ID: HR19-1481

Presenting author: Ehab Salah

Presenting author biography:

Ehab is a medical doctor specialized in epidemiology and has more than 20 years of experience in communicable disease research and prevention. Prior to joining UNODC in Vienna, he was coordinating UNODC’s HIV in Prisons Programme in Sub-Saharan Africa. Earlier, he was the UNODC HIV focal point in MENA region.

HIV, viral hepatitis and TB in prisons: A global systematic review of infections and mortality, and service coverage

Ehab Salah

Background: In 2017, UNODC commissioned a survey on HIV in prisons. This survey had two components; the first is the assessment of the epidemiological situation of HIV and related infections in prisons. The second component was a review of the availability and coverage of the 15 interventions of the Comprehensive Package for HIV services in prison.
Methodology: Electronic databases and Web of Science were searched. A search of grey-literature, websites were conducted. The main instrument was a Survey to collect data on the epidemiology and service provision in prisons around the world. The Survey was distributed to key informants in each country. Survey distribution was via ‘Survey Monkey’, an online tool. In addition, a call for data was made to key contacts in regional and country offices of WHO, UNODC and UNAIDS. Invitations to participate in the Survey were sent to all 189 UNAIDS listed countries.
Results: The data obtained on HIV prevalence in prison covered 121 of 189 countries (64%), HCV prevalence covered 28 countries and HBV prevalence covered 23 countries, and data on prisoners with TB covered just 36 countries. In terms of co-infections, data were located on HIV/TB prevalence for 13 countries, for HIV/HCV for 13 countries and for HCV/HBV for six countries only.
Conclusion: The four infections under review place a significant burden on the prison systems in some countries, although there was considerable variation, reflecting the disease burden in the general population. However, a major concern was the lack of HIV data for about one third of the countries in the world. Data for hepatitis C, hepatitis B and TB infections were even scarcer. In many countries, people who inject drugs are the main group in prison in terms of HIV risk behaviour, infection and transmission, however, data on these prisoners were scarce.