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The prevalence of hepatitis B, hepatitis C and HIV in a representative sample of the Armenian male adult prison population has been determined and prisoners and staff were anonymously asked on risk behaviours (542 prisoners) and on knowledge, attitude and behaviour towards infectious diseases (348 staff members) Prisoners’ knowledge about the sources of transmission of HIV is quite poor, most of the wrong answers relate to activities in the daily prison life. The acceptance of HIV‐infected inmates tends towards extremely negative attitudes. The reported rate of intravenous drug use was 13.3%, and 51% among those are current injectors. Of the ‘ever injectors’, between 15% and 30% reported high‐risk behaviour. Of particular interest was the fact that the self‐reported HIV test results did not correlate at all with the results of the saliva tests. In the study the prevalence of HIV was 2.4%, a rate which is 27 times higher than in the general population. The prevalence rate for hepatitis B among prisoners is 3.7% and for hepatitis C 23.8%. The most important risk factor for contracting an HCV infection was drug use and the second, time spent in prison within the last 10 years, which is an independent risk factor. A substantial number of prison employees perceive their working condition as risky and themselves as at risk for TB, hepatitis B/C or HIV, but large groups had no idea about infection rates. Regarding HIV and hepatitis, knowledge is poor and patchy. While staff show quite good knowledge regarding the main transmission routes via blood and unprotected sex, a low level of knowledge becomes obvious when considering everyday‐life situations, which may cause fears in such a closed setting like prison. Standards including confidentiality and non‐segregation are not accepted in respect of HIV positive prisoners. Here, attitudes range between ‘inclusion’ and ‘exclusion’, which might express uncertainty and insecurity about the risks HIV‐positive persons carry. The provision of sterile needles for tattooing and sterile syringes and needles for injecting drugs users to prevent the spread of infectious diseases are not agreed by the majority of prison staff.

This paper aims to investigate the role that Italian third sector organizations have in the process of social and administrative categorization of newly arrived migrants living with human immunodeficiency virus/acquired immunodeficiency syndrome (HIV/Aids) or hepatitis b. In Italy, free access to health is provided to all migrants and residence permits for medical treatment is granted for migrants living with a “serious illness” since the 1990s. The case of HIV/Aids and hepatitis b shows how this political openness, however, clashes with the tightening of migration policies.

The study is based on ethnographic research conducted between 2014 and 2016 within an associative centre that deals with the socio-health care of newly arrived migrants in Rome. In addition to the participant observations, the study is based in semi-structured interviews conducted with 10 health-care providers (nurses, health-care assistants and socio-cultural mediators) and doctors and with 22 migrants coming from Sub-Saharan Africa and living with HIV/AIDS (10) and hepatitis b (12).

In Italy, the two infections have been identified as top diseases among migrant populations in the country but if HIV/Aids is always considered as a “serious illness”, hepatitis b is considered as a public health priority only in the case of a treatment prescription. These aspects have an important impact on the interactions between medical and social professionals and migrants affected by HIV/AIDS and hepatitis b, contributing differently to the creation of legal categories assigned to migrants.

The case of HIV/Aids and hepatitis b shows how the political openness of the public health system, clashes with the tightening of migration policies and analyse the role of the third sector has in this issue.

Prison populations in Western countries are characterised by a high hepatitis C prevalence. This reflects a high rate of imprisonment for drug related offences. Prison entrants who are HCV‐negative face a significant risk of acquiring hepatitis C. Effective prevention strategies and successful treatment of a significant percentage of hepatitis C‐positive inmates could reduce the risk of transmission in the prison context significantly. Several reports of treating hepatitis C in prisoners in major facilities have been published. We report our experience of establishing a liver clinic service in two regional prisons in New South Wales, Australia. Liver biopsy requirements to access treatment in Australia meant that only 46 of 196 reviewed patients were able to commence treatment in our 5‐year experience. Treatment completion rate was 61% and end of treatment viral response was 57%. The removal of liver biopsy requirements in Australia in April 2006 has freed up access to treatment and our results encourage further effort to optimise the process of assessment and treatment in this high‐risk population.

Correctional facilities host a disproportionately high prevalence of HBV, HCV and HIV infection. We evaluated the prevalence of HBV and/or HCV co‐infection among HIV‐infected inmates entering our correctional facility. Over a 30‐month period, 173 consecutive HIV‐infected inmates entered our institution and were evaluated. HCV co‐infection was observed in more than 90% of the tested HIV‐infected inmates, past HBV infection in 77.4% and active HBV co‐infection in 6.7%; triple coinfection (HIV, HCV and HBs‐Ag positivity) was seen in 6.1% of them. Given the observed high prevalence of co‐infection, testing for HBV and HCV in all HIV‐infected inmates at entry in any correctional system is recommended to identify those in need of specific care and/or preventing interventions.

Hepatitis C is one of the major health issues in both developed and developing countries. Hepatitis C virus (HCV) infection is more common in prisoners than in the general population. The purpose of this study was to determine the prevalence of HCV and its associated risk factors in Iranian male prisoners in Tehran.

In this cross-sectional study, the authors investigated the frequency and risk factors of hepatitis C infection among male prisoners in the Great Tehran Prison. Information on risk factors including the length of imprisonment, previous history of imprisonment, history of drug injection, history of tattooing, history of piercing, history of high-risk sex and family history of hepatitis C were extracted from patients’ records. To evaluate HCV status, blood samples were collected and tested.

In this study, 179 participants were included. Nine participants (5.0%, 95% CI, 2.3-9.3) were positive for hepatitis C. HCV infection was not significantly associated with age, marital status, education, previous history of imprisonment, length of imprisonment, piercing and high-risk sex; however, there was a significant association between a history of tattooing and a history of injecting drug use and Hepatitis C.

The prevalence of hepatitis C among male prisoners in Great Tehran Prison was 5% in this study, similar to recent studies on prisoners in Tehran. A history of drug injections as well as tattooing were the most important risk factors for hepatitis C in male prisoners.

This paper aims to describe the strategies being put in place to develop blood borne virus (BBV) services across prisons in Wales, UK, in response to the recommendations for prisons within the Welsh Government's Blood Borne Viral Hepatitis Action Plan for Wales.

A task and finish group was established to ensure multidisciplinary engagement between healthcare and custody staff. A service improvement package was developed focusing on awareness raising and/or development of clinical services for prisoners, prison officers and prison healthcare staff.

Prison healthcare staff have undergone training in BBVs and are being supported to deliver clinical services to prisoners. Training has been delivered in pre/post test discussion and dried blood spot testing; care pathways have been established between prison and community specialists for treatment referrals. An e‐learning module is being rolled out to raise awareness amongst custody staff and encourage occupational hepatitis B vaccination. Literature on “liver health” has been produced to be given to every prisoner across Wales.

It is envisaged that BBV services will become a routine part of prison care in Wales. Data on activity are being collected for evaluation and it is hoped that tackling BBVs in prisons will help reduce rates of infection both within prisons and in the wider community.

This paper describes new initiatives that have been established to tackle BBVs across Welsh prisons and will be relevant to any prison healthcare staff looking to develop similar services.

The purpose of this paper is to provide education on blood-borne viruses (BBVs) to prison staff to help reduce stigma within the prisons, improve the care prisoners receive and reduce the risk of occupational transmission.

An e-module was used to improve staff understanding of hepatitis B (HBV), hepatitis C (HCV) and HIV at a prison in Wales, UK. An assessment was used to gather data on prison staff understanding of BBVs prior to undertaking the e-module.

In total, 530/697 (76 per cent) prison staff completed the BBV e-module. Average pre- and post-course assessment scores were 8.6/11 and 10.85/11, respectively. Most staff understood the modes of hepatitis transmission, however, gaps in understanding were highlighted. In total, 22 per cent of staff believed HBV and HCV were airborne, 9 per cent believed transmission occurred through sharing cutlery. In total, 31 per cent of staff believed prisoners with hepatitis should declare their status to the prison.

The e-module significantly improved staff understanding of BBVs and should be incorporated into future prison training packages. Future education should include how BBVs are not transmitted with an emphasis on casual contact. Medical confidentiality in prisons should also be addressed. Improving understanding will help reduce the stigma of BBVs within prison and improve the multidisciplinary care the prisoner receives.

To the authors knowledge this is the first published evaluation of a BBV learning package for custodial staff. Evaluation of this educational package demonstrates a unique and valuable insight into the general understanding of BBVs by prison staff in Wales, UK.

Hepatitis C virus (HCV) is highly prevalent in the United States, yet is largely culturally invisible. This study examines what people know about their illness, both before and after diagnosis, and the relationship to race. The data are from in-depth interviews in 2004 with 53 persons, mostly white or African American, with HCV in the southeastern United States. The respondents have varying educational backgrounds, family incomes, and possible modes of transmission of HCV. Regardless of whether the diagnosis of HCV came as a surprise, respondents had a range of reactions including fear, shock, sadness, and ambivalence. Knowledge of the disease postdiagnosis varies as some people have expert knowledge, moderate knowledge, or inaccurate to no knowledge of the disease. Minority respondents have less knowledge of HCV than whites. This racial disparity in knowledge has profound implications for people with HCV and the larger society.

Injecting drug use addiction is a main factor in hepatitis B, C infection and HIV–AIDS infection. The purpose of this paper is to measure seroprevalence of hepatitis B, C virus and HIV–AIDS amongst injecting drug users (IDUs) and its influencing factors.

The cross-sectional method was used in mid-2017 in Ahwaz city, southwest Iran. In total, 133 IDUs, aged 29–71 years (mean age=48.21 ± 10.4), were chosen from Aria addiction treatment centre. The data were collected on demographic and behavioural characteristics. In addition, serum samples were screened for those diseases.

In a total of 131 IDUs, 2 (1.5 per cent) were HIV+, 16 (11.7 per cent) HCV+ and 8 (6.1 per cent) HBV+. There was a significant correlation between diseases and IDU. Results of multiple regression stated that IDU was a more predicting variable as β=0.76 and the model was able to predict 74.1 per cent of the variance, F (3, 35)=12.42, ρ<0.001, R²=0.741, OR=3.01, 95% CI [1.44, 3.83]. The synchronised pairwise effect of age, imprisonment and IDU with GLM analysis was significant, F (2, 114)=20.433, ρ<0.000, η HCV + 2 = 0.609 , η HBV + 2 = 0.616 , and η HCV + 2 = 0.612 , λ_Wilks’=0.056. The infection rate among IDUs was significant and the most important risk factor for these infections has been intravenous drug use, together with age of misusing and imprisonment.

The non-cooperation of two samples, lack of participation of three addiction rehabilitation centres in Ahwaz city, the end of cooperation in the first two months of the implementation of the plan, and the lack of consistency of the three serum samples in the cases (two cases) were limitations of the study.

Based on the results, the following suggestions could be presented: establishing “Intervention Clubs” for treatment in the peripheral urban areas for the participation of women drug users – the responsible organisation is Cultural and Social Deputy of Ahwaz Municipality Organisation. Integration of “Small Self-caring Groups” in Sepidar Women’s Penitentiary in the East Ahwaz region – the responsible organisation is Khuzistan Province Prisons Organisation (the southwestern Iranian prisons authority); constructing “Community-based Committees” to increase the level of social intervention – the responsible organisation is the Iran Drug Control Headquarters at Iranian Presidential Office; screening of injecting drug use in the populations at risk, especially girls and women in marginalised areas – the responsible organisation is Deputy Director of Prevention and Treatment of Addiction in the Iran Welfare and Rehabilitation Organisation; establishing an “Patient Treatment Center” in high-risk areas along with directing drug users and supervising the relevant authorities – the responsible organisation is Deputy Police Commander on Social Assistance; providing education to families involved with addiction in the “Neighborhood Parks” – the responsible organisation is Deputy for Health Affairs.

They are mixed with practical implications as well.

The comprehensive harm reduction plan and prison-related issues of IDUs with shared syringe along with the pairwise age and imprisonment need to consider the above factors.

Prisons, which are hazardous places for various contagious diseases, carry additional risks for HBV and HCV because of the communal lifestyle (common use of tools like razor blades, tattoo applications, intravenous drug use and homosexual intercourse). The purpose of this paper is to determine the prevalence of HBV and HCV, and also provide information for prisoners in this respect.

This study included 180 prisoners from the Buca F-Type Closed Prison, and 180 prisoners from the Foça Open Prison in Turkey. After the training seminars, serum levels of HBsAg, anti HBs, anti HBc total and anti HCV in the prisoners were assessed using the MICROELISA method.

All the prisoners were male. The mean age was 40(21–73) years. According to the results of 360 prisoners from both prisons, 17 (4.7 percent) prisoners were HBsAg positive and were diagnosed as HBV. Isolated anti HBs was positive in 33 (9.1 percent) prisoners who had been previously vaccinated. In 25 (6.9 percent) prisoners isolated Anti HBc total was positive, and in 61 (16.9 percent) prisoners both Anti HBs and Anti HBc total was positive in those who were considered to be recovered from the HBV. Anti HCV was positive in 2 (0.5 percent) prisoners; the process was repeated twice, and found to be repeatedly positive. Coinfection of HBV and HCV was not detected.

In this study, the prevalence of HBV and HCV was determined to be similar to those in the normal population. However, it is not expedient to generalize this result and apply it to all prisons. For the sake of public health, prisons should be scanned for infectious diseases, and vaccinations must be applied as necessary, in order to provide protection.

It is a study to determine the prevalence of HBV and HCV in the prisoner population, which constitute one of the risk groups because of the communal lifestyle (common use of some tools such as the razor blade, tattoo applications, intravenous drug use and homosexual intercourse), and to compare the results with other groups in Turkey and globally.