Did you know that people in prison are at much higher risk for hepatitis B than the general population? You would think that means there are programs in place to prevent and treat it — but unfortunately, that’s often not the case.
In a recent episode of the B Heppy podcast, researchers Heidi Emery and Kathryn Jack talk about some of the major barriers to accessing critical hepatitis B prevention and treatment services in prisons. Dr. Emery and Dr. Jack, who work at the University of Nottingham School of Medicine, reviewed prior research on the topic and spoke with people in the prison system — including those who are incarcerated, prison healthcare workers, and even guards — to understand what was happening within the prison system and hepatitis B.
You can find their published research here. Additionally, the Hepatitis B Foundation has also released a white paper on recommendations for HBV screening and prevention in corrections.
Common Barriers to Care:
- Stigma and lack of information about hepatitis B
One of the biggest roadblocks? People just do not know enough about hepatitis B. There is a lot of fear and misunderstanding about how hepatitis B spreads and what it means to have it. That leads to stigma — and stigma makes people less likely to get tested or treated.
- Health care isn’t always a priority in prisons
Prisons are mostly focused on safety and security — not health care. That means people might miss appointments because of lockdowns or staffing shortages. Even if someone wants care, they might not get it when they need it.
- Lack of resources
Many prisons just don’t have the staff, funding, or systems in place to handle hepatitis B testing, treatment, or education properly. This makes it difficult for people to get timely education on hepatitis B prevention, management, and treatment.
- No support after release
Often, there’s no follow-up care or connection to outside health services after someone is released from prison. So even if someone starts treatment, it might not continue. People are less likely to follow up with care when they are out of the prison system or may lack the resources to navigate the health system on their own.
Recommendations to improve care
Within this review, researchers provided recommendations on how to address these major challenges to hepatitis B prevention, care, and treatment within the prison system. They are described below-
- Education makes a big difference
When people understand hepatitis B better — both those in prison and those working there, stigma goes down, and people are more likely to get help. Education programs can make a big difference to address low knowledge and stigma.
- Better health systems inside and out
Connecting prison healthcare to public health systems on the outside means care doesn’t have to stop once someone is released. It can be an opportunity to make sure people stay connected to health care after they get out.
- Policy changes that put health first
Routine testing and vaccinations for hepatitis B should be part of prison intake. With the right policies, prisons could become places where people actually get the health care they have been missing out on.
This issue is not just about prisons — it’s about public health. If we ignore hepatitis B in these high-risk settings, we miss a big chance to stop the virus from spreading in communities, too.