Australasian Society for HIV Medicine

No other country produces a similar report were Tony Butler’s (Associate Professor, Curtin University of Technology, Health Research Campus) sentiments when he launched the most recent version of the National Prison Entrants’ Bloodborne Virus and Risk Behaviour Survey Report at the 20th Annual ASHM Conference in Perth.  Tony and Cerissa Papanastasiou (Research Associate Curtin University of Technology, Health Research Campus) prepared the report for the National Drug Research Institute (NDRI), which is the second prisoner health research project to be conducted through the institute. The report is unique in the world in providing ongoing surveillance on the prevalence of blood-borne viruses (HIV, hepatitis B, hepatitis C) amongst this population group.  Monitoring these viruses among prisoners is important as many are unaware they are infected and that they could be spreading infectious diseases during their activities.  

The prevalence of hepatitis C amongst prison entrants is highest in NSW with 42% and lowest in WA (21%).  Women were 20% more likely to have hepatitis C than men. Prison entrants are underserved with regard to treatment for hepatitis C infection - a population that would definitely benefit from a comprehensive prison-based treatment programme.1 

Fortunately, the prevalence of HIV remains less than 1%, in all states, for both sexes.  However, the incidence of hepatitis B remains elevated at just under 30% nationally.1 Dr Susan Carrothers, President of Hepatitis Council of Western Australia suggested that this population is at greater risk of hepatitis B infection as many people showed no evidence of immunity against hepatitis B when screened for the virus.  The number of individuals susceptible depending on the state and ranges from 14% to 60% of prisoners.1 Many delegates attending the launch voiced the opinion that national and state governments should be doing far more about this situation given the availability of the hepatitis B vaccine. The report suggests that a detained population with no antibodies to the virus should be vaccinated as a matter of priority.  Presently, staffs working in this setting have access to free HBV vaccine; it could be an extension of this system for prisoners.1   

Another area requiring attention relates to staff knowledge and training in relation to recognising and managing amphetamine withdrawal on entry to prison. Amphetamines were the most frequently reported drug last injected by prison entrants.1 Tobacco smoking was highlighted as being at epidemic proportions in this population with around 9 out of 10 prisoners reporting they currently smoke. Incarceration is an important, but under-utilised public health opportunity to initiate quit smoking programmes amongst this group.1  

Susan and Tony both agreed that the prison environment in general provided many opportunities for prisoners to engage in a range of health risk behaviours resulting in an increased risk of exposure to blood-borne viruses.  They anticipated the 2007 survey report would be used by states and territories in policy development and planning.