Community incidence of hepatitis B and C among reincarcerated women.

Background: The incarceration rate has increased 239% in the United States over the past 2 decades. This increase in incarceration has been fueled by the movement towards a criminal, rather than medical, response to the problem of drug dependence. For women in particular, incarceration and drug use are interdependent epidemics. Given that incarceration is common among drug-dependent persons, infectious diseases--including hepatitis B virus (HBV) and hepatitis C virus (HCV) infection--are prevalent among incarcerated persons. We sought to determine the incidence of HBV and HCV infection among recidivist women prisoners.

Methods: From 1996 through 1997, excess from serum samples collected during HIV testing of female admittees to a state Department of Corrections facility were tested for HBV and HCV. Multiple samples obtained from women incarcerated multiple times during the study period were compared for incidence.

Results: Baseline prevalences of markers of HBV and HCV were 36% and 34%, respectively. Incidence rates for HBV and HCV infection among reincarcerated women were 12.2 and 18.2 per 100 person-years, respectively. The majority of the time spent between serial intakes was not spent in the correctional facility; thus, incident infections likely occurred in the community.

Conclusions: Incidences of HBV and HCV infection among reincarcerated women were high. Prisons and jails can be efficient locations for the diagnosis, treatment, and prevention of hepatitis B and C through programs such as testing, counseling, education, vaccination, and linkage to medical and drug treatment services.