Theme: Social Science & Policy Research Year: 2024
Background: Hepatitis B, Hepatitis C and HIV (Human immunodeficiency virus) infections are major health concern among prisoners. It proposes a regular routine care pathway for assessment, screening, diagnosis, and treatment to be established in all prisons, integrated within managed clinical networks and national programs.
Methods: A pharmacist led clinic within a district jail of adult prisoners was established, offering health education on hepatitis B, hepatitis C, and HIV infections and prevention, along with advice on harm reduction, testing and availability of free treatment under national programs [National Viral Hepatitis Control Program (NVHCP) and National AIDS control program (NACP)]. Infected prisoners were offered access to a care pathway leading to treatment. Outcome measures were uptake of the service, and diagnosis and treatment of hepatitis B & C and HIV.
Results: Regular health education, screening, testing clinics were organized and linkage to care was done for the adult prisoners in collaboration with Jail Authority and NVHCP in last one year starting on the occasion of world hepatitis day 2023. Health education sessions were organized. A total of 1265 prisoners (Mean age 35±8 years, 1000 males, 65 females) were screened using HBsAg, Anti-HCV and HIV rapid diagnostic kits and reflex testing was done if detected positive. Positivity rate was over 2% for Hepatitis C and HIV, 0.8% for hepatitis B. 100% reflex testing was done. All patients tested positive for Hepatitis B&C and HIV chronic infections were put on treatment by linking to District Treatment Unit NVHCP and ART center of NACP, respectively. Almost 20 percent of prisoners were staying for shorter durations (1-3 weeks), so a fortnight clinic was very useful for maximum coverage.
Conclusion: An in-house education, testing and treatment clinic is an effective approach to increase testing uptake and linkage to care among prisoners. It’s an apt example of WHO’s recommendation of decentralization (within the jail), task sharing (pharmacist led clinic) and Integration (with national programs) approach.
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