Yohann Courtemanche1, Céline Poulin1, Bouchra Serhir2, Michel Alary3,4,5,6. 1. Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada. 2. Laboratoire de santé publique du Québec, Institut national de santé publique du Québec, Sainte-Anne de Bellevue, Canada. 3. Axe santé des populations et pratiques optimales en santé, Centre de recherche du CHU de Québec-Université Laval, Québec, Canada. michel.alary@crchudequebec.ulaval.ca. 4. Département de médecine sociale et préventive, Université Laval, Québec, Canada. michel.alary@crchudequebec.ulaval.ca. 5. Institut national de santé publique du Québec, Québec, Canada. michel.alary@crchudequebec.ulaval.ca. 6. Centre de recherche du CHU de Québec, Hôpital du Saint-Sacrement, 1050 Chemin Ste-Foy, Québec, QC, G1S 4L8, Canada. michel.alary@crchudequebec.ulaval.ca.
Abstract
OBJECTIVES: To compare the prevalence of HIV, hepatitis C virus (HCV) infections, and related risky behaviours among inmates in Quebec's provincial prisons between 2003 and 2014-2015. METHODS: Cross-sectional data were anonymously collected from May 2014 to March 2015 for men (n = 1315) and women (n = 250) and combined with data collected in 2003 to evaluate trends in the last decade. Participants completed a questionnaire and provided saliva samples. The data from the 2003 and 2014-2015 surveys were merged for statistical analysis. RESULTS: HIV prevalence was stable between 2003 and 2014-2015 for men (2.4% vs. 1.8%, p = 0.4), whereas it decreased for women (8.8% vs. 0.8%, p < 0.001). HCV prevalence decreased between 2003 and 2014-2015 for both men (16.6% vs. 11.9%, p < 0.001) and women (29.2% vs. 19.2%, p = 0.02). HIV and HCV prevalence were higher among people who inject drugs (PWID), for both sexes and both studies. PWID-specific prevalence did not change between 2003 and 2014-2015, except for a decrease in HIV prevalence in PWID women. However, the proportion of prisoners reporting a history of injection drug use outside prison was lower in 2014-2015 than in 2003 for men (19.8% vs. 27.7%, p < 0.0001) and women (28.6% vs. 42.6%, p = 0.002). CONCLUSION: The lower proportion of PWID inmates in 2014-2015 compared to 2003 explained in large part the decrease in HIV and HCV prevalence. Despite the decrease in prevalence, HIV and HCV infections among incarcerated individuals still represent a major public health problem due to the sizable increase of individuals in Quebec's correctional system over the same period.
OBJECTIVES: To compare the prevalence of HIV, hepatitis C virus (HCV) infections, and related risky behaviours among inmates in Quebec's provincial prisons between 2003 and 2014-2015. METHODS: Cross-sectional data were anonymously collected from May 2014 to March 2015 for men (n = 1315) and women (n = 250) and combined with data collected in 2003 to evaluate trends in the last decade. Participants completed a questionnaire and provided saliva samples. The data from the 2003 and 2014-2015 surveys were merged for statistical analysis. RESULTS:HIV prevalence was stable between 2003 and 2014-2015 for men (2.4% vs. 1.8%, p = 0.4), whereas it decreased for women (8.8% vs. 0.8%, p < 0.001). HCV prevalence decreased between 2003 and 2014-2015 for both men (16.6% vs. 11.9%, p < 0.001) and women (29.2% vs. 19.2%, p = 0.02). HIV and HCV prevalence were higher among people who inject drugs (PWID), for both sexes and both studies. PWID-specific prevalence did not change between 2003 and 2014-2015, except for a decrease in HIV prevalence in PWID women. However, the proportion of prisoners reporting a history of injection drug use outside prison was lower in 2014-2015 than in 2003 for men (19.8% vs. 27.7%, p < 0.0001) and women (28.6% vs. 42.6%, p = 0.002). CONCLUSION: The lower proportion of PWID inmates in 2014-2015 compared to 2003 explained in large part the decrease in HIV and HCV prevalence. Despite the decrease in prevalence, HIV and HCV infections among incarcerated individuals still represent a major public health problem due to the sizable increase of individuals in Quebec's correctional system over the same period.
Authors: Ryan Van Meer; Tony Antoniou; Daniel McCormack; Sumeet Khanna; Claire Kendall; Lori Kiefer; Fiona G Kouyoumdjian Journal: Can J Public Health Date: 2019-06-27