Trends in hepatitis B prevalence and associated risk factors among Indigenous and non-Indigenous prison entrants in Australia, 2004 to 2013.

Objective This study describes and compares prevalence trends of markers for hepatitis B (HBV) from 2004 to 2013 and HBV risk factors between Indigenous and non-Indigenous prison entrants. Methods A cross-sectional survey carried out over two weeks in 2004, 2007, 2010 and 2013 in reception prisons in New South Wales, Queensland, Western Australia and Tasmania. Results The study included 2,223 prison entrants; 544 were Indigenous. Indigenous prison entrants had significantly higher hepatitis C core antibody (anti-HBc) prevalence than non-Indigenous prisoners in 2004 (29% vs. 18%, P=0.026), 2007 (40% vs. 15%, P<0.001) and 2010 (21% vs. 16% 2010, P=0.002), and similar anti-HBc prevalence to non-Indigenous entrants in 2013 (14% vs. 14%, P=0.888), with a significant decline from 2007 for Indigenous entrants (P=0.717). Being more than 30 years old and coming from an area classified as 'non-highly accessible' were associated with anti-HBc positivity in both populations. For Indigenous prison entrants, first time in prison and survey year was associated with anti-HBc positivity. For non-Indigenous participants, a history of injecting drug use and body piercings was associated with anti-HBc positivity. Conclusion There are unique risk factors associated with HBV prevalence for both Indigenous and non-Indigenous prison entrants. Implications for public health In developing public health programs and policies for HBV, consideration of similarities and differences of associated HBV risk factors between Indigenous and non-Indigenous offenders is required.