Abstract
A corollary of the high proportion of people who inject drugs cycling through prisons worldwide is the accompanying high prevalence of viral hepatitis, particularly hepatitis C (HCV). Prisons have the potential to either escalate or interrupt the transmission of viral hepatitis: prisons that do not provide access to even basic prevention programs are high-risk environments for viral hepatitis transmission. In contrast, prisons can also reduce prevalence through testing and treatment programs. This chapter provides an overview of the global prevalence and incidence of HCV and hepatitis B (HBV) in prisons and the occurrence of known transmission vectors, including injecting drug use, tattooing and other body modification practices, and unprotected sexual intercourse. It discusses policy and practice options to reduce the risk behaviors associated with HCV and HBV transmission, prevent transmission through vaccination, and potentially expand viral hepatitis treatment in prisons using new directly acting anti-viral medication, and the prospect of treatment as prevention.
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