Exploring HIV infection in a UK vulnerable prisoner population in response to newly identified cases

• Date: 29 August 2019
• Pages: 244-249
• DOI: https://doi.org/10.1108/IJPH-03-2018-0010
• Published date: 29 August 2019
• Author: Stephanie E. Perrett,Thomas D. Waite
• Subject Matter: Health & social care,Criminology & forensic psychology,Prisoner health,Sociology,Sociology of crime & law,Public policy & environmental management,Policing,Criminal justice

Exploring HIV infection in a UK vulnerable

prisoner population in response to newly

identified cases

Stephanie E. Perrett and Thomas D. Waite

Abstract

Purpose –Prison populations are considered at elevated risk of blood borne virus (BBV ) transmission.

Between December 2015 and February 2016, four new cases of HIV infection were diagnosed across two

male vulnerable prisoner (VP) custodial units in Wales, UK. Cases were identified through routine BBV testing.

The paper aims to discuss these issues.

Design/methodology/approach –As a result of identifying four new HIV cases, targeted BBV testing

across the VP units using dried blood spot testing for HIV, Hepatitis C (HCV) and Hepatitis B was undertaken.

Findings –A total of 617 men were offered testing, 256 (41 per cent) were tested. No further cases of

HIV were identified. Eight men were identified as HCV antibody positive. There was no evidence to suggest

the four original cases of HIV were linked.

Practical implications –Embedding universal BBV screening within prison health provision will ensure

timely identification of cases. Further research is needed to better understand BBV transmission risks within

subsets of the prison population such as the VP and sex offending groups.

Originality/value –Little is known about the prevalence of BBVs in vulnerable prison populations. The

findings add to the knowledge available for practitioners in the field.

Keywords HIV, Health in prison, Blood-borne viral infections, Hepatitis C

Paper type General review

Introduction

Prison populations worldwide are at a high risk of blood borne virus (BBV ) transmission,

including hepatitis C (HCV), hepatitis B (HBV ) and HIV (World Health Organisation, 2014). Across

the UK and Republic of Ireland prevalence estimates of HCV in the prison population vary

between 7 and 31 per cent, the higher prevalence being found in those with a history of injecting

drug use (IDU) (Allwright et al., 2000; Weild et al., 2000; Kirwan et al., 2011). HIV prevalence has

been found to be 0.4–0.5 per cent (Weild et al., 2000). Published UK prison prevalence figures

are several years old; European and international figures are of concern. HIV prevalence was

2.6 per cent amongst prisoners in Italy (Babudieri et al., 2015) and 2 per cent amongst prison

populations in France (Semaille et al., 2013). Globally the burden of HIV in prisons remains

concerning (Kinner et al., 2018). The prison environment is considered high risk for BBV

transmission compounded by the lack of harm reduction measures such as needle exchange

and often poor condom availability (World Health Organisation, 2014).

Whilstrates of BBVs are known to be highwithin the general prisonpopulation, littleis known about

prevalenceamongst specific subsetsof the prison populationsuch as vulnerableprisoners (VPs) or

juveniles or by offence group such as by sexual offences (Gough et al.,2010).TheUKprisonVP

population is defined as “those who need protection from other prisoners fora variety of reasons,

including the nature of their offence, debt, or conflicts outside or within the prison”(HMIP, 2012).

The majority of men held for sexual offences thus reside within VP units. Wales holds a prison

Received 6 March 2018

Revised 23 July 2018

10 September 2018

11 October 2018

Accepted 12 October 2018

The authors would like to thank

Heather Lewis, Consultant in

Health Protection, Public Health

Wales, Sion Lingard, Consultant in

Health Protection, Public Health

Wales, staff at the Welsh Specialist

Virology Centre, Public Health

Wales Microbiology Cardiff and

staff at the prisons concerned.

Stephanie E. Perrett and

Thomas D. Waite are both

based at Public Health Wales,

Cardiff, UK.

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INTERNATIONALJOURNAL OF PRISONER HEALTH

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VOL. 15 NO. 3 2019, pp. 244-249, © Emerald Publishing Limited, ISSN 1744-9200 DOI 10.1108/IJPH-03-2018-0010