HIV, hepatitis C and risk behaviour in a Canadian medium-security federal penitentiary

In a voluntary anonymous HIV and hepatitis C serology screen in a Canadian male medium security federal penitentiary, 68% of 520 prisoners volunteered a blood sample and 99% of those giving a blood sample completed a risk beh aviour questionnaire which was linked numerically to the blood sample. Comp ared to previous screenings for HIV (4 years earlier), and hepatitis C (3 y ears earlier) in the same institution, HIV seroprevalence had risen from 1% to 2% and hepatitis C seroprevalence from 28% to 33%. The overwhelming ris k association for hepatitis C was with drug use outside prison, although th ere was a small group of men who had only ever injected drugs inside prison , over half of whom had been infected with hepatitis C. The proportion of p risoners who had injected drugs in prison rose from 12% in 1995 to 24% in 1 998. The proportion of surveyed individuals sharing injection equipment at some time in prison was 19%, and while HIV rates in the prison are currentl y low, HIV prevalence amongst Canadian street i.v. drug users is rising rap idly, underlining the need for urgent preventative measures in prisons.