An opt-out approach to hepatitis C virus testing in English prisons: the literature underpinning the policy

Br J Nurs. 2021 Nov 11;30(20):1158-1164. doi: 10.12968/bjon.2021.30.20.1158.

Abstract

Background: The World Health Organization's aim to eliminate hepatitis C virus (HCV) infection as a public health threat by 2030 is dependent on testing people. HCV prevalence is higher in prisons, so to increase test uptake an 'opt-out' approach to blood-borne virus testing in English and Welsh prisons was introduced.

Aims: This literature review examines the evidence behind the introduction of this public health policy.

Methods: Four healthcare databases were searched for publications between January 2000 and February 2020 on the opt-out approach to blood-borne virus testing in prisons.

Findings: Sixteen studies published between 2009 and 2019 were included. Analysis of their findings showed that an increase in HCV test uptake in prisons occurs when an opt-out approach is used in combination with additional interventions. Contextual differences between UK and US prisons may affect HCV test uptake.

Conclusion: An opt-out approach to HCV testing in prisons can increase test uptake as part of a complex of interventions.

Keywords: Blood-borne virus; HIV; Hepatitis C virus; Jail; Opt-out testing; Prison.

Publication types

  • Review

MeSH terms

  • Hepacivirus
  • Hepatitis C* / diagnosis
  • Hepatitis C* / epidemiology
  • Humans
  • Policy
  • Prisoners*
  • Prisons