Background Social and behavioural risk factors, as well as the conditions within penitentiary centers, place incarcerated people at high risk for infectious diseases. Few data exist for penitentiary health in Latin America and even fewer outside the context of small sample size studies, usually focused on a single one disease or infection. Our study aimed to probe Mexico City's inmates' health status and relevant, associated Behaviours with focus on HIV and other sexually transmitted infections (STI).
Methods A cross-sectional health survey was implemented in three penitentiary centers for male and two for female detainees, between May and September 2010. All inmates were offered voluntary HIV, Hepatitis C (HCV), Hepatitis B (HBV) and Syphilis tests, along with screening for metabolic disorders. Informed consent and usable blood samples were obtained from 78% of males (15 835/20 688) and 92% of females (1757/ 1914). A random sample of participants answered a risk-factor questionnaire. The institutional review board (IRB) at Mexico's National Institute of Public Health approved study methods. Data analysis was performed using SPSS 16.
Results HIV prevalence was 0.7%, irregardless of sex. For HCV, we found 3.3% and 2.7% for men and women, respectively. HBV antibodies were found in 3.0% of men (of which 5% had positive surface antigen (sAg+)) and 3.2% of women (of which 9% of had sAg+). Of men, 3.6% had antitreponemic antibodies for syphilis (half of these were untreated). Among women 8.8% ever had syphilis, just over a third of these (36%) untreated. Lifetime marijuana use was 48.7% and 29.6% for men and women, respectively; 38.44% and 27.4% ever used cocaine; 5.2% and 3.5% ever injected drugs; 2.2 and 1.1 ever used heroine; 32.9% of men and 25.7% of women reported sex in prison, 75% of both genders declared unprotected last coitus.
Conclusion Despite the challenges in penitentiary centers of middle-income countries, ethical testing for HIV and STIs proved feasible and acceptable. All diagnosed individuals are now receiving the follow-up or treatment they need. HIV and other STI rates were low compared with prisons in other countries but higher than the general population in Mexico. Our study provides baseline data which can be used to design and evaluate prevention strategies within the prison system.
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