Centre for Adolescent Health, Murdoch Children's Research Institute, Parkville, Victoria, Australia; Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia; Mater Research Institute-UQ, University of Queensland, South Brisbane, Queensland, Australia; School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia; Griffith Criminology Institute, Griffith University, Mt Gravatt, Queensland, Australia. Electronic address: firstname.lastname@example.org.
Melbourne School of Population and Global Health, University of Melbourne, Carlton, Victoria, Australia; Centre for International Child Health, Department of Paediatrics, University of Melbourne, Royal Children's Hospital, Parkville, Victoria, Australia.
Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland.
Section of Infectious Diseases, Yale University School of Medicine and Public Health, New Haven, Connecticut.
Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, New South Wales, Australia.
This study aims to compare the global prevalence of hepatitis B, hepatitis C, HIV, and tuberculosis in incarcerated adolescents and young adults (AYAs) and older prisoners.
This study is a systematic review and meta-analysis of studies reporting the age-specific prevalence of each infection in prisoners. We grouped age-specific prevalence estimates into three overlapping age categories: AYA prisoners (<25 years), older prisoners (≥25 years), and mixed category (spanning age 25 years). We used random effects meta-analysis to estimate the relative risk (RR) of each infection in AYAs versus older prisoners.
Among 72 studies, there was marked heterogeneity in prevalence estimates among AYA prisoners for all infections: hepatitis B (.4%-25.2%), hepatitis C (.0%-70.6%), HIV (.0%-15.8%), and active tuberculosis (.0%-3.7%). The pooled prevalence of HIV (RR = .39, 95% confidence interval .29-.53, I2 = 79.2%) and hepatitis C (RR = .51, 95% confidence interval .33-.78, I2 = 97.8%) was lower in AYAs than in older prisoners.
The prevalence of HIV and hepatitis C is lower in AYA prisoners than in older prisoners. Despite lower prevalence, acquisition begins early among incarcerated populations. There is an urgent need for targeted, age-appropriate prevention, treatment, and harm reduction measures in and beyond custodial settings to reduce the incidence of infection in these extremely vulnerable young people.