Meet Maria

Maria is a 36-year-old mother of four children, all under the age of 10, who lives with her family.

A Closer Look

Maria lost her job as a barista at a local coffee shop after being under the influence at work. Her husband, Marco, is a teacher. To help make ends meet, she had started selling drugs and paraphernalia before and after work. She was also injecting. Her husband was unaware of this, but had noticed that Maria seemed more erratic, easily agitated, and even paranoid over the previous few months.

Maria was eventually arrested for possession of heroin with intent to distribute and possession of paraphernalia. She was carrying less than 10 grams and was charged with a third-degree felony, punishable by a maximum of five years in prison and a $5,000 fine.

A Look Ahead

Marco is concerned about his wife’s health, but also upset that she lied about her substance use. He’s worried about her being away from him and their children for such a long time and doesn’t know how he can manage the hefty fine.

Healthcare Outlook

Maria is in decent health. She understands that her struggles with postpartum depression and anxiety went untreated and led to further anxiety, depression, and stress, which triggered her substance use disorder. She disclosed that she had been sharing needles with a former coworker and wanted to be tested for disease when she entered the correctional facility, but testing was not available, which is not uncommon across correctional facilities. Maria is worried that she contracted something and will now go untreated while she’s incarcerated.

The Bigger Picture

HCV infection disproportionally affects individuals in correctional institutions. 6-41% of US inmates had serological evidence of prior HCV exposure and 12-35% had chronic infection. 30% of all persons with HCV in the United States spend at least part of the year in correctional institution. HCV testing and treatment are relatively uncommon in jails and routine opt-out testing is not conducted regularly. Estimates for the incarcerated population far exceed the general population.

HCV infection disproportionally affects individuals in correctional institutions
6-41% of US inmates had serological evidence of prior HCV exposure and 12-35% had chronic infection
Estimates for the incarcerated population far exceed the general population
30% of all persons with HCV in the United States spend at least part of the year in correctional institution
HCV testing and treatment are relatively uncommon in jails and routine opt-out testing is not conducted regularly
Estimates for the incarcerated population far exceed the general population

To reduce barriers, increased HCV testing and treatment in correctional institutions would aid HCV elimination, and universal opt-out testing of inmates for chronic HCV is highly cost-effective and has been shown to reduce ongoing HCV transmission¹

Healthcare providers using opt-out HCV testing in jails followed by linking inmates infected with HCV to community healthcare professionals upon their release is an advantageous approach to combating HCV¹

Additional Third-Party Resources

HCV Testing and Treatment in Correctional Settings

What is Hepatitis C?

What to Expect When Getting Tested for Hepatitis C

1. AASLD-IDSA. https://www.hcvguidelines.org/unique-populations/correctional. Last updated November 6, 2020. Accessed October 13, 2021.

2. Emory Center for the Health of Incarcerated Persons and MGH Institute for Technology Assessment. http://www.hepcorrections.org. Accessed January 28, 2022.