les deux sexes et les deux études. Les prévalences chez les UDI n’ont pas changé entre 2003 et 2014–2015, sauf pour le VIH chez les femmes UDI. La proportion de prisonniers UDI à l’extérieur de prison était moindre en 2014–2015 qu’en 2003 pour les hommes (19,8% c. 27,7%, p < 0,0001) et les femmes (28,6% c. 42,6%, p = 0,002).
Conclusion
La diminution de la proportion de prisonniers UDI en 2014–2015 se traduit par une diminution des prévalences globales du VIH et VHC. Malgré ces diminutions, les infections au VIH et au VHC demeurent un problème de santé publique en milieu carcéral.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Begier, E. M., Bennani, Y., Forgione, L., et al. (2010). Undiagnosed HIV infection among New York City jail entrants, 2006: results of a blinded serosurvey. J Acquir Immune Defic Syndr, 54, 93–101.
Calzavara, L., Ramuscak, N., Burchell, A. N., et al. (2007). Prevalence of HIV and hepatitis C virus infections among inmates of Ontario remand facilities. CMAJ, 177, 257–261.
Carter, W, Connelly, S, & Struble, K. (2016). Reinventing HCV treatment: past and future perspectives. J Clin Pharmacol.
Chéné, B. C. (2015). E. Analyse prospective de la population carcérale adulte des établissements de détention du Québec de 2013–2014 à 2023–2024: Direction générale des services correctionnels, ministère de la Sécurité publique du Québec.
Christensen, P. B., Krarup, H. B., Niesters, H. G., Norder, H., & Prevalence, G. J. (2000). Incidence of bloodborne viral infections among Danish prisoners. Eur J Epidemiol, 16, 1043–1049.
De, P., Connor, N., Bouchard, F., & Sutherland, D. (2004). HIV and hepatitis C virus testing and seropositivity rates in Canadian federal penitentiaries: a critical opportunity for care and prevention. Can J Infect Dis Med Microbiol, 15, 221–225.
Dolan, K., Wirtz, A. L., Moazen, B., et al. (2016). Global burden of HIV, viral hepatitis, and tuberculosis in prisoners and detainees. Lancet, 388, 1089–1102.
Dufour, A., Alary, M., Poulin, C., et al. (1996). Prevalence and risk behaviours for HIV infection among inmates of a provincial prison in Quebec City. AIDS, 10, 1009–1015.
Elliott, R. (2007). Deadly disregard: government refusal to implement evidence-based measures to prevent HIV and hepatitis C virus infections in prisons. CMAJ, 177, 262–264.
Eyawo, O., Hogg, R. S., & Montaner, J. S. (2013). The Holy Grail: The search for undiagnosed cases is paramount in improving the cascade of care among people living with HIV. Can J Public Health, 104, e418–e419.
Fang, J. (2011). Using SAS procedures FREQ, GENMOD, LOGISTIC, and PHREG to estimate adjusted relative risks––a case study. SAS Global Forum 2011. Statistics and Data Analysis.
Ford PM, Pearson M, Sankar-Mistry P, Stevenson T, Bell D, Austin J. HIV, hepatitis C and risk behaviour in a Canadian medium-security federal penitentiary. Queen’s University HIV Prison Study Group QJM 2000;93:113–119.
Giroux, L. (2011). Profil correctionnel 2007–2008: La population correctionnelle du Québec: Services correctionnels, Ministère de la Sécurité publique.
Hall, H. I., Holtgrave, D. R., & Maulsby, C. (2012). HIV transmission rates from persons living with HIV who are aware and unaware of their infection. AIDS, 26, 893–896.
Hankins, C., Gendron, S., Handley, M., Rouah, F., & O'Shaughnessy, M. (1991). HIV-1 infection among incarcerated men—Quebec. Can Dis Wkly Rep, 17, 233–235.
Hankins, C. A., Gendron, S., Handley, M. A., Richard, C., Tung, M. T., & O'Shaughnessy, M. (1994). HIV infection among women in prison: an assessment of risk factors using a nonnominal methodology. Am J Public Health, 84, 1637–1640.
Iacomi, F., Iannicelli, G., Franceschini, A., et al. (2013). HCV infected prisoners: should they be still considered a difficult to treat population? BMC Infect Dis, 13, 374.
Iroh, P. A., Mayo, H., & Nijhawan, A. E. (2015). The HIV care cascade before, during, and after incarceration: a systematic review and data synthesis. Am J Public Health, 105, e5–e16.
Kamarulzaman, A., Reid, S. E., Schwitters, A., et al. (2016). Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners. Lancet, 388, 1115–1126.
Larney, S., Kopinski, H., Beckwith, C. G., et al. (2013). Incidence and prevalence of hepatitis C in prisons and other closed settings: results of a systematic review and meta-analysis. Hepatology, 58, 1215–1224.
Leclerc, P., Vandal, A. C., Fall, A., et al. (2014). Estimating the size of the population of persons who inject drugs in the island of Montreal, Canada, using a six-source capture-recapture model. Drug Alcohol Depend, 142, 174–180.
Liu, S., Watcha, D., Holodniy, M., & Goldhaber-Fiebert, J. D. (2014). Sofosbuvir-based treatment regimens for chronic, genotype 1 hepatitis C virus infection in US incarcerated populations: a cost-effectiveness analysis. Ann Intern Med, 161, 546–553.
Maruschak, L. (2012).HIV in prisons, 2001-2010. Department of Justice, Bureau of Justice Statistics. Report no. NCJ238877.
MSPQ (2003). Statistiques correctionnelles du Québec 2003–2004. Ministère de la Sécurité publique du Québec :http://www.securitepublique.gouv.qc.ca/services-correctionnels/publications-statistiques-sc/statistiques-2003-2004/tableaux.html. Accessed 11 août 2014.
MSPQ. Tableau - Statistiques correctionnelles du Québec 2014-2015. 2016; Ministère de la Sécurité publique du Québec:http://www.securitepublique.gouv.qc.ca/services-correctionnels/publications-et-statistiques/statistiques-annuelles/2014-2015.html. Accessed 20 août 2014.
Poulin, C., Alary, M., Lambert, G., et al. (2007). Prevalence of HIV and hepatitis C virus infections among inmates of Quebec provincial prisons. CMAJ, 177, 252–256.
Public Health Agency of Canada (2012). HIV and AIDS in Canada: Surveillance Report to December 31st, In: Canada PHAo, ed 2013.
Reekie, J. M., Levy, M. H., Richards, A. H., et al. (2014). Trends in HIV, hepatitis B and hepatitis C prevalence among Australian prisoners––2004, 2007, 2010. Med J Aust, 200, 277–280.
Remis, R. (2007). Modelling the incidence and prevalence of hepatitis C infection and its sequelae in Canada, 2007 Public Health Agency of Canada.
Rothon, D. A., Mathias, R. G., & Schechter, M. T. (1994). Prevalence of HIV infection in provincial prisons in British Columbia. CMAJ, 151, 781–787.
Strick, L. B., MacGowan, R., J., Margolis, A., et al. (2011). HIV screening of male inmates during prison intake medical evaluation––Washington, 2006–2010. MMWR Morbidity Weekly Report, 60, 811–813.
Vescio, M. F., Longo, B., Babudieri, S., et al. (2008). Correlates of hepatitis C virus seropositivity in prison inmates: a meta-analysis. J Epidemiol Community Health, 62, 305–313.
Yang, Q., Boulos, D., Yan, P., et al. (2010). Estimates of the number of prevalent and incident human immunodeficiency virus (HIV) infections in Canada, 2008. Can J Public Health., 101, 486–490.
Zou, G. (2004). A modified Poisson regression approach to prospective studies with binary data. Am J Epidemiol, 159, 702–706.
Zou, S., Tepper, M., & El Saadany, S. (2000). Prediction of hepatitis C burden in Canada. Can J Gastroenterol, 14, 575–580.
Acknowledgements
The authors thank the community organizations for their expertise and collaboration in the data collection. We are grateful to all the inmates who met with the research team. We also thank authorities and staff from the detention centres for their support.
Funding
This study was funded by Quebec’s ministère de la Santé et des Services sociaux.
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Conflict of interest
Michel Alary and Bouchra Serhir both received funding from Quebec’s ministère de la Santé et des Services sociaux.
Rights and permissions
About this article
Cite this article
Courtemanche, Y., Poulin, C., Serhir, B. et al. HIV and hepatitis C virus infections in Quebec’s provincial detention centres: comparing prevalence and related risky behaviours between 2003 and 2014-2015. Can J Public Health 109, 353–361 (2018). https://doi.org/10.17269/s41997-018-0047-4
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.17269/s41997-018-0047-4