Differences in Sexual Identity,Risk Practices,and Sex Partners between Bisexual Men and Other Men among a Low-Income Drug-Using Sample

Hepatitis B vaccination and targeted testing for hepatitis C virus (HCV) are recommended for jails with medical services available. This study estimates hepatitis B virus (HBV) and HCV infection prevalence among jail inmates, since most previous studies have been conducted among prison inmates. Prison and jail populations differ: jails hold a wide spectrum of persons for an average of 10–20 days, including persons awaiting arraignment, trial, conviction, or sentencing, while prisons typically hold convicted criminals for at least 1 year. A stratified random sample of sera obtained during routine syphilis testing of inmates entering jails in Chicago (March–April 2000), Detroit (March–August 1999), and San Francisco (June 1999–December 2000) was tested for serologic markers of HBV and HCV infection. All sera had been previously tested for antibody to HIV (anti-HIV). A total of 1,292 serum samples (12% of new inmates) was tested. Antibody to HCV (anti-HCV) prevalence was 13%. Antibody to hepatitis B core antigen (anti-HBc) prevalence was 19%, and hepatitis B surface antigen (HBsAg) prevalence was 0.9%; 12% had serologic evidence of hepatitis B vaccination. Hispanics had high rates of chronic HBV infection (3.6% HBsAg positive) along with Asians (4.7% HBsAg positive). Among HIV-infected persons, 38% were anti-HCV positive and 8.2% were HBsAg positive. Anti-HBc positivity was associated with anti-HCV positivity (aOR = 4.58), anti-HIV positivity (aOR = 2.94), syphilis infection (aOR = 2.10), and previous incarceration (aOR = 1.78). Anti-HCV-positivity was associated with anti-HBc positivity (aOR = 4.44), anti-HIV-positivity (aOR = 2.51), and previous incarceration (aOR = 2.90). Jail entrants had high levels of HCV and HBV infection and HIV co-infection; HBV prevalence was comparable to previous prison studies, and HCV prevalence was lower than prison studies. Hispanics had an unexpectedly high rate of chronic hepatitis B infection and had the lowest rate of hepatitis B vaccination. The finding that hepatitis B vaccination coverage among jail entrants is lower than the general population, despite this population’s increased risk for infection, highlights the need to support vaccination in jail settings.     

Hepatitis virus and HIV infections in inmates of a state correctional facility in Mexico

We sought to determine the prevalence and associated characteristics of hepatitis A, B, C and D viruses and HIV infections in a prison in Durango, Mexico. Sera from 181 inmates were analysed for HAV antibody, hepatitis B core antibody (HBcAb), hepatitis B surface antigen (HBsAg), HCV antibody, HDV antibody, HIV antibody and HCV genotypes. Prevalence of HAV antibody, HBcAb, HBsAg, HCV antibody, HDV antibody and HIV antibody were 99.4, 4.4, 0.0, 10.0, 0.0 and 0.6% respectively. HCV genotype 1a predominated in HCV-infected inmates (62.5%), followed by HCV genotype 1b (25%) and HCV genotype 3 (12.5%). An association between HBV infection and age > 30 years was found. HCV infection was associated with being born in Durango City, history of hepatitis, ear piercing, tattooing, drug abuse history, intravenous drug use and lack of condom use. We concluded that the prevalence of HAV, HBV, HDV and HIV infections in inmates in Durango, Mexico were comparable to those of the Mexican general population and blood donors, but lower than those reported in other prisons around the world. However, HCV infection in inmates was higher than that reported in Mexican blood donors but lower than those reported in other prisons of the world. These results have implications for the optimal planning of preventive and therapeutic measures.     

Prevalence of HIV,syphilis, hepatitis B,and hepatitis C among entrants to Maryland correctional facilities

Although high prevalence of hepatitis C virus (HCV) in correctional institutions has been established, data are sparse regarding the comorbidities of hepatitis B virus (HBV), HCV, and human immunodeficiency virus (HIV), all of which may complicate the management of HCV. This study sought to estimate the prevalence and correlates associated with HCV prevalence among entrants into the Maryland Division of Correction and the Baltimore City Detention Center. Participants included all newly incarcerated entrants between January 28 and March 28, 2002. Excess sera with identifiers removed from samples drawn for routine syphilis testing were assayed for antibodies to HIV and HCV and for HBV surface antigen and surface and total core antibodies. Separately, all HIV-positive specimens were tested using the serological testing algorithm for recent HIV seroconversion. Of the 1,081 immates and 2,833 detainees, reactive syphilis serology was noted in 0.6% of the combined population; HIV seroprevalence was 6.6%; HCV prevalence was 29.7%; and 25.2% of detainees and prisoners had antigen or core or surface antibodies to HBV. A multivariate analysis of predictors of HCV positivity indicated that detainees, women, whites, older age groups, those who were HIV seropositive, and individuals with past or present infection with HBV were significantly more likely to be positive for HCV. These data indicate that hepatitis C remains an important public health concern among entrants to jail and prison and is complicated with coinfections that need to be addressed for effective treatment.     

Prevalence and incidence of bloodborne viral infections among Danish prisoners

In order to determine the prevalence and incidence of bloodborne viral infections among prisoners, we conducted a prospective study in a Danish medium security prison for males. The prisoners were offered an interview and blood test for hepatitis and human immunodeficiency virus HIV at inclusion as well as at release from prison or end of study. Of 403 prisoners available 325 (79%) participated in the initial survey and for 142 (44%) a follow-up test was available. 43% (140/325) of the participants were injecting drug users (IDUs) of whom 64% were positive for hepatitis B (HBV) and 87% for hepatitis C (HCV) markers. No cases of HIV or human T lymphotropic virus (HTLV) were found. 32% of all prisoners could transmit HBV and/or HCV by blood contact. 70% of IDUs had shared injecting equipment, and 60% had injected inside prison. Only 2% of IDUs were vaccinated against HBV. Duration of injecting drug use, numbers of imprisonments, and injecting in prison were independently and positively associated with the presence of HBV antibodies among IDUs by logistic regression analysis. The HBV incidence was 16/100 PY (95% CI: 2–56/100 PY) and the HCV incidence 25/100 PY (1–140) among injecting drug users (IDUs). We conclude that IDUs in prison have an incidence of hepatitis B and C 100 times higher than reported in the general Danish population. They should be vaccinated against hepatitis B and new initiatives to stop sharing of injecting equipment in and outside prison is urgently needed.     

社区美沙酮维持治疗新入组者HCV感染率变化趋势及危险因素

目的 探讨社区美沙酮维持治疗（methadone maintenance treatment,MMT）新入组者丙型肝炎病毒（hepatitis C virus,HCV）感染率的变化趋势及相关危险因素。方法 以2006-2014年广东省8 830名MMT新入组者为研究对象,计算不同年份HCV感染率,采用Logistic回归分析相关危险因素。结果 2006-2008年、2009-2011年、2012-2014年分别新入组4 485人、3 028人、1 317人,HCV感染率分别为77.1%、80.7%、77.0%,趋势性χ²检验差异无统计学意义（χ_趋势²=1.72,P=0.189）。多因素分析结果显示：2006-2008年较高的文化程度、已婚有配偶是HCV感染的保护因素（均有P<0.05）;吸毒年限长、过去半年与毒友交往次数多、有注射吸毒史是HCV感染的危险因素（均有P<0.05）。2009-2011年较高的文化程度、已婚有配偶是HCV感染的保护因素（均有P<0.05）;吸毒年限长、过去半年与毒友交往次数多、有注射吸毒史是HCV感染的危险因素（均有P<0.05）。2012-2014年女性、吸毒年限长、有注射吸毒史是HCV感染的危险因素（均有P<0.05）。结论 MMT新入组者HCV感染率较高且无下降趋势;危险因素有所变化,但吸毒年限长和注射吸毒是HCV感染的持续性高危因素。应进一步加强MMT门诊宣传及HCV防控工作。     

Prevalence and Correlates of HCV,HVB, and HIV Infection among Prison Inmates and Staff,Hungary

The aim of this national, multicenter, cross-sectional study was to assess the prevalence of hepatitis B (HBV), hepatitis C (HCV), and human immunodeficiency viruses (HIV) among prisoners, and to identify related risk behaviors including injection drug use. Overall, 4,894 inmates from 20 prisons were enrolled. To have a comparison group, prison staff were also asked to take part. Altogether, 1,553 of the 4,894 inmates from seven prisons completed a questionnaire on risk behaviors. According to the survey, 1.5%, 4.9%, and 0.04% of the prisoners were tested positive for HBsAg, anti-HCV and anti-HIV, respectively. These prevalence data are among the lowest reported from prisons worldwide, although comparable to the Central European data. The prevalence of HBV, HCV, and HIV in the Hungarian prison staff was low (0.38%, 0.47%, and 0%, respectively). The rate of HCV infection was significantly higher among inmates who have ever injected drugs (22.5%) than among inmates who reported they had never injected drugs (1.1%). This first prevalence study of illegal drug injection-related viral infections among Hungarian prisoners points out that ever injecting drugs is the main reason for HCV infection among inmates. The opportunity to reach drug users infected with HCV for treatment underlines the importance of screening programs for blood-borne viruses in prisons.     

Trends in hepatitis B prevalence and associated risk factors among Indigenous and non‐Indigenous prison entrants in Australia, 2004 to 2013

Objective : This study describes and compares prevalence trends of markers for hepatitis B (HBV) from 2004 to 2013 and HBV risk factors between Indigenous and non‐Indigenous prison entrants. Methods : A cross‐sectional survey carried out over two weeks in 2004, 2007, 2010 and 2013 in reception prisons in New South Wales, Queensland, Western Australia and Tasmania. Results : The study included 2,223 prison entrants; 544 were Indigenous. Indigenous prison entrants had significantly higher hepatitis B core antibody (anti‐HBc) prevalence than non‐Indigenous prisoners in 2004 (29% vs. 18%, P=0.026), 2007 (40% vs. 15%, P<0.001) and 2010 (21% vs. 16% 2010, P=0.002), and similar anti‐HBc prevalence to non‐Indigenous entrants in 2013 (14% vs. 14%, P=0.888), with a significant decline from 2007 for Indigenous entrants (P=0.717)^?. Being more than 30 years old and coming from an area classified as ‘non‐highly accessible’ were associated with anti‐HBc positivity in both populations. For Indigenous prison entrants, first time in prison and survey year was associated with anti‐HBc positivity. For non‐Indigenous participants, a history of injecting drug use and body piercings was associated with anti‐HBc positivity. Conclusion : There are unique risk factors associated with HBV prevalence for both Indigenous and non‐Indigenous prison entrants. Implications for public health : In developing public health programs and policies for HBV, consideration of similarities and differences of associated HBV risk factors between Indigenous and non‐Indigenous offenders is required.     

Viral infections in short-term injection drug users: the prevalence of the hepatitis C, hepatitis B, human immunodeficiency, and human T-lymphotropic viruses.

OBJECTIVES: The purpose of this study was to estimate the prevalence and correlates of four blood-borne viral infections among illicit drug injectors with up to 6 years of injecting experience. METHODS: We analyzed data from 716 volunteers recruited in 1988 and 1989. Test results for hepatitis C virus (HCV), hepatitis B virus (HBV), human immunodeficiency virus, type 1 (HIV), and human T-lymphotropic virus types I and II (HTLV) were examined across six sequential cohorts defined by duration of drug injection. RESULTS: Overall, seroprevalence of HCV, HBV, HIV, and HTLV was 76.9%, 65.7%, 20.5% and 1.8%, respectively, and 64.7%, 49.8%, 13.9%, and 0.5%, respectively, among those who had injected for 1 year or less. Among the newest initiates, HCV and HBV were associated with injecting variables, and HIV was associated with sexual variables. CONCLUSIONS: The high rates of HCV, HBV, and HIV infections among short-term injectors emphasizes the need to target both parenteral and sexual risk reduction interventions early. Renewed efforts at primary prevention of substance abuse are indicated.     

Risk behaviours of young Indo-Chinese injecting drug users in Sydney and Melbourne

OBJECTIVE: To investigate patterns of drug use and injection-related risk behaviours among young Indo-Chinese injecting drug users (IDUs). METHOD: Cross-sectional survey. A structured questionnaire was administered to 184 Indo-Chinese IDUs aged 15 to 24 in Sydney and Melbourne. Participants were recruited using snowball sampling techniques; measures included patterns of heroin and other drug use, injection-related risk behaviours, perceived susceptibility to HIV and HCV infection and access to services. RESULTS: Despite perceived high availability of sterile injecting equipment, 36% had ever shared a needle and syringe and 22% had done so in the preceding month. Lifetime sharing was significantly associated with duration of injecting, history of incarceration and residence in Sydney. Sharing of injecting paraphernalia other than needles and syringes was also common, with young women and Sydney residents significantly more likely to report sharing equipment in the preceding month. CONCLUSIONS: Young Indo-Chinese IDUs are at high risk of infection with hepatitis C and other blood-borne viruses. Results indicate an urgent need for culturally appropriate and sustainable risk reduction programs which specifically target this population. Implications: Health services must respond swiftly to implement effective blood-borne virus prevention programs for young Indo-Chinese IDUs. Failure to do so may sustain the current epidemic of hepatitis C among IDUs.     

Prevalence and incidence of HIV, hepatitis B virus, and hepatitis C virus infections among males in Rhode Island prisons

OBJECTIVES: We evaluated prevalence and intraprison incidence of HIV, hepatitis B virus, and hepatitis C virus infections among male prison inmates. METHODS: We observed intake prevalence for 4269 sentenced inmates at the Rhode Island Adult Correctional Institute between 1998 and 2000 and incidence among 446 continuously incarcerated inmates (incarcerated for 12 months or more). RESULTS: HIV, hepatitis B virus, and hepatitis C virus prevalences were 1.8%, 20.2%, and 23.1%, respectively. Infections were significantly associated with injection drug use (odds ratio = 10.1, 7.9, and 32.4). Incidence per 100 person-years was 0 for HIV, 2.7 for HBV, and 0.4 for HCV. CONCLUSIONS: High infection prevalence among inmates represents a significant community health issue. General disease prevention efforts must include prevention within correctional facilities. The high observed intraprison incidence of HBV underscores the need to vaccinate prison populations.     

Association between heroin use, needle sharing and tattoos received in prison with hepatitis B and C positivity among street-recruited injecting drug users in New Mexico, USA.

This study aimed to assess the seroprevalence and risk factors for hepatitis B virus (HBV), hepatitis C virus (HCV), and HIV-1 infections among injecting drug users (IDU) in New Mexico. Serological and behavioural surveys were conducted in conjunction with street-based outreach, education and HIV counselling and testing. High rates of antibody positivity for HCV (82.2%) and HBV (61.1%), and a low rate for HIV (0.5%) were found. In multivariate analyses, both HBV and HCV infection were positively associated with increasing age, increasing years of injection and heroin use. Receipt of a tattoo in prison/jail was associated with HBV (odds ratio = 2.3, 95% confidence interval 1.4, 3.8) and HCV (OR = 3.4, 95% CI = 1.6, 7.5) infections. Prevention of bloodborne pathogens among IDUs should focus on young users, early in their drug use experience. Studies examining the relationship between tattooing and HBV and HCV infection are needed as are efforts to promote sterile tattooing, in prisons and elsewhere.     

Seroprevalence of blood-borne infections and population sizes estimates in a population of injecting drug users in Croatia

Similar to some other Central European countries, Croatia has low HIV prevalence among injecting drug users (IDUs) but high hepatitis C (HCV) prevalence. This may indicate different patterns of risk behaviour in this region than in other parts of Europe. The main objectives of this study were to assess the seroprevalence of HIV and hepatitis B and C and related risk factors among IDUs in the three largest Croatian cities (Zagreb, Split, Rijeka) and within the national prison system, as well as to apply a multiplier-method population size estimation of IDUs in Zagreb, Split and Rijeka. Recruitment sites were selected in collaboration with the local public health institutes, NGOs, Centers for treatment municipalities and the judiciary system. Participants were recruited during September and October 2007. Trained peer-recruiters were used to recruit IDU participants at treatment and harm reduction centres as well as pre-identified social, commercial and street based venues. Participants completed the study questionnaire and provided venous blood samples for HIV, hepatitis B and hepatitis C testing. The study included 601 participants, of whom 121 were recruited in Split, 130 in Zagreb, 150 in Rijeka and 200 in the prison system. The prevalence of positive anti-HCV tests was 65% in Split, 51% in Zagreb, 29% in Rijeka and 44% in the prisons. The prevalence of anti-HBcAg was 31% in Split, 13% in Zagreb, 9% in Rijeka and 24% in prison. No case of HIV infection was found. The estimated IDUs population sizes were 2,805 for Zagreb area, 3,347 for Split and 1,370 for Rijeka area, however confidence intervals were very large, indicating the need for larger samples. A high frequency of positive markers on hepatitis B virus and C virus in the population of injecting drug users in Croatia has been confirmed with this research, as well as a low prevalence of HIV infection. This may be related to relatively low levels of injecting risk behaviour and injecting frequency although it is not possible to make strong conclusions on risk behaviour, as participants were mostly recruited in harm reduction programmes. This research should be followed by targeted activities for reducing risks of infectious diseases among injecting drug users in the Republic of Croatia and future research at the national level.     

A survey of HIV and HCV among female prison inmates in Portugal

HIV and hepatitis C virus (HCV) monitoring among prison inmates is instrumental in countries with concentrated HIV/AIDS epidemics. Knowledge on these dynamics in imprisoned women in Portugal is scarce. The HIV and HCV prevalence was estimated among inmates in the largest Portuguese prison for women, which holds 57% of all female inmates in Portugal, according to sociodemographic and behavioural variables and characterised attitudes towards HIV/AIDS according to serological status. Collected variables included age, education, country of birth, penal status, and accumulated time in prison. Drug injection and sharing of injection material were inquired, as well as age at first sexual intercourse. Inmates also characterised their attitudes towards HIV/AIDS. A venous blood sample was collected and tested for anti-HIV and anti-HCV antibodies. In this sample of 445 female inmates, 10% were HIV-positive, while 11% were HCV-positive. Longer imprisonment periods were associated with relatively higher HCV prevalence and women with later ages at first sexual intercourse were less frequently HIV-positive, regardless of drug injecting behaviour. HIV prevalence was 44% in women who had ever injected drugs and 6% in those who had never injected. HCV frequency was 69% among injecting drug users (IDUs) and 4% among non-IDUs. In women who injected drugs both HIV and HCV were more frequent when the number of injections was higher and when women reported sharing of injection material. Similar attitudes towards HIV/AIDS were found for HIV-positive and negative women, but those living with HIV had more tolerant positions. This study emphasizes the role of injecting drug use in the transmission of HIV and HCV in women in Portuguese prisons and reinforces the need for the systematic adoption of harm reduction measures.     

Prevalence of antibodies to hepatitis C virus, HIV and human T-cell leukaemia/lymphoma viruses in injecting drug users in Tayside, Scotland, 1993-7

The prevalence of blood-borne viruses in injecting drug users (IDUs) in Tayside, Scotland was determined by testing serum samples from IDUs who underwent attributable HIV antibody testing during 1993-7. The prevalence of antibodies to HIV was 29/802, (3.6%); to hepatitis C virus (HCV) 451/691, (65.3%); and to human T-cell leukaemia/lymphoma viruses type 1 and 2 (HTLV) 0/679, (0.0%). The prevalence of HIV and HCV antibodies were higher in subjects over the age of 25 (P = 0.03 and P = 0.001, respectively). During 1993-7 the prevalence of HCV fell only in younger female IDUs (P < 0.01). HIV prevalence has declined dramatically since 1985, when a rate of 40% was recorded in similar populations. Harm reduction measures have failed to control HCV the spread of infection among IDUs in Tayside, as indicated by the high proportion of antibody positive IDUs, particularly males under the age of 25. Future studies should address the nature and effective reduction of continuing risk taking among IDUs in Tayside.     

Prevalence of HIV, hepatitis B, and hepatitis C antibodies in prisoners in England and Wales: a national survey

Prisoners in eight of the 135 prisons in England and Wales were surveyed in 1997 and 1998 to study the prevalence of and risk factors for transmission of bloodborne viruses in prison. Subjects voluntarily completed a risk factor questionnaire and provided oral fluid specimens for unlinked anonymous testing for the presence of antibodies to HIV, hepatitis C virus (HCV), and the core antigen of hepatitis B virus (HBc). Almost 8% (4778) of the total of 60,561 prisoners were eligible and four fifths (3942) of those eligible took part. Among all those tested (3930) 0.4% (14) were positive for anti-HIV, 8% (308) for anti-HBc, and 7% (293) for anti-HCV (the anti-HBc and anti-HCV prevalences were not adjusted for assay sensitivities of 82% and 80%, respectively). Twenty-four per cent (777/3176) of adult prisoners reported ever having injected drugs, 30% of whom (224/747) reported having injected in prison. Three quarters of those who injected in prison (167/224) shared needles or syringes. Among adult injecting drug users, 0.5% (4/775) had anti-HIV, 31% (240/775) anti-HCV, and 20% (158/775) anti-HBc. The presence of anti-HCV and anti-HBc was associated with injecting inside prison and number of previous times in prison. The results suggest that hepatitis viruses are probably being transmitted in prisons through sharing non-sterile injecting equipment and that a risk of HIV transmission exists. Harm minimisation measures for the 6% of prisoners who continue to inject while in prison should be strengthened.     

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 risk of some infections related to sexual and/or injecting drugs practices. Mathematical techniques were applied to estimate time-dependent incidence densities 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 HIV infection was analyzed, and serological tests for HIV, hepatitis C and syphilis 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 results of the mathematical analysis suggest that HIV transmission in this population is predominantly due to parenteral exposure by injecting drug, and that it increases with time of imprisonment.     

Hepatitis B and C infections, human immunodeficiency virus and other sexually transmitted infections among women of childbearing age in C?te d'Ivoire, West Africa.

Few studies have been conducted in developing countries to estimate the prevalence of hepatitis C virus (HCV) infection and its association with human immunodeficiency virus (HIV) and other sexually transmitted diseases (STDs). We have screened for hepatitis B virus (HBV) and HCV markers 200 HIV-1-positive, 23 HIV-2-positive and 206 HIV-negative women attending gynaecology clinics in 1995/96 in Abidjan, C?te d'Ivoire, a sample selected among 2198 consecutive consultants. Taking into account the prevalence of 21.7% for HIV in this population, the overall prevalence of anti-HBV core antibody was 81.6%, that for hepatitis B surface antigen was 9.9% and for HCV antibody was 3.3%. HIV infection and other STDs were not associated with HBV or HCV markers. Moreover, HBV and HCV markers were not statistically associated. Our results confirm the high prevalence of HIV in Abidjan and the endemic situation of HBV infection. Furthermore, HCV infection is not infrequent in this developing country setting, not explained by sexual transmission.     

Age-specific seroprevalence of HIV, hepatitis B virus, and hepatitis C virus infection among injection drug users admitted to drug treatment in 6 US cities

OBJECTIVES: This study measured age-specific seroprevalence of HIV, hepatitis B virus, and hepatitis C virus (HCV) infection among injection drug users (IDUs) admitted to drug treatment programs in 6 US cities. METHODS: Remnant sera collected from persons entering treatment with a history of illicit drug injection were tested for antibodies to HIV, hepatitis C (anti-HCV), and hepatitis B core antigen (anti-HBc). RESULTS: Prevalence of anti-HBc and anti-HCV increased with age and reached 80% to 100% among older IDUs in all 6 cities. Although overall age-specific HIV prevalence was lower than anti-HCV or anti-HBc, this prevalence was greater in the Northeast than in the Midwest and West. CONCLUSIONS: The need continues for effective primary prevention programs among IDUs specifically targeting young persons who have recently started to inject drugs.     

Seroprevalence of HIV, HCV and syphilis in Brazilian prisoners: Preponderance of parenteral transmission

Between November 1993 and April 1994, our physicians' team interviewed and took blood samples of 631 prisoners randomly drawn from the largest prison of South America, which counted about 4700 inmates at that time. The interview consisted of questions related to risk behaviour for HIV infection, and the subjects were asked to provide blood for serological tests for HIV, hepatitis C and syphilis. Our main purpose was to investigate the relationship between HCV and injecting drug use as related to HIV seropositivity. Participation in the study was voluntary and confidentiality was guaranteed. Overall prevalences found were as follows: HIV: 16% (95% confidence interval (CI): 13–19%); HCV: 34% (95% CI: 30–38%), and syphilis: 18% (95% CI: 15–21%). Acknowledged use of ever injecting drug was 22% and no other parenteral risk was reported. Our results, as compared with other studies in the same prison, suggest that HIV prevalence has been stable in recent years, and that the major risk factor for HIV infection in this population is parenteral exposure by injecting drug use.