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People who are Incarcerated or Adults-in-Custody (AIC)

Homeless tents lined up on sidewalk.


Poor health among incarcerated people has many roots: a history of trauma, poverty and high-risk means of survival; insecure-housing or houselessness; substance use and mental health needs; and engagement in criminal behaviors to resource housing and drug use. Globally, people who are incarcerated have a higher prevalence of viral hepatitis B and C than the general population. Between 2017 and 2021, several states in the U.S. reported HAV outbreaks among people who were cycling between jails and homelessness. Given the intersection of multiple social determinants of health among incarcerated people, interventions to eliminate viral hepatitis in this population will need to take a multidisciplinary approach to address psychosocial, educational, housing, and employment needs in addition to treatment of substance use disorder and viral hepatitis.

Vaccine for HAV and HBV

inmate receiving injection
In Oregon, up to about 30% of adults-in-custody (AIC) in the Oregon prison system have viral hepatitis C. Fortunately, many incarcerated persons have had the option of being vaccinated against viral hepatitis A and B due to a long-standing community vaccine effort and an effective vaccine partnership between Oregon Department of Corrections and Oregon Health Authority, Oregon Immunization Program


Incarcerated man getting blood drawn 

 CDC now recommend universal adult viral hepatitis B and C testing. These recommendations in combination with the understanding that AIC are more likely to have HBV or HCV and be at risk for HAV if previously homeless or had a history of drug use, highlight the need for carceral settings to partner with OHA to address viral hepatitis in Oregon.

Community standard of care for AIC include vaccinating the unvaccinated against hepatitis A and B; testing for viral hepatitis B and C; treating to cure for hepatitis C; and suppressing virus for hepatitis B. This work within carceral settings will go a long way to support the health and well-being of people within all communities across Oregon.