Jail-Based HCV Testing and Treatment Strategy Reduces Infection and Deaths Among People Who Inject Drugs, Simulation Study Finds

A jail-based strategy that includes hepatitis C virus testing, treatment and post-release navigation services could reduce incidence and related deaths among people who inject drugs, results of a simulation study showed.

“People cycling through jails have substantially higher HCV prevalence than the general population, and even brief contact with the health system in this setting can be leveraged to expand testing, initiate treatment and connect individuals to care after release,” Lin Zhu, MBBS, PhD, assistant professor of health services research and policy at University of Miami Miller

The findings come from a cost-effectiveness analysis published in JAMA Internal Medicine on March 23, 2026, which used a network simulation model to evaluate jail-based hepatitis C elimination interventions. The study concluded that providing treatment during detention substantially reduced prevalent and incident HCV cases and HCV-related deaths among people who inject drugs both within and beyond jail settings.

Researchers from Stanford University, the University of Miami Miller School of Medicine, Philadelphia FIGHT, the Philadelphia Department of Public Health, and the Centers for Disease Control and Prevention collaborated on the analysis. The model simulated the impact of various interventions, finding that strategies combining testing, treatment during incarceration, and post-release navigation services offered the greatest public health benefit and cost-effectiveness.

According to the study, jail-based HCV elimination interventions not only improved health outcomes for incarcerated individuals but also contributed to broader community-level reductions in transmission by linking people to care after release. The researchers emphasized that short periods of detention represent a critical opportunity to engage a high-risk population that often faces barriers to healthcare access in the community.

The analysis highlighted that treating hepatitis C in jails is a key component of stopping the spread of the virus, particularly among people who inject drugs, a group disproportionately affected by both incarceration and HCV infection. By intervening during detention, the study suggests, public health systems can interrupt transmission cycles and move closer to elimination goals.

While the study did not specify exact percentage reductions in infections or deaths, related research cited in the same news cycle indicates that testing and treatment strategies in jails could cut HCV infections by nearly half among people who inject drugs. These findings align with earlier reports from the Freeman Spogli Institute for International Studies and Liver Disease News, which identified jail-based HCV care as a cost-effective public health approach.

The study’s authors noted that implementing such programs requires coordination between correctional facilities, public health agencies, and community healthcare providers to ensure continuity of care after release. They also called for further research to optimize intervention models and assess long-term outcomes in diverse jail populations.

As of April 21, 2026, the research adds to growing evidence that integrating hepatitis C services into correctional settings is not only clinically beneficial but also a strategically efficient use of limited public health resources to address a concentrated epidemic.