Blood-borne and sexually transmitted infections: a cross-sectional study in a Swiss prison

Komal Chacowry Pala,Nguyen Toan Tran,Hans Wolff,Stéphanie Baggio,Laurent Gétaz,François Girardin

doi:10.1186/s12879-018-3445-6

Abstract

BackgroundIncarcerated people carry a high burden of infection, including blood-borne diseases (BBDs). It is also known that one million people contract a sexually transmitted infection (STI) every day worldwide, which represents a global public health challenge. However, data regarding the prevalence of STIs and the risk factors among incarcerated populations are lacking. The objective of this study was to determine the prevalence and associated factors of BBDs and STIs among detainees in the largest pre-trial prison in Switzerland.MethodsIn a cross-sectional study conducted at the Champ-Dollon pre-trial prison, 273 male detainees answered a standardized questionnaire and were screened for syphilis, herpes simplex virus 2 (HSV-2), HIV, and hepatitis C (HCV). Prevalence rates and associations of BBDs and STIs with risk factors were computed.ResultsMost participants (90.9%) were migrants from outside Western Europe, and 5.9% were injecting drug users. HCV was diagnosed among 6.2% of participants (antibody prevalence). The prevalence of HCV was higher among injecting drug users (81.2%) than non-injectors (1.6%). The prevalence of HIV, syphilis, and HSV-2 was 0.4%, 1.1%, and 22.4%, respectively. HCV was associated with a history of injecting drug use and HSV-2 with a lower education level and being older than 26 years.ConclusionsThis study showed the infection prevalence of 2–9 times higher among detainees than in the Swiss community. It also illustrated that these infections are associated with sociodemographic and risk factors. Therefore, the prison environment offers an opportunity to strengthen infectious disease control programs targeting specific subgroups of at-risk people. Such programs would benefit both the prison population and broader society.

Highlights

Incarcerated people carry a high burden of infection, including blood-borne diseases (BBDs)
Study population and setting Capitalizing on the blood samples taken to test for varicella immunity in all varicella-exposed detainees, we offered these same consenting participants the opportunity to test for HIV, HCV, and syphilis (HSV-2 was only offered to the 2011 cohort) and to take a structured socio-demographic survey
Almost three-quarters (73.0%) reported having had more than five sexual partners in their lifetime, and 5.9% of the participants declared a history of injecting drug use

Summary

Introduction

Incarcerated people carry a high burden of infection, including blood-borne diseases (BBDs). Syphilis and herpes simplex virus 2 (HSV-2) are known to be major global causes of acute illness and long-term disability and cause significant complications [5] Both can increase the risk of acquiring and Chacowry Pala et al BMC Infectious Diseases (2018) 18:539 transmitting other infections [6], HSV-2, which is associated with an increased risk of HIV acquisition by two- to threefold [7, 8]. Of the estimated 10.2 million people incarcerated worldwide, it is reported that 3.8% are infected with HIV (389,000 living with HIV) and 15.1% with HCV (1,546,500) [12] This prevalence is much higher than in the general population, primarily because of high-risk behaviors, in particular, sharing needles to inject drugs [12, 13]

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