Correlation between HIV and HCV in Brazilian prisoners: evidence for parenteral transmission inside prison

Objective It is an accepted fact that confinement conditions increase the r isk of some infections related to sexual and/or injecting drugs practices. Mathematical techniques were applied to estimate time-dependent incidence d ensities of HIV infection among inmates. Methods A total of 631 prisoners from a Brazilian prison with 4,900 inmates at that time were interviewed and their blood drawn. Risky behavior for HI V infection was analyzed, and serological tests for HIV, hepatitis C and sy philis were performed, intended as surrogates for parenteral and sexual HIV transmission, respectively. Mathematical techniques were used to estimate the incidence density ratio, as related to the time of imprisonment. Results Prevalence were: HIV - 16%; HCV - 34%; and syphilis - 18%. The main risk behaviors related to HIV infection were HCV prevalence (OR=10.49) and the acknowledged use of injecting drugs (OR=3.36). Incidence density ratio derivation showed that the risk of acquiring HIV infection increases with the time of imprisonment, peaking around three years after incarceration. Conclusions The correlation between HIV and HCV seroprevalence and the resu lts of the mathematical analysis suggest that HIV transmission in this popu lation is predominantly due to parenteral exposure by injecting drug, and t hat it increases with time of imprisonment.