Using time in prison as an ideal opportunity to treat Hepatitis C - PIONEER Framework Proposal

Objectives: Prisons present a unique opportunity to address the high prevalence of hepatitis C (HCV) among inmates, a population disproportionately affected by the disease. Specific conditions within correctional facilities contribute to increased HCV transmission rates. Incarceration offers a strategic chance to reach individuals who are often inaccessible through traditional healthcare systems, transforming prison time into a window for targeted health interventions. Material and method: This study utilized a qualitative approach, conducting a comprehensive literature review on HCV management within correctional settings and incorporating data and insights from the “Let’s End HepC” European project. The findings informed the development of the PIO-NEER framework, which emphasizes evidence-based public health policies to enhance health safety in prisons for hepatitis C. Results: Effective control of HCV in prisons requires a multifaceted approach, including education, counseling, harmreduction initiatives such as safe tattooing practices, provision of direct-acting antiviral (DAA) treatments, and improvements in prison conditions. Emphasis should also be placed on fostering respect for prisoners’ human rights, implementing preventive measures, and reducing HCV transmission within correctional facilities. Discussion: Incarceration represents a critical opportunity for diagnosing and treating hepatitis C, contrib-uting to improved health outcomes for inmates and reducing transmission risks within the wider community. By addressing HCV in prisons, incarceration can be reframed as a public health intervention to mitigate community health risks when inmates are reintegrated.