Since 2004, we have run a fortnightly in-reach sexual health clinic in a medium security male prison which houses 1200 inmates, with a specific wing for men who have committed drugs related offences. In 2007, we reported that the prevalence of Hepatitis C (HCV) in the prisoners we tested was 9% [1]. Since then, there has been increased awareness of the burden of HCV in prison settings and new recommendations to increase HCV testing [2].

We aimed to review the current prevalence of HCV in local prisoner sexual health screens, and compare this firstly, to our previous 2007 estimate, and secondly, to that in a contemporary male sexual health clinic population.

Methods We performed a retrospective review of all Hepatitis C antibody tests requested for prisoners and male sexual health clinic patients by our service from 1.09.10 – 30.9.11. Samples were identified by laboratory electronic records and supplementary data was acquired by case note review.

Results HCV antibody screens were performed in 118 prisoners, and 716 men attending our general sexual health clinic. The prevalence of HCV antibody was significantly greater in the prison population compared with the sexual health clinic population (11.1% V 1.1%, 2 sample test of proportion p < 0.0005) however the prevalence in prisoners was unchanged from the 2007 estimate (11.1% V 9%, 2 sample test of proportion p < 0.6). Injecting drug use was reported in 89% of HCV positive cases.

Conclusion The prevalence of HCV in our local institution remains high and injecting drug use is the most commonly reported risk factor. Implementing expanded testing strategies in prisons is a priority of great importance, along with further work to examine the effectiveness of currently strategies to address intravenous drug use.

1. Int J STD & AIDS 2007 (18) 4: 228–30.

2. NICE PH43 http://guidance.nice.org.uk/PH43.