Home > Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries.

Bielen, Rob and Stumo, Samya R and Halford, Rachel and Werling, Klára and Reic, Tatjana and Stover, Heino and Robaeys, Geert and Lazarus, Jeffrey V . (2018) Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries. BioMed Central. Harm Reduction Journal, 15 (25) https://doi.org/10.1186/s12954-018-0230-1

URL: https://harmreductionjournal.biomedcentral.com/art...

Background: Current estimates suggest that 15% of all prisoners worldwide are chronically infected with the hepatitis C virus (HCV), and this number is even higher in regions with high rates of injecting drug use. Although harm reduction services such as opioid substitution therapy (OST) and needle and syringe programs (NSPs) are effective in preventing the further spread of HCV and HIV, the extent to which these are available in prisons varies significantly across countries.

Methods: The Hep-CORE study surveyed liver patient groups from 25 European countries in 2016 and mid-2017 on national policies related to harm reduction, testing/screening, and treatment for HCV in prison settings. Results from the cross-sectional survey were compared to the data from available reports and the peer-reviewed literature to determine the overall degree to which European countries implement evidence-based HCV recommendations in prison settings.

Results: Patient groups in nine countries (36%) identified prisoners as a high-risk population target for HCV testing/screening. Twenty-one countries (84%) provide HCV treatment in prisons. However, the extent of coverage of these treatment programs varies widely. Two countries (8%) have NSPs officially available in prisons in all parts of the country. Eleven countries (44%) provide OST in prisons in all parts of the country without additional requirements.

Conclusion: Despite the existence of evidence-based recommendations, infectious disease prevention measures such as harm reduction programs are inadequate in European prison settings. Harm reduction, HCV testing/screening, and treatment should be scaled up in prison settings in order to progress towards eliminating HCV as a public health threat.

Item Type:Evidence resource
Drug Type:Alcohol or other drugs in general, Opioid
Intervention Type:AOD disorder harm reduction
Date:May 2018
Publisher:BioMed Central
Subjects:G Health and disease > Disorder by cause > Communicable disease > Hepatitis C
J Health care, prevention and rehabilitation > Substance use prevention > Substance use harm reduction
J Health care, prevention and rehabilitation > Health care programme or facility > Prison-based health service
MM-MO Crime and law > Justice system > Correctional system and facility > Prison
T Demographic characteristics > Person who injects drugs (Intravenous / injecting)
T Demographic characteristics > Prison Inmate (prisoner)
VA Geographic area > Europe

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