REVIEW PAPER
Locked up and infected. Unveiling worldwide heterogeneity of HIV prevalence in prison populations: a systematic review and
meta-analysis
1
Department of Biostatistics and Epidemiology, Faculty of Medicine, Urmia University of Medical Sciences, Urmia, Iran
2
Department of Public Health, Khoy University of Medical Sciences, Khoy, Iran
3
Department of Health Information Technology, School of Medical Sciences, Urmia University of Medical Sciences, Urmia, Iran
4
Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Sciences, Urmia, Iran
Submission date: 2023-09-05
Final revision date: 2023-10-07
Acceptance date: 2023-10-08
Publication date: 2026-06-10
Corresponding author
Mohammad Heidari
Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Science, Urmia, Iran
Social Determinants of Health Research Center, Clinical Research Institute, Urmia University of Medical Science, Urmia, Iran
KEYWORDS
TOPICS
ABSTRACT
Introduction:
Prisoners are at higher risk of human immunodeficiency virus (HIV) infection. This study aimed to investigate the prevalence of HIV among prisoners in different continents, and investigate its heterogeneity.
Material and Methods:
International databases, including PubMed/Medline, Scopus, Google Scholar, and ISI Web of Science were explored for original articles reporting the prevalence of HIV among prisoners from 2000 to 2022. Random effect model was applied to estimate pooled prevalence, and analysis was performed with Stata 13 using the metaprop package.
Results:
Sixty-three studies evaluating HIV prevalence among total of 9,034 prisoners worldwide were included in the study. The prevalence rates of HIV varied considerably, ranging from 0 in Iran and England to > 0.23 in Zambia and 0.19 in Ghana. While the pooled prevalence of HIV among prisoners in all countries was 0.03 (95% CI: 0.03-0.04%), it was estimated that 0.01 (95% CI: 0.01-0.21%), 0.02 (95% CI: 0.01-0.03%), 0.03 (95% CI: 0.02-0.04%), and 0.02 (95% CI: 0.01-0.03%) prevalence rates were reported in Africa, Asia, North America, and Europe and South America, respectively. The prevalence among men was 0.04 but raised to 0.11 in Asia, and in women, it was 0.03 but also raised to 0.09 in Africa (one study).
Conclusions:
Although the overall rate of HIV-infected male prisoners showed a higher prevalence than women, this difference was more evident in Asia. The prevalence and heterogeneity were very high among males in Asia. In contrast, among males in North America and Europe, the rates were low and more homogenous, which may be due to better healthcare infrastructure, effective government policies, and HIV education.
Prisoners are at higher risk of human immunodeficiency virus (HIV) infection. This study aimed to investigate the prevalence of HIV among prisoners in different continents, and investigate its heterogeneity.
Material and Methods:
International databases, including PubMed/Medline, Scopus, Google Scholar, and ISI Web of Science were explored for original articles reporting the prevalence of HIV among prisoners from 2000 to 2022. Random effect model was applied to estimate pooled prevalence, and analysis was performed with Stata 13 using the metaprop package.
Results:
Sixty-three studies evaluating HIV prevalence among total of 9,034 prisoners worldwide were included in the study. The prevalence rates of HIV varied considerably, ranging from 0 in Iran and England to > 0.23 in Zambia and 0.19 in Ghana. While the pooled prevalence of HIV among prisoners in all countries was 0.03 (95% CI: 0.03-0.04%), it was estimated that 0.01 (95% CI: 0.01-0.21%), 0.02 (95% CI: 0.01-0.03%), 0.03 (95% CI: 0.02-0.04%), and 0.02 (95% CI: 0.01-0.03%) prevalence rates were reported in Africa, Asia, North America, and Europe and South America, respectively. The prevalence among men was 0.04 but raised to 0.11 in Asia, and in women, it was 0.03 but also raised to 0.09 in Africa (one study).
Conclusions:
Although the overall rate of HIV-infected male prisoners showed a higher prevalence than women, this difference was more evident in Asia. The prevalence and heterogeneity were very high among males in Asia. In contrast, among males in North America and Europe, the rates were low and more homogenous, which may be due to better healthcare infrastructure, effective government policies, and HIV education.
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