Johns Hopkins study finds prisons contribute to spread of HIV, tuberculosis, hepatitis

Inmates moving in and out of prisons worldwide contribute significantly to global health epidemics such as HIV, viral hepatitis, and tuberculosis, according to a new study by researchers at the Johns Hopkins Bloomberg School of Public Health.

The study was published July 17 in The Lancet as part of a series of studies on HIV and prisoners.

Andrea Wirtz, a co-author of the study and an assistant scientist at the Bloomberg School, told The Baltimore Sun that the findings could have important implications in Baltimore, for example, considering the racial and economic makeup of the prison population in the city.

"By having disparity in imprisonment in the city, are we increasing peoples' risk of HIV and other infectious diseases?" she said. "We can say this is part of the bigger picture of the HIV epidemic."

For the study, researchers analyzed nearly 300 scientific papers published around the world over the past 10 years about prisoners and infectious diseases. They also used research data from United Nations organizations and from prisons in 17 countries, including China and Russia.

The study found that of the estimated 10.2 million people incarcerated worldwide on any given day in 2014, 3.8 percent had HIV, 15.1 percent had hepatitis C, 4.8 percent had hepatitis B, and 2.8 percent had tuberculosis. In less wealthy countries, between 10 percent and 20 percent of prisoners have HIV.

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The study authors said corrections officials ought to do more to improve how they combat the spread of infectious diseases, including offering condoms, needle exchanges and other services to address the public health issue.

"We knew from a lot of the literature that HIV would be higher in the prisons," Wirtz said. "But while there are improvements in jails and other detention centers, there is a higher rate of HIV and other infectious diseases globally, even when there are improvements."

The authors blamed prisons' role in the spread of disease around the world on laws, policies and policing practices that don't ensure a continuity of medical treatment for inmates in detention, during imprisonment and after release. Interventions to treat HIV, tuberculosis, and hepatitis are required by international law but are not commonly available, the authors wrote.