4259.0: Tuesday, November 14, 2000 - Board 1

Abstract #10901

Prevalence and intraprison transmission of HIV and other bloodborne pathogens among prisoners in Rhode Island

Christopher M. Salas, BS1, Grace E. Macalino, MPH1, Josiah D. Rich, MD1, Megan E. Gaydos, BS1, Michelle McKenzie, MPH1, Anne Spaulding, MD2, and David Vlahov, PhD3. (1) Department of Immunology, The Miriam Hospital/Brown University, 164 Summit Ave, Providence, RI 02906, 401-793-4860, chrissalas@yahoo.com, (2) Rhode Island Department of Corrections/Brown University, (3) New York Academy of Medicine

Background: Prisoners are more likely to have a history of injection drug use (IDU) than the community, increasing their risk for HIV and other bloodborne pathogens. Our goals were to measure intake prevalence of bloodborne pathogens among sentenced inmates in Rhode Island, and to begin assessing intraprison transmission. Methods: Discarded intake sera from 675 individuals (86.2% male; 62.5% white, 23.5% black, 12.9% hispanic) incarcerated between 1998-99 were tested for HIV, hepatitis B, C, and HTLV I/II in a blinded fashion. Intraprison incidence was estimated by consenting inmates continuously incarcerated for 11 months or more to a follow-up test. Results: At intake, HIV prevalence was 1.3%, hepatitis B, 19.8%, hepatitis C, 24.7%, and HTLV-II, 1.2%. All HIV+ inmates had coinfections. Overall, 6.2% had visible track marks, compared to those that tested positive for at least one infection (21.8%). The entire study group reported rate of IDU was 13%; higher reports were given for those infected: HIV (66.7%), HBV (38.1%), HCV (46.7%), HTLV-II (50.0%). 41 of the 675 inmates were still incarcerated 11 months later, consented, and tested (53.1 person-years). No seroconversions to HIV, hepatitis C, or HTLV-II were found; two cases of hepatitis B seroconversion were detected based on HbcAb (2/53.1 person-years). Conclusions: Among incarcerated Rhode Island inmates the intake prevalence of HIV is lower than hepatitis B and C. Preliminary data suggests intraprison transmission is very low. Since risk behaviors associated with these infections are similar, prisons represent a public health opportunity for the treatment and prevention of HIV and other bloodborne pathogens.

Learning Objectives: After viewing the poster, participants will be able to recognize the extent of the epidemic of hepatitis facing prisoners in Rhode Island, and will recognize the tremendous opportunity that exists to fund intervention, vaccination, and treatment efforts in this population

Keywords: Correctional Health Care, Injecting Drug Use

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA