Status of hiv and hepatitis c virus infections among prisoners in the middle east and north Africa

Review and synthesis

Marieke Heijnen, Ghina R. Mumtaz, Laith Aburaddad

Research output: Contribution to journalReview article

13 Citations (Scopus)

Abstract

Introduction: The status of HIV and hepatitis C virus (HCV) infections among incarcerated populations in the Middle East and North Africa (MENA) and the links between prisons and the HIV epidemic are poorly understood. This review synthesized available HIV and HCV data in prisons in MENA and highlighted opportunities for action. Methods: The review was based on data generated through the systematic searches of the MENA HIV/AIDS Epidemiology Synthesis Project (2003 to December 15, 2015) and the MENA HCV Epidemiology Synthesis Project (2011 to December 15, 2015). Sources of data included peer-reviewed publications and country-level reports and databases. Results and discussion: We estimated a population of 496,000 prisoners in MENA, with drug-related offences being a major cause for incarceration. Twenty countries had data on HIV among incarcerated populations with a median prevalence of 0.6% in Afghanistan, 6.1% in Djibouti, 0.01% in Egypt, 2.5% in Iran, 0% in Iraq, 0.1% in Jordan, 0.05% in Kuwait, 0.7% in Lebanon, 18.0% in Libya, 0.7% in Morocco, 0.3% in Oman, 1.1% in Pakistan, 0% in Palestine, 1.2% in Saudi Arabia, 0% in Somalia, 5.3% in Sudan and South Sudan, 0.04% in Syria, 0.05% in Tunisia, and 3.5% in Yemen. Seven countries had data on HCV, with a median prevalence of 1.7% in Afghanistan, 23.6% in Egypt, 28.1% in Lebanon, 15.6% in Pakistan, and 37.8% in Iran. Syria and Libya had only one HCV prevalence measure each at 1.5% and 23.7%, respectively. There was strong evidence for injecting drug use and the use of non-sterile injecting-equipment in prisons. Incarceration and injecting drugs, use of non-sterile injecting-equipment, and tattooing in prisons were found to be independent risk factors for HIV or HCV infections. High levels of sexual risk behaviour, tattooing and use of non-sterile razors among prisoners were documented. Conclusions: Prisons play an important role in HIV and HCV dynamics in MENA and have facilitated the emergence of large HIV epidemics in at least two countries, Iran and Pakista.There is evidence for substantial but variable HIV and HCV prevalence, as well as risk behaviour including injecting drug use and unprotected sex among prisoners across countries. These findings highlight the need for comprehensive harm-reduction strategies in prisons.

Original languageEnglish
Article number20873
JournalJournal of the International AIDS Society
Volume19
Issue number1
DOIs
Publication statusPublished - 27 May 2016
Externally publishedYes

Fingerprint

Northern Africa
Eastern Africa
Hepatitis Viruses
Prisoners
Middle East
Virus Diseases
Hepacivirus
Prisons
HIV
Iran
Libya
Syria
Tattooing
Lebanon
Afghanistan
Egypt
Pakistan
Risk-Taking
Pharmaceutical Preparations
Djibouti

Keywords

  • HCV
  • HIV
  • Incarceration
  • Middle east and north Africa
  • Prisons
  • PWID.

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Status of hiv and hepatitis c virus infections among prisoners in the middle east and north Africa : Review and synthesis. / Heijnen, Marieke; Mumtaz, Ghina R.; Aburaddad, Laith.

In: Journal of the International AIDS Society, Vol. 19, No. 1, 20873, 27.05.2016.

Research output: Contribution to journalReview article

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abstract = "Introduction: The status of HIV and hepatitis C virus (HCV) infections among incarcerated populations in the Middle East and North Africa (MENA) and the links between prisons and the HIV epidemic are poorly understood. This review synthesized available HIV and HCV data in prisons in MENA and highlighted opportunities for action. Methods: The review was based on data generated through the systematic searches of the MENA HIV/AIDS Epidemiology Synthesis Project (2003 to December 15, 2015) and the MENA HCV Epidemiology Synthesis Project (2011 to December 15, 2015). Sources of data included peer-reviewed publications and country-level reports and databases. Results and discussion: We estimated a population of 496,000 prisoners in MENA, with drug-related offences being a major cause for incarceration. Twenty countries had data on HIV among incarcerated populations with a median prevalence of 0.6{\%} in Afghanistan, 6.1{\%} in Djibouti, 0.01{\%} in Egypt, 2.5{\%} in Iran, 0{\%} in Iraq, 0.1{\%} in Jordan, 0.05{\%} in Kuwait, 0.7{\%} in Lebanon, 18.0{\%} in Libya, 0.7{\%} in Morocco, 0.3{\%} in Oman, 1.1{\%} in Pakistan, 0{\%} in Palestine, 1.2{\%} in Saudi Arabia, 0{\%} in Somalia, 5.3{\%} in Sudan and South Sudan, 0.04{\%} in Syria, 0.05{\%} in Tunisia, and 3.5{\%} in Yemen. Seven countries had data on HCV, with a median prevalence of 1.7{\%} in Afghanistan, 23.6{\%} in Egypt, 28.1{\%} in Lebanon, 15.6{\%} in Pakistan, and 37.8{\%} in Iran. Syria and Libya had only one HCV prevalence measure each at 1.5{\%} and 23.7{\%}, respectively. There was strong evidence for injecting drug use and the use of non-sterile injecting-equipment in prisons. Incarceration and injecting drugs, use of non-sterile injecting-equipment, and tattooing in prisons were found to be independent risk factors for HIV or HCV infections. High levels of sexual risk behaviour, tattooing and use of non-sterile razors among prisoners were documented. Conclusions: Prisons play an important role in HIV and HCV dynamics in MENA and have facilitated the emergence of large HIV epidemics in at least two countries, Iran and Pakista.There is evidence for substantial but variable HIV and HCV prevalence, as well as risk behaviour including injecting drug use and unprotected sex among prisoners across countries. These findings highlight the need for comprehensive harm-reduction strategies in prisons.",
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