HIV, hepatitis B and C, syphilis and Tuberculosis prevalence in people deprived of liberty for criminal reasons in Argentina. Final results of a national study.

Abstract

Background: One of the sanitarian policies implemented by the Ministry of Health of Argentina in the last decade was to improve health conditions and access to care for incarcerated people. For this reason, between 2015 and 2017, a nationwide study was conducted to determine the prevalence of HIV, syphilis, hepatitis B and C and Tuberculosis in federal prisons in Argentina. Methods & Materials: An observational cross-sectional study was designed based on a representative sample of the universe of 10300 imprisoned people in federal prisons. Extractions were made to study HIV (fourth generation ELISA), HBV (HBsAg and Anti-HBc), HCV and syphilis (VDRL confirmed by TF-PA). Samples were taken from those who had TB-related symptoms to perform a baciloscopy. A self-administered survey was conducted on sexual practices, care history and drug use. The fieldwork was carried out in 2016. The study was approved by a bioethics committee and was supported by UNAIDS, PAHO and UNODC. The Ministries of Health and Justice signed an agreement that made it possible to enter into prisons. Results: 2181 blood samples were taken and 2277 surveys were carried out in 6 federal prisons (89% men, 10% women and 1% trans). All estimates and prevalence values presented here were adjusted based on prison population structure, through sample weights (taking in account 6 variables). The weighted prevalence of HIV was 2.7% (CI: 2.4% -3%); syphilis 6.8% (5.8%-7.7%); positive HBsAg was 0.51% (0.37%-0.65%); positive Anti-HBc and negative HBsAg was 6.1% (5.5%-6.5%); HCV was 3.3% (3%-3.6%). In one case baciloscopy was positive, so a TB prevalence was 29.6 × 100000. Conclusion: The findings demonstrate the high prevalence of the infections studied in prison population and reinforce the need to develop interventions that facilitate access to prevention, diagnosis and care in this population. This investigation also allowed improving the diagnosis and care circuits of the prisons where it was developed. Federal prisons house 15% of the total number of people incarcerated in Argentina. It is possible that the prevalence of the infections studied is a little higher in the rest of the prisons.