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Section 2. Recommendations for Care of Children in Special Circumstances
Hepatitis and Youth in Correctional Settings
Hepatitis B
Hepatitis B virus in the United States is transmitted mainly through exposure to blood, saliva, semen, and vaginal fluid; chronic infection with hepatitis B virus mainly is found among people born in countries with prevalence higher than 2% where most infections are transmitted in the perinatal period or during early childhood (see Hepatitis B, p 337). Adolescents in correctional facilities may include foreign-born (eg, Asia, Africa) residents who can have chronic infection and can transmit infection to susceptible residents. Resident adolescents also can include people with high-risk behaviors, including adolescents 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 people with chronic hepatitis
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Red Book 2009 2009: 337-356.