1825. Risk Behaviors Associated to HCV-infection Among Inmates in a Prison State System in Mexico
Session: Oral Abstract Session: Hepatitis C
Saturday, October 5, 2013: 2:00 PM
Room: The Moscone Center: 250-262
Background: Prison inmates are at high risk of HCV infection which is commonly associated to IDU in this population. Little is known about the epidemiology of HCV in Mexico, a country with low prevalence for both conditions and high incarceration rate.

Methods: To identify factors associated to HCV-infection among inmates in the State Prison System of Guanajuato, Mexico (Sep-2011 to Feb-2012) we did a cross-sectional study in 10 prisons in the state. We offered HCV testing and applied questionnaires for risk behaviors. We compared variables between HCV(+) and HCV(-) subjects and investigated associations to HCV with logistic regression.

Results: 3,639 of 4,266 inmates participated. HCV prevalence was 4.7% (95%CI 4-5.5). Most HCV(+) inmates were male (149/151,99%), and more educated (p=0.05), and were more likely to have been previously incarcerated (10% vs 2.5%, p<0.01) than HCV(-). Before incarceration, HCV(+) were more often tattooed (79% vs 44%, p<0.01), greater number of tattoos (8.4 vs 5, p<0.001) and tattooed in previous incarcerations more frequently (22% vs 10%, p=<0.01). HCV(+) inmates consumed alcohol more commonly (88.3% vs 78.3%, p=0.01), got drunk (2.5 vs 1.8 days/week, p=0.01), and used drugs (85% vs 60%, p<0.0001) more frequently. Drug use pattern differed: HCV(+) used more frequently heroine, crack and amphetamines, but not other drugs. They also had greater IDU (79% vs 11%) and more likely shared materials for IDU (59% vs 2%, p=0.001). During current incarceration, HCV(+) got tattoos (31% vs 21%, p=0.03), and used drugs (53% vs 31%, p=<0.001) more often. The pattern of drug use was similar to that before incarceration, including IDU and sharing materials. In a multivariate model including demographic and behavioral risk factors before and during incarceration, only drug use (OR=2.7), IDU (OR=22) and being tattooed (OR=3) before incarceration were independently associated to HCV. 

Conclusion: The prevalence of HCV-infection and associated behavioral risk factors are very high in comparison to those of the general population in Mexico. The single most important risk factor for HCV infection in this inmate population in a country with low prevalence of HCV and IDU is IDU before incarceration. Preventive programs, such as clean tattooing, and methadone provision should be considered as a public health intervention for these inmates.

Pablo F. Belaunzaran-Zamudio, MD, MSc, DTM&H, International Health, Johns Hopkins Bloomberg School of Public Health, Bethesda, MD, Juan Mosqueda-Gomez, MD, School of Medicine, University of Guanajuato, Leon, Guanajuato, Mexico, Juan Sierra Madero, MD, Infectious Diseases, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico City, Mexico, Alejandro Macías Hernández, MD MS, National Institute of Medical Sciences and Nutrition, Mexico, Mexico and Chris Beyrer, M.D., M.P.H, Johns Hopkins, Baltimore, MD


P. F. Belaunzaran-Zamudio, Pfizer: Received scolarship in 2006, Educational grant
Tibotec: Received scolarship in 2007, Educational grant

J. Mosqueda-Gomez, None

J. Sierra Madero, None

A. Macías Hernández, None

C. Beyrer, None

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