An opt-out approach to hepatitis C virus testing in English prisons: the literature underpinning the policy.

Abstract

The World Health Organization's aim to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030 is dependent on testing people. HCV prevalence is higher in prisons, so to increase test uptake an 'opt-out' approach to blood-borne virus testing in English and Welsh prisons was introduced. This literature review examines the evidence behind the introduction of this public health policy. Four healthcare databases were searched for publications between January 2000 and February 2020 on the opt-out approach to blood-borne virus testing in prisons. Sixteen studies published between 2009 and 2019 were included. Analysis of their findings showed that an increase in HCV test uptake in prisons occurs when an opt-out approach is used in combination with additional interventions. Contextual differences between UK and US prisons may affect HCV test uptake. An opt-out approach to HCV testing in prisons can increase test uptake as part of a complex of interventions.