National Prison Entrants' Bloodborne Virus & Risk Behaviour Survey 2004, 2007, and 2010

The first National Prison Entrants’ Bloodborne Virus & Risk Behaviour Survey (NPEBBV&RBS) was conducted in 2004 and we are pleased to present the third iteration of this study - the 2010 national report. The prevalence of hepatitis C is over thirty times higher among prisoners than the general community, highlighting the need to monitor blood-borne viruses in this population. The NPEBBV&RBS fulfils this important role and represents one of the few nationally collaborated prisoner health projects in Australia. The 2010 survey includes data, for the first time, from all jurisdictions across Australia. It is unique in the world in providing routine surveillance on the prevalence of blood-borne viruses (HIV, hepatitis B, hepatitis C) among this population on a national basis. The NPEBBV&RBS is an important adjunct to the Australian National Needle and Syringe Program Survey on which the survey was originally based. The prison survey screens prisoners who report injecting drug use and also those with no history of injecting who are nonetheless at risk of contracting blood-borne viruses from other routes such as tattooing and other blood-to-blood contact. The NPEBBV&RBS has several features which enhance our knowledge of blood-borne virus epidemiology in Australia: it provides unique access to groups known to be over-represented in prisons such as Indigenous Australians (25% of Australia’s prisoners are Indigenous), the survey tests for hepatitis B immunity in a marginalised group, and venous blood samples are used providing a high degree of test accuracy and permits the test results to be provided back to participants. Prisoners are known to engage in sexual risk behaviours and thus the 2010 survey was expanded to screen for three sexually transmissible infections - syphilis, gonorrhoea and chlamydia. It is reassuring that the 2010 survey findings did not indicate these infections to be at levels indicating an outbreak among those entering prison. No cases of HIV were detected in 2010 which is reassuring. Monitoring blood-borne viruses among prisoners is important for the overall community response to preventing the spread of infectious diseases and the planning of appropriate prevention strategies. The utility of this survey is highlighted by its use in all of the Commonwealth Government’s recently released national communicable diseases strategies which recognise prisoners as a key population in communicable disease control in Australia.