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Section 2. Recommendations for Care of Children in Special Circumstances
HEPATITIS AND YOUTH IN CORRECTIONS SETTINGS
Hepatitis B
The rate of hepatitis B virus infection in the general population in the United States is influenced by well-recognized risk factors that promote exchange of or exposure to blood, saliva, semen, and vaginal fluid (see Hepatitis B, p 335). At-risk adolescents in corrections facilities include inmates from minority populations (Asian, American Indian/Alaska Native, black, and Hispanic, in descending order of hepatitis B disease prevalence); inmates engaged in injection drug use with needle sharing; inmates who have had early initiation of sexual intercourse, unprotected sexual activity, multiple sexual partners, or history of STIs; and male adolescents who engage in homosexual activity. Although no published national studies have determined hepatitis B prevalence rates for incarcerated juveniles, rates of hepatitis B seroprevalence in homeless and high-risk street youth are higher when compared with peers lacking risk factors. Studies investigating hepatitis B outbreaks in prison settings also suggest that horizontal transmission may occur when chronic carriers of hepatitis B virus are present. Adolescent female inmates present additional challenges
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