One in Three Inmates Entering Maryland Prisons Test Positive for HIV or Other Infectious Diseases, Survey Shows
More than one in three inmates entering the Maryland prison system tests positive for HIV, syphilis, hepatitis B or hepatitis C, and many prisoners have more than one infection, according to a blood survey released Tuesday by the Maryland AIDS Administration, the Baltimore Sun reports (Bykowicz, Baltimore Sun, 5/8). The survey was based on blood tests administered to 3,914 inmates over 60 days in 2002 upon admission to a Baltimore detention center and a state receiving facility for inmates who are on their way to prisons throughout Maryland (Associated Press, 5/6). In February and March 2002, every detainee or inmate underwent a blood test for syphilis and those who tested positive received follow-up care. Identifying information was then removed from the blood samples before further testing for the other viruses was completed, the Washington Post reports. The survey shows that prevalence rates for the diseases among the state's prison population is "dramatically higher" than the rates among the general population. For example, the survey found that 29.7% of inmates tested positive for hepatitis C -- the most prevalent of the diseases among inmates -- while only 2% of the U.S. population has the disease, according to Liza Solomon, head of the MAA (Goldstein, Washington Post, 5/7). In addition, the report found that almost 65% of HIV-positive inmates are coinfected with hepatitis C, and more than 50% of the inmates with hepatitis B also have hepatitis C. Richard Rosenblatt, assistant secretary for treatment services in the Department of Public Safety and Correctional Services, said that Maryland has one of the highest HIV prevalence rates of any prison system in the United States (Baltimore Sun, 5/8). The report noted that most of the diseases are transmitted primarily through the use of contaminated needles for injection drug use; however, syphilis is a sexually transmitted bacterium and is only transmitted in that manner. The study, which Solomon said is the first to show systematically that prisoners often have several infectious diseases simultaneously, also found that women entering Maryland prisons are "far more likely" to have HIV, syphilis and hepatitis C than men entering state facilities.
Maryland prisons currently offer treatment for syphilis and HIV but do not "routinely" administer hepatitis B vaccinations to inmates or staff members, nor do they offer routine treatment of inmates who have hepatitis C, Solomon said, according to the Post. The higher prevalence of these infectious diseases among prisoners could have "major public health implications" because some inmates eventually rejoin society, where they can spread the infections, Solomon said. Maryland Division of Corrections officials are reviewing the survey "with an eye toward new medical policies," division spokesperson Mark Vernarelli said, adding, "Health and treatment issues are a priority for this administration. Preventing the spread of communicable diseases among inmates is critical" (Washington Post, 5/7). According to Rosenblatt, treatment of prisoners with hepatitis C infection will begin "somewhere down the road" (Baltimore Sun, 5/8).
Hepatitis C in Virginia Prisons
Thirty-nine percent of Virginia's inmates have hepatitis C, according to a new study, titled "Accountable to No One," conducted by the American Civil Liberties Union of Virginia, the Richmond Times-Dispatch reports. Laura LaFay, former ACLU of Virginia associate director, conducted the "months-long" study, which relied on a "relatively small number of cases," according to the Times-Dispatch. The state Department of Corrections barred access to completed medical records about treatment and deaths, but LaFay asserts that the state's prisons are "breeding grounds" for hepatitis C. She added that only 50 prisoners out of approximately 12,800 infected inmates have received treatment for the virus since November 2002. According to LaFay, the state has "severely limited" access to treatment for hepatitis C -- which can cost $15,000 per inmate per year -- through stringent eligibility rules, the Times-Dispatch reports. The report offered 10 recommendations for the public, inmates and health care providers, including repealing a state law that allows prisons to withhold all records about an inmate's imprisonment and calling for a public database on infectious diseases in prisons, as well as information on the medical treatment. Kent Willis, executive director of ACLU of Virginia, said that the report found that state prison medical care "is woefully inadequate and leads to much unnecessary suffering, and in some cases, death." He added, "The state hasn't put in place mechanisms so that the public knows what's going on behind bars." Larry Traylor, corrections department spokesperson, said, "Inmates receive the same community standard of care" as other state residents, adding, "Oftentimes, they receive better medical care than they received on the street." But LaFay said that there seams to be "little governmental interest in dealing with the growing" hepatitis C epidemic. "If we don't treat the prisoners inside the prisons, we'll have to pay twice as much to treat complications of their disease after they're released. ... By taking care of (inmate), we take care of ourselves," she said (Hardy, Richmond Times-Dispatch, 5/8).