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Austin A, Favril L, Craft S, Thliveri P, Freeman TP. Factors associated with drug use in prison: A systematic review of quantitative and qualitative evidence. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2023; 122:104248. [PMID: 37952319 DOI: 10.1016/j.drugpo.2023.104248] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2023] [Revised: 10/18/2023] [Accepted: 10/20/2023] [Indexed: 11/14/2023]
Abstract
BACKGROUND About a third of people use drugs during their incarceration, which is associated with multiple adverse health and criminal justice outcomes. Many studies have examined factors associated with in-prison drug use, but this evidence has not yet been systematically reviewed. We aimed to systematically review and synthesise the evidence on factors related to drug use in prison. METHODS Three databases (PubMed, PsycINFO and Embase) were systematically searched as well as grey literature, for quantitative, qualitative and mixed-methods studies examining factors related to drug use inside prison. We excluded studies that did not explicitly measure in prison drug use or only measured alcohol and/or tobacco use. Study quality was assessed using the Newcastle Ottawa Scale (NOS) for quantitative studies and Critical Appraisal Skills Programme (CASP) for qualitative studies. The review was prospectively registered on PROSPERO (CRD42021295898). RESULTS Fifty-four studies met the inclusion criteria, reporting data on 26,399 people in prison. Most studies were of low or moderate-quality, and all used self-report to assess drug use. In quantitative studies, studies found that previous criminal justice involvement, poor prison conditions, pre-prison drug use and psychiatric diagnosis were positively associated with drug use in prison. In qualitative studies, reasons for drug use were closely linked to the prison environment lacking purposeful activity and the social context of the prison whereby drug use was seen as acceptable, necessary for cohesion and pressurised. CONCLUSION In the first systematic review of factors associated with drug use in prison, key modifiable risk factors identified from quantitative and qualitative studies were psychiatric morbidity and poor prison conditions. Non-modifiable factors included previous drug use and criminal history linked to substance use. Our findings indicate an opportunity to intervene and improve the prison environment to reduce drug use and associated adverse outcomes.
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Affiliation(s)
- Alice Austin
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Louis Favril
- Faculty of Law and Criminology, Ghent University, Belgium
| | - Sam Craft
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Phoebe Thliveri
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK
| | - Tom P Freeman
- Addiction and Mental Health Group (AIM), Department of Psychology, University of Bath, UK.
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Simpson PL, Gardoll B, White L, Butler T. HIV policies in Australian prisons: a structured review assessing compliance with international guidelines. THE LANCET REGIONAL HEALTH. WESTERN PACIFIC 2023; 41:100813. [PMID: 38223398 PMCID: PMC10786648 DOI: 10.1016/j.lanwpc.2023.100813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 05/15/2023] [Accepted: 05/22/2023] [Indexed: 01/16/2024]
Abstract
Globally, people living with the Human Immunodeficiency Virus (HIV) are over-represented in incarcerated populations. The current study aimed to provide a national (Australian) snapshot of current HIV prison policies against the United Nations' (UN) 15 key HIV interventions for prisons. Publicly available policies, reports, and data were obtained, and interviews were conducted with prison health staff in five of eight Australian jurisdictions. We rated whether policies were compliant, partially compliant, or not compliant to the UN interventions and assigned an overall grade (A to E, where A = most compliant and E = least compliant) for each jurisdiction. Three jurisdictions received a B grade, three received a C grade, and two were not assessed due to insufficient data. In all jurisdictions HIV policies fell short of full compliance to most UN interventions. Prison-based needle and syringe programs and initiatives beyond education to reduce HIV transmission from body modification procedures (eg, tattooing) were absent in all jurisdictions. No condom programme existed in one jurisdiction and access issues were reported in others. Opioid substitution therapy, and peer-education access varied across and within most jurisdictions. Findings indicate that more action is required to meet the UN recommended interventions for HIV prevention in prisons.
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Affiliation(s)
- Paul L. Simpson
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Bree Gardoll
- Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
| | - Luella White
- Faculty of Law and Justice, University of New South Wales, Sydney, New South Wales, Australia
| | - Tony Butler
- School of Population Health, Faculty of Medicine and Health, University of New South Wales, Sydney, New South Wales, Australia
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3
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Yilin D, Bellerose M, Borbely C, Rowell-Cunsolo TL. Assessing the relationship between drug use initiation age and racial characteristics. J Ethn Subst Abuse 2023:1-15. [PMID: 37882363 DOI: 10.1080/15332640.2023.2271871] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2023]
Abstract
Initiating drug use in adolescence is associated with greater risk of drug misuse and dependence in adulthood and co-occurring mental health disorders. Initiating drug use in adulthood has been linked to higher-risk drug use networks and primary use of "harder drugs". The aim of our research is to examine racial/ethnic differences in age at drug use initiation and its relationship with adult outcomes. Based on data from the 2019 National Survey on Drug Use and Health (NSDUH), we used survey-weighted Poisson regression models with robust variance to identify associations between racial characteristics, age at drug use initiation, and three adult outcomes - past year polydrug use, substance use, and mental illness - adjusting for individual-level characteristics. Among 25,986 respondents who ever used drugs and reported their drug use initiation age, Asian-Americans reported the oldest drug use initiation age (19.5) on average, while Native Americans reported the youngest initiation age (16.6). While there were no significant differences in type of drug used during onset by race or ethnicity, generally, individuals start to use inhalants at the earliest age (17.4), while the misuse of sedatives is initiated at the oldest age (46.4). Initiation during late adolescence was associated with greater likelihood of a substance use disorder diagnosis, mental health diagnoses, and polydrug use in adulthood. Drug use prevention interventions should be tailored and accessible during adolescence to delay onset. Interventions that are culturally sensitive, screen for vulnerability to drug use, and offer age-appropriate services should be prioritized.
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Affiliation(s)
- Diandian Yilin
- School of Human Ecology, University of Wisconsin-Madison, Madison, Wisconsin, USA
| | - Meghan Bellerose
- Mailman School of Public Health, Columbia University, New York, New York, USA
| | - Carson Borbely
- School of Social Work, University of Wisconsin-Madison, Madison, Wisconsin, USA
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Thomas EG, Spittal MJ, Taxman FS, Puljević C, Heffernan EB, Kinner SA. Association between contact with mental health and substance use services and reincarceration after release from prison. PLoS One 2022; 17:e0272870. [PMID: 36070251 PMCID: PMC9451082 DOI: 10.1371/journal.pone.0272870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2021] [Accepted: 07/27/2022] [Indexed: 11/24/2022] Open
Abstract
Objective People released from prison who experience mental health and substance use problems are at high risk of reincarceration. This study aimed to examine the association between contact with mental health and substance use treatment services, and reincarceration, among adults released from prison. Methods Pre-release survey data from 1,115 adults released from prisons in Queensland, Australia were linked with administrative health and correctional records covering a median of 787 days post-release. We constructed marginal structural Cox proportional hazards models, adjusting for pre-release variables and time-varying indicators of emergent mental health and substance use problems, to examine the association between contact with mental health and substance use treatment services, and reincarceration. Results The adjusted hazard ratio (AHR) for reincarceration associated with mental health service contact was 1.76 (95%CI 1.23,2.51). Among those not on parole following release, the AHR for reincarceration associated with substance use treatment service contact was 3.16 (95%CI 2.09,4.77); we found no evidence for an association among those who were released on parole (AHR = 1.07; 95%CI 0.80,1.43). Conclusions Although we cannot eliminate the possibility of residual confounding, our findings suggest that infrequent or unsustained contact with community-based mental health and substance use treatment services is not protective against reincarceration, and may even be iatrogenic. Increased investment in high-quality and timely behavioural health services for people released from prison may simultaneously improve health outcomes, and reduce reincarceration.
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Affiliation(s)
- Emma G. Thomas
- RAND Corporation, Santa Monica, California, United States of America
| | - Matthew J. Spittal
- Centre for Mental Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
| | - Faye S. Taxman
- Criminology, Law & Society, College of Humanities and Social Sciences, George Mason University, Fairfax, Virginia, United States of America
| | - Cheneal Puljević
- School of Public Health, The University of Queensland, Brisbane, Australia
- Centre for Health Services Research, The University of Queensland, Brisbane, Australia
| | - Edward B. Heffernan
- School of Public Health, The University of Queensland, Brisbane, Australia
- Queensland Forensic Mental Health Service, Brisbane, Australia
| | - Stuart A. Kinner
- Justice Health Unit, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, Melbourne, Australia
- School of Population Health, Curtin University, Perth, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- * E-mail:
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Scott R, Aboud A, O'Gorman T. Long-acting injectable buprenorphine - 'best practice' opioid agonist therapy for Australian prisoners. Australas Psychiatry 2022; 30:498-502. [PMID: 34852654 DOI: 10.1177/10398562211059086] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE To consider opioid agonist therapy in prisons. CONCLUSIONS Given the substantial risks of substance misuse by prisoners, long-acting injectable buprenorphine should be adopted as 'best practice' treatment in Australian prison populations.
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Affiliation(s)
- Russ Scott
- Prison Mental Health Service, Brisbane, Queensland, Australia
| | - Andrew Aboud
- Prison Mental Health Service, Brisbane, Queensland, Australia
| | - Thomas O'Gorman
- Metro North Mental Health Alcohol and Drug Service, Brisbane, Queensland, Australia
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Murphy M, Sosnowy C, Rogers B, Napoleon S, Galipeau D, Scott T, Tao J, Berk J, Clarke J, Nunn A, Chan PA. Defining the Pre-exposure Prophylaxis Care Continuum Among Recently Incarcerated Men at High Risk for HIV Infection: Protocol for a Prospective Cohort Study. JMIR Res Protoc 2022; 11:e31928. [PMID: 35142633 PMCID: PMC8874820 DOI: 10.2196/31928] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2021] [Revised: 12/07/2021] [Accepted: 12/08/2021] [Indexed: 11/25/2022] Open
Abstract
BACKGROUND HIV disproportionately impacts criminal justice-involved individuals, including men who experience incarceration. Men make up the vast majority of those experiencing incarceration as well as those newly diagnosed with HIV infection. Pre-exposure prophylaxis (PrEP) is a highly effective biomedical intervention that significantly reduces the risk of HIV acquisition. However, implementation in criminal justice systems is limited. Little is known about effective PrEP implementation and use in this unique public health context. OBJECTIVE The aim of this study is to characterize the experience of implementing PrEP clinical care in a criminal justice setting for men vulnerable to HIV acquisition. METHODS This article describes a PrEP care continuum for men experiencing incarceration who are at increased risk of HIV acquisition, which can help conceptualize approaches to evaluating PrEP implementation. RESULTS The outlined study will enroll 100 men experiencing incarceration at high risk for HIV acquisition prior to release into the community. The goal is to initiate PrEP prior to release and link individuals to PrEP providers in the community, capturing barriers and facilitators to PrEP use during this uniquely vulnerable time period for HIV acquisition. CONCLUSIONS Based on the proposed care continuum and what is known about HIV risk and prevention efforts in the criminal justice context, we outline key future research efforts to better understand effective approaches to preventing HIV infection among this vulnerable population. The described approach presents a powerful public health opportunity to help end the HIV epidemic. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID) DERR1-10.2196/31928.
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Affiliation(s)
| | | | | | | | | | - Ty Scott
- Brown University, Providence, RI, United States
| | - Jun Tao
- Brown University, Providence, RI, United States
| | - Justin Berk
- Brown University, Providence, RI, United States
| | | | - Amy Nunn
- Brown University, Providence, RI, United States
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Ranapurwala SI, Figgatt MC, Remch M, Brown C, Brinkley-Rubinstein L, Rosen DL, Cox ME, Proescholdbell SK. Opioid Overdose Deaths Among Formerly Incarcerated Persons and the General Population: North Carolina, 2000‒2018. Am J Public Health 2022; 112:300-303. [PMID: 35080937 PMCID: PMC8802580 DOI: 10.2105/ajph.2021.306621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2021] [Indexed: 02/03/2023]
Abstract
Objectives. To compare opioid overdose death (OOD) rates among formerly incarcerated persons (FIPs) from 2016 to 2018 with the North Carolina population and with OOD rates from 2000 to 2015. Methods. We performed a retrospective cohort study of 259 861 North Carolina FIPs from 2000 to 2018 linked with North Carolina death records. We used indirectly standardized OOD mortality rates and ratios and present 95% confidence intervals (CIs). Results. From 2017 to 2018, the OOD rates in the North Carolina general population decreased by 10.1% but increased by 32% among FIPs. During 2016 to 2018, the highest substance-specific OOD rate among FIPs was attributable to synthetic narcotics (mainly fentanyl and its analogs), while OOD rates for other opioids were half or less than that from synthetic narcotics. During 2016 to 2018, the OOD risk for FIPs from synthetic narcotics was 50.3 (95% CI = 30.9, 69.6), 20.2 (95% CI = 17.3, 23.2), and 18.2 (95% CI = 15.9, 20.5) times as high as that for the North Carolina population at 2-week, 1-year, and complete follow-up after release, respectively. Conclusions. While nationwide OOD rates declined from 2017 to 2018, OOD rates among North Carolina FIPs increased by about a third, largely from fentanyl and its analogs. (Am J Public Health. 2022;112(2):300-303. https://doi.org/10.2105/AJPH.2021.306621).
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Affiliation(s)
- Shabbar I Ranapurwala
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - Mary C Figgatt
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - Molly Remch
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - Carrie Brown
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - Lauren Brinkley-Rubinstein
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - David L Rosen
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - Mary E Cox
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
| | - Scott K Proescholdbell
- Shabbar I. Ranapurwala, Mary C. Figgatt, and Molly Remch are with the Department of Epidemiology, Gillings School of Global Public Health, University of North Carolina at Chapel Hill. Carrie Brown is with the North Carolina Department of Mental Health, Developmental Disabilities, and Substance Abuse Services, Raleigh. Lauren Brinkley-Rubinstein is with the Department of Social Medicine, School of Medicine, University of North Carolina at Chapel Hill. David L. Rosen is with the Division of Infectious Diseases, School of Medicine, University of North Carolina at Chapel Hill. Mary E. Cox and Scott K. Proescholdbell are with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh
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Mussie KM, Pageau F, Merkt H, Wangmo T, Elger BS. Challenges in providing ethically competent health care to incarcerated older adults with mental illness: a qualitative study exploring mental health professionals' perspectives in Canada. BMC Geriatr 2021; 21:718. [PMID: 34922493 PMCID: PMC8683829 DOI: 10.1186/s12877-021-02687-9] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 11/29/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The population of incarcerated older adults is the fastest growing demographic in prisons. Older persons in custody have poorer health as compared with those in the community. The unmet and complex health care needs of incarcerated older adults with mental illness raise justice, safety, dignity and fairness in care as ethical concerns. As there exists research gap to better understand these concerns, the current study aimed at exploring the perspectives of mental health professionals on challenges in delivering ethically competent care to mentally ill incarcerated older adults in Canada. METHODS Thirty-four semi-structured interviews were conducted between August 2017 and November 2018 with prison mental health professionals in Canada who were selected using purposive and convenience sampling techniques. The audio recorded interviews were transcribed verbatim and analysed inductively to generate themes. RESULTS The results were distilled into three main categories and seven subcategories that related to ethical issues in the provision of health care for mentally ill incarcerated older adults. The main categories included imprisoned older persons with special care needs, lack of resources, and the peer-support program. CONCLUSIONS Results of this study showed that existing practices of care of mentally ill incarcerated older adults are characterised by challenges that increase their vulnerability to worse health conditions. It is imperative for local authorities, policy makers and representatives to prepare for and respond to the challenges that compromise ethically competent health care for, and healthy ageing of, mentally ill incarcerated older adults.
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Affiliation(s)
- Kirubel Manyazewal Mussie
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.
| | - Félix Pageau
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Helene Merkt
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Tenzin Wangmo
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland
| | - Bernice Simone Elger
- Institute for Biomedical Ethics, University of Basel, Bernoullistrasse 28, 4056, Basel, Switzerland.,Center for Legal Medicine, University of Geneva, Geneva, Switzerland
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Rivera Saldana CD, Beletsky L, Borquez A, Kiene SM, Strathdee SA, Zúñiga ML, Martin NK, Cepeda J. Impact of cumulative incarceration and the post-release period on syringe-sharing among people who inject drugs in Tijuana, Mexico: a longitudinal analysis. Addiction 2021; 116:2724-2733. [PMID: 33620749 PMCID: PMC8380753 DOI: 10.1111/add.15445] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/15/2020] [Revised: 12/14/2020] [Accepted: 02/02/2021] [Indexed: 11/29/2022]
Abstract
BACKGROUND AND AIMS Syringe-sharing among people who inject drugs, which can occur during incarceration and post-release, has been linked with increased risk of blood-borne infections. We aimed to investigate the cumulative effect of repeated incarceration and the post-release period on receptive syringe-sharing. DESIGN Ongoing community-based cohort, recruited through targeted sampling between 2011 and 2012 with 6-month follow-ups. SETTING Tijuana, Mexico. PARTICIPANTS Sample of 185 participants (median age 35 years; 67% female) with no history of incarceration at study entry, followed to 2017. MEASUREMENTS Cumulative incarceration and post-release period were constructed from incarceration events reported in the past 6 months for each study visit. Receptive syringe-sharing in the past 6 months was assessed as a binary variable. We used logistic regression with generalized estimating equations to examine the association between cumulative incarceration events and the post-release period with receptive syringe-sharing over time. Missing data were handled through multiple imputation. FINDINGS At baseline, 65% of participants engaged in receptive syringe-sharing in the prior 6 months. At follow-up, 150 (81%) participants experienced a total of 358 incarceration events [median = 2, interquartile range (IQR) = 1-3]. The risk of receptive syringe-sharing increased with the number of repeated incarcerations. Compared with never incarcerated, those with one incarceration had 1.28 [95% confidence interval (CI) = 0.97-1.68] higher adjusted odds of syringe-sharing; two to three incarcerations, 1.42 (95% CI = 1.02-1.99) and more than three incarcerations, 2.10 (95% CI = 1.15-3.85). Participants released within the past 6 months had 1.53 (95% CI = 1.14-2.05) higher odds of sharing syringes compared with those never incarcerated. This post-release risk continued up to 1.5 years post-incarceration (adjusted odds ratio = 1.41, 95% CI = 1.04-1.91), but then waned. CONCLUSIONS A longitudinal community cohort study among people who inject drugs suggested that the effects of incarceration on increased injecting risk, measured through syringe-sharing, are cumulative and persist during the post-release period.
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Affiliation(s)
- Carlos D. Rivera Saldana
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, United States
- School of Public Health, San Diego State University, San Diego, CA, 92182, United States
| | - Leo Beletsky
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, United States
- School of Law and Bouve College of Health Sciences, Northeastern University, Boston, MA, 02115, United States
| | - Annick Borquez
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, United States
| | - Susan M. Kiene
- School of Public Health, San Diego State University, San Diego, CA, 92182, United States
| | - Steffanie A. Strathdee
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, United States
| | - María Luisa Zúñiga
- School of Social Work, San Diego State University, San Diego, CA, 92182, United States
| | - Natasha K. Martin
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, United States
- Population Health Sciences, University of Bristol, Bristol BS8 1QU, United Kingdom
| | - Javier Cepeda
- Division of Infectious Diseases and Global Public Health, Department of Medicine, University of California San Diego, La Jolla, CA, 92093, United States
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Patterns of Drug Use and Related Factors Among Prisoners in Iran: Results from the National Survey in 2015. J Prim Prev 2021; 41:29-38. [PMID: 31912408 DOI: 10.1007/s10935-019-00574-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Drug use by prisoners is one of the world's most important problems. We sought to determine the pattern of drug use behavior and related factors among prisoners of Iran in 2015. This cross-sectional study was part of the bio-behavioral surveillance survey conducted among 6200 prisoners in 26 prison sites in Iran who were selected through multi-stage sampling. Data were collected through questionnaires and interviews which inquired about participants' demographics and drug use behaviors. We analyzed study data using descriptive statistics, and crude and adjusted logistic regressions, in STATA-12. Of all prisoners, 74.0% had a history of lifetime drug use, and 16.6% of drug users had a history of lifetime injection drug use (IDU). According to the results of a multivariate logistic regression, male sex, being between the ages of 24 and 45, having a history of imprisonment, and having a history of lifetime high-risk sexual behavior were significant risk factors for lifetime drug use. Also, male sex, single status, and a history of previous imprisonment were significant risk factors for lifetime IDU. The prevalence of drug use in Iran's prison population is high and alarming. There is a continuing need for harm reduction programs, including the methadone maintenance treatment, among imprisoned drug users and IDUs.
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Ahmadi Gharaei H, Fararouei M, Mirzazadeh A, Sharifnia G, Rohani-Rasaf M, Bastam D, Rahimi J, Kouhestani M, Rezaian S, Dianatinasab M. The global and regional prevalence of hepatitis C and B co-infections among prisoners living with HIV: a systematic review and meta-analysis. Infect Dis Poverty 2021; 10:93. [PMID: 34210349 PMCID: PMC8252262 DOI: 10.1186/s40249-021-00876-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/08/2021] [Accepted: 06/16/2021] [Indexed: 01/02/2023] Open
Abstract
BACKGROUND Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are common among individuals with human immune deficiency virus (HIV) infection worldwide. In this study, we did a systematic review and meta-analysis of the published literature to estimate the global and regional prevalence of HCV, HBV and HIV coinfections among HIV-positive prisoners. METHODS We searched PubMed via MEDLINE, Embase, the Cochrane Library, SCOPUS, and Web of science (ISI) to identify studies that reported the prevalence of HBV and HCV among prisoners living with HIV. We used an eight-item checklist for critically appraisal studies of prevalence/incidence of a health problem to assess the quality of publications in the included 48 cross-sectional and 4 cohort studies. We used random-effect models and meta-regression for the meta-analysis of the results of the included studies. RESULTS The number of the included studies were 50 for HCV-HIV, and 23 for HBV-HIV co-infections. The pooled prevalence rates of the coinfections were 12% [95% confidence interval (CI) 9.0-16.0] for HBV-HIV and 62% (95% CI 53.0-71.0) for HCV-HIV. Among HIV-positive prisoners who reported drug injection, the prevalence of HBV increased to 15% (95% CI 5.0-23.0), and the HCV prevalence increased to 78% (95% CI 51.0-100). The prevalence of HBV-HIV coinfection among prisoners ranged from 3% in the East Mediterranean region to 27% in the American region. Also, the prevalence of HCV-HIV coinfections among prisoners ranged from 6% in Europe to 98% in the East Mediterranean regions. CONCLUSIONS Our findings suggested that the high prevalence of HBV and HCV co-infection among HIV-positive prisoners, particularly among those with a history of drug injection, varies significantly across the globe. The results of Meta-regression analysis showed a sliding increase in the prevalence of the studied co-infections among prisoners over the past decades, rising a call for better screening and treatment programs targeting this high-risk population. To prevent the above coinfections among prisoners, aimed public health services (e.g. harm reduction via access to clean needles), human rights, equity, and ethics are to be seriously delivered or practiced in prisons. Protocol registration number: CRD42018115707 (in the PROSPERO international).
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Affiliation(s)
- Hasan Ahmadi Gharaei
- Department of Epidemiology, School of Public Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
- Department of Health, Faculty of Public Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Mohammad Fararouei
- Department of Epidemiology, School of Public Health and Nutrition, Shiraz University of Medical Sciences, Shiraz, Iran
| | - Ali Mirzazadeh
- Department of Epidemiology and Biostatistics and Institute for Global Health Sciences, University of California San Francisco, San Francisco, CA, USA
| | - Golnaz Sharifnia
- Department of Epidemiology, School of Public Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
| | - Marzieh Rohani-Rasaf
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran
| | - Dariush Bastam
- Medical School, Yasuj University of Medical Sciences, Yasuj, Iran
| | - Jamileh Rahimi
- Department of Epidemiology and Biostatistics, School of Public Health, North Khorasan University of Medical Sciences, Bojnurd, Iran
| | - Mostafa Kouhestani
- Department of Health, Faculty of Public Health, Social Determinants of Health Research Center, Gonabad University of Medical Sciences, Gonabad, Iran
| | - Shahab Rezaian
- Infectious Diseases Research Center, Kermanshah University of Medical Sciences, Kermanshah, Iran
| | - Mostafa Dianatinasab
- Department of Epidemiology, School of Public Health, Shahroud University of Medical Sciences, Shahroud, Iran.
- Department of Complex Genetics and Epidemiology, School of Nutrition and Translational Research in Metabolism, Maastricht University, Universiteitssingel 40 (Room C5.570), 6229 ER, Maastricht, the Netherlands.
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McKendy L, Biro SM, Miron M, Keown LA. Understanding overdose incidents in Canadian federal custody. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 92:103131. [PMID: 33558166 DOI: 10.1016/j.drugpo.2021.103131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 01/12/2021] [Accepted: 01/13/2021] [Indexed: 10/22/2022]
Abstract
BACKGROUND While the community effects of the opioid-related drug crisis in Canada are well documented, limited detailed data is available on overdose trends among custodial populations. Given that this crisis has disproportionate impacts on justice involved persons, research is needed to understand the implications of this crisis within institutional settings. METHODS We examined all overdose incidents that occurred between the 2012/2013 and 2018/2019 fiscal years in a federal correctional institution in Canada. An incident report search was conducted to identify overdose related incidents during this period. Information about the incident and characteristics of the victim was collected from incident reports, investigations, and victim case files. RESULTS Over the period under examination, overdose incidents steadily increased (i.e., from 40 in 2012/2013, to 110 non-fatal incidents in 2018/2019), although there was considerable regional and institutional variation. The number of incidents involving opioids, particularly fentanyl, increased both in raw numbers and as a percentage of overall incidents (i.e., from 3% in 2012/2013 to 47% in 2017/2018, and 34% of non-fatal incidents in 2018/2019). Other substances continue to contribute to overdose incidents; in fact, non-opioid prescription medications (i.e., non-illicit medications such as anti-convulsant drugs and anti-depressants) remain the most common among intentional non-fatal incidents. Relative to the general in-custody population, victims of overdose incidents tended to be younger and were more likely to be serving a determinate sentence, be on a repeat federal sentence, and be serving time for robbery. Mental health conditions and histories of substance use were common. CONCLUSION The effects of the overdose crisis are pronounced within certain Canadian federal institutions, illustrated by a growing number of fentanyl-related incidents. Institutional variation and variation in incidents (e.g., substance and intentionality) highlight diversity in drug activities among this custodial population and the need for multi-faceted responses that are reflective of local situations.
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Affiliation(s)
- Laura McKendy
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada.
| | - Stephanie M Biro
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada
| | - Magda Miron
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada
| | - Leslie Anne Keown
- Research Branch, Correctional Service of Canada, 340 Laurier Ave. W., Ottawa, Ontario, K1A 0P9 Canada
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Crowley D, Lambert JS, Betts-Symonds G, Cullen W, Keevans M, Kelly E, Laird E, McHugh T, McKiernan S, Miggin SJ, Murphy C, Murtagh R, O'Reilly D, Tobin C, Van Hout MC. The seroprevalence of untreated chronic hepatitis C virus (HCV) infection and associated risk factors in male Irish prisoners: a cross-sectional study, 2017. ACTA ACUST UNITED AC 2020; 24. [PMID: 30968825 PMCID: PMC6462789 DOI: 10.2807/1560-7917.es.2019.24.14.1800369] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Abstract
IntroductionData on chronic hepatitis C (HCV) infection prevalence in European prisons are incomplete and impact the public health opportunity that incarceration provides.AimsWe aimed to estimate the seroprevalence of untreated chronic HCV infection and to identify associated risk factors in an Irish male prison.MethodsWe conducted a cross-sectional study involving a researcher-administered questionnaire, review of medical records and HCV serology.ResultsOf 422 prisoners (78.0% of the study population) who participated in the study, 298 (70.6%) completed the questionnaire and 403 (95.5%) were tested for HCV antibodies. Of those tested, 92 (22.8%) were HCV antibody-positive, and of those, 53 (57.6%) were HCV RNA-positive, 23 (25.0%) had spontaneous clearance, 16 (17.4%) had a sustained viral response, 10 (11.0%) were co-infected with HIV and six (6.0%) with HBV. The untreated chronic HCV seroprevalence estimate was 13.1% and the seroprevalence of HCV among prisoners with a history of injecting drug use (IDU) was 79.7%. Risk factors significantly associated with past HCV infection were IDU (p < 0.0001), having received a prison tattoo (p < 0.0001) or a non-sterile community tattoo (p < 0.0001), sharing needles and other drug-taking paraphernalia (p < 0.0001). Small numbers of prisoners had a history of sharing razors (n=10; 3.4%) and toothbrushes (n=3; 1.0%) while incarcerated. On multivariable analysis, history of receiving a non-sterile community tattoo was the only significant risk factor associated with HCV acquisition (after IDU was removed from the model) (p = 0.005, β = 0.468).ConclusionThe level of untreated chronic HCV infection in Irish prisons is high, with IDU the main associated risk.
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Affiliation(s)
| | - John S Lambert
- Department of Infectious Diseases, Mater Misericordiae University Hospital, Dublin, Ireland.,School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Walter Cullen
- School of Medicine, University College Dublin, Dublin, Ireland
| | | | | | | | - Tina McHugh
- Mater Misericordiae University Hospital, Dublin, Ireland
| | | | | | | | - Ross Murtagh
- School of Medicine, University College Dublin, Dublin, Ireland
| | | | - Ciara Tobin
- University of Florida, Gainesville, United States
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Bukten A, Lund IO, Kinner SA, Rognli EB, Havnes IA, Muller AE, Stavseth MR. Factors associated with drug use in prison - results from the Norwegian offender mental health and addiction (NorMA) study. HEALTH & JUSTICE 2020; 8:10. [PMID: 32399643 PMCID: PMC7218530 DOI: 10.1186/s40352-020-00112-8] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/13/2019] [Accepted: 04/01/2020] [Indexed: 05/27/2023]
Abstract
BACKGROUND Remarkably little is known about drug use during imprisonment, including whether it represents a continuation of pre-incarceration drug use, or whether prison is also a setting for drug use initiation. This paper aims to describe drug use among people in prison in Norway and investigate risk factors associated with in-prison drug use. METHODS We used data from the Norwegian Offender Mental Health and Addiction (NorMA) Study, a cross-sectional survey of 1499 individuals in Norwegian prisons. Respondents reported on drug use (narcotics and non-prescribed medications) both before and during imprisonment. We used multivariate logistic regression to investigate the associations between drug use in prison and demographics, previous drug use, mental health, and criminal activity. RESULTS Sixty-five percent of respondents reported lifetime drug use, and about 50% reported daily use of drugs during the 6 months before incarceration. Thirty-five percent reported ever using drugs in prison, but initiation of drug used during incarceration was uncommon. In a multivariate model, factors independently associated with drug use in prison included lifetime number of drugs used (adjusted odds ratio [aOR] = 1.17; 95% confidence interval [CI] 1.12-1.23; p < 0.001), daily drug use in the 6 months before imprisonment (aOR = 7.12; 95%CI 3.99-12.70; p < 0.001), and being intoxicated while committing the crime related to current imprisonment (aOR = 2.13; 95%CI 1.13-4.03; p = 0.020). CONCLUSIONS In-prison drug use is independently associated with high-risk drug use before imprisonment. To reduce drug use in prison, correctional services must systematically screen for pre-prison drug use and offer effective drug treatment for those in need.
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Affiliation(s)
- Anne Bukten
- Norwegian Centre for Addiction Research, University of Oslo, Kirkveien 166, 0407, Oslo, Norway.
- Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway.
| | | | - Stuart A Kinner
- Justice Health Unit, Centre for Health Equity, Melbourne School of Population and Public Health, University of Melbourne, Melbourne, Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- School of Population and Public Health, University of British Columbia, Vancouver, Canada
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Mater Research Institute-UQ, University of Queensland, Brisbane, Australia
| | - Eline Borger Rognli
- Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway
| | | | | | - Marianne Riksheim Stavseth
- Norwegian Centre for Addiction Research, University of Oslo, Kirkveien 166, 0407, Oslo, Norway
- Section for Clinical Addiction Research, Oslo University Hospital, Oslo, Norway
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"A spray bottle and a lollipop stick": An examination of policy prohibiting sterile injecting equipment in prison and effects on young men with injecting drug use histories. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2019; 80:102532. [PMID: 31427211 DOI: 10.1016/j.drugpo.2019.07.027] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2018] [Revised: 05/21/2019] [Accepted: 07/14/2019] [Indexed: 12/20/2022]
Abstract
BACKGROUND Australian young male prisoners with histories of injecting drug use are more likely to report injecting in prison, to do so more frequently, and to be involved in more un-safe injecting-related practices than their older counterparts. Despite international evidence that prison needle and syringe programs are both feasible and effective in reducing the harms associated with injecting drug use in prison, these young men do not have access to such equipment. METHODS We critically analyse the interview transcripts of 28 young men with histories of injecting drug use who were recently released from adult prisons in Victoria, Australia, and prison drug policy text. We use Bacchi's 'What's the problem represented to be?' approach to examine how the 'problem' of injecting drug use in prison is represented in prison drug policy, including the assumptions that underpin these problematisations, and the subjectification and lived effects that are produced for the young men in our study. RESULTS Our analysis reveals how prison drug policy enables the creation and re-use of homemade injecting equipment crafted from unsterile items found in prison, and that in doing so the policy produces a range of stigmatising subjectification effects and other harmful material effects (such as hepatitis C virus transmission and injecting related injury and harms). Findings highlight, how injecting drug use is represented in policy silences other ways of understanding the 'problem' that may have less harmful effects for incarcerated young men who inject drugs. CONCLUSION We argue that somewhat paradoxically, the approach of prohibiting access to sterile injecting equipment in prison-which is constituted as a solution for addressing such harms-in fact helps to produce them.
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Kirwan A, Curtis M, Dietze P, Aitken C, Woods E, Walker S, Kinner S, Ogloff J, Butler T, Stoové M. The Prison and Transition Health (PATH) Cohort Study: Study Protocol and Baseline Characteristics of a Cohort of Men with a History of Injecting Drug Use Leaving Prison in Australia. J Urban Health 2019; 96:400-410. [PMID: 30989484 PMCID: PMC6565648 DOI: 10.1007/s11524-019-00353-5] [Citation(s) in RCA: 30] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
People who inject drugs (PWID) are disproportionately represented among individuals who experience imprisonment and often have more complex physical and mental health needs than people in prison without injecting histories. The trajectories of PWID after prison release are poorly understood, hampering the development of effective strategies to address their distinct health needs. The Prison and Transition Health (PATH) Cohort Study is characterising the post-release trajectories of incarcerated male PWID in Victoria, Australia. We outline study methodology and baseline characteristics of participants prior to their release. Four hundred participants were recruited from three prisons and completed researcher-administered baseline interviews covering socio-demographics, social supports, physical health, mental health, alcohol and other drug use, and pre-release and transitional service utilisation. The median age among participants was 36 years (IQR 30-42), and they reported a median of five (IQR 3-9) previous adult incarcerations. Almost half (49%) were reliant on government payments prior to incarceration. One quarter (25%) of participants reported removal from their parents' care as children and 64% reported being a parent or primary caregiver to children. Most participants (81%) reported a previous mental health diagnosis and 44% reported three or more diagnoses. The most common drugs injected prior to incarceration were crystal methamphetamine (80%) and heroin (62%), and most (85%) reported being under the influence of drugs at the time of committing offences for which they were currently incarcerated. Injecting drug use during their current sentence was reported by 40% of participants, and 48% reported engaging with some form of drug treatment during their current sentence. Study participants are characterised by significant mental health and substance use morbidities, social disadvantage and criminogenic histories that present challenges for the provision of post-release support services. Data from the PATH Cohort Study will help inform strategies to improve the health and social outcomes of this population.
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Affiliation(s)
- Amy Kirwan
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Michael Curtis
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Paul Dietze
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Campbell Aitken
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Emma Woods
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
| | - Shelley Walker
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia
- National Drug Research Institute, Curtin University, Perth, Western Australia
| | - Stuart Kinner
- National Drug Research Institute, Curtin University, Perth, Western Australia
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia
- Centre for Mental Health, Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Australia
- Mater Research Institute-UQ, University of Queensland, Mount Gravatt, Australia
| | - James Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, Australia
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Stoové
- Behaviours and Health Risks Program, Public Health Discipline, Burnet Institute, 85 Commercial Rd, Melbourne, VIC, 3004, Australia.
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.
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Azbel L, Wegman MP, Polonsky M, Bachireddy C, Meyer J, Shumskaya N, Kurmanalieva A, Dvoryak S, Altice FL. Drug injection within prison in Kyrgyzstan: elevated HIV risk and implications for scaling up opioid agonist treatments. Int J Prison Health 2019; 14:175-187. [PMID: 30274558 DOI: 10.1108/ijph-03-2017-0016] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023]
Abstract
Purpose Within-prison drug injection (WPDI) is a particularly high HIV risk behavior, yet has not been examined in Central Asia. A unique opportunity in Kyrgyzstan where both methadone maintenance treatment (MMT) and needle-syringe programs (NSP) exist allowed further inquiry into this high risk environment. The paper aims to discuss these issues. Design/methodology/approach A randomly selected, nationally representative sample of prisoners within six months of release in Kyrgyzstan completed biobehavioral surveys. Inquiry about drug injection focused on three time periods (lifetime, 30 days before incarceration and during incarceration). The authors performed bivariate and multivariable generalized linear modeling with quasi-binomial distribution and logit link to determine the independent correlates of current WPDI. Findings Of 368 prisoners (13 percent women), 109 (35 percent) had ever injected drugs, with most (86 percent) reporting WPDI. Among those reporting WPDI, 34.8 percent had initiated drug injection within prison. Despite nearly all (95 percent) drug injectors having initiated MMT previously, current MMT use was low with coverage only reaching 11 percent of drug injectors. Two factors were independently correlated with WPDI: drug injection in the 30 days before the current incarceration (AOR=12.6; 95%CI=3.3-48.9) and having hepatitis C infection (AOR: 10.1; 95%CI=2.5-41.0). Originality/value This study is the only examination of WPDI from a nationally representative survey of prisoners where both MMT and NSP are available in prisons and in a region where HIV incidence and mortality are increasing. WPDI levels were extraordinarily high in the presence of low uptake of prison-based MMT. Interventions that effectively scale-up MMT are urgently required as well as an investigation of the environmental factors that contribute to the interplay between MMT and WPDI.
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Affiliation(s)
- Lyuba Azbel
- Yale University , New Haven, Connecticut, USA
| | | | | | - Chethan Bachireddy
- University of Pennsylvania Department of Medicine , Philadelphia, Pennsylvania, USA
| | | | - Natalya Shumskaya
- AIDS Foundation East-West in the Kyrgyz Republic, Bishkek, Kyrgystan
| | | | - Sergey Dvoryak
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
| | - Frederick L Altice
- Medicine at the School of Medicine, Yale University , New Haven, Connecticut, USA
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Coles T, Simpson P, Saulo D, Kaldor J, Richards A, Levy M, Wake C, Siddall DA, Harrod ME, Kariminia A, Butler T. Trends in hepatitis B prevalence and associated risk factors among Indigenous and non-Indigenous prison entrants in Australia, 2004 to 2013. Aust N Z J Public Health 2019; 43:236-240. [PMID: 30690821 DOI: 10.1111/1753-6405.12870] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/01/2018] [Revised: 07/01/2018] [Accepted: 12/01/2018] [Indexed: 12/13/2022] Open
Abstract
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 B 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)ᶺ . 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.
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Affiliation(s)
- Tayla Coles
- The Kirby Institute, University of New South Wales
| | - Paul Simpson
- The Kirby Institute, University of New South Wales
| | - Dina Saulo
- The Kirby Institute, University of New South Wales
| | - John Kaldor
- The Kirby Institute, University of New South Wales
| | | | - Michael Levy
- Australian National University Medical School, Australian Capital Territory
| | - Christopher Wake
- Tasmania Health Services - Mental Health and Statewide Services, Tasmania
| | | | | | | | - Tony Butler
- The Kirby Institute, University of New South Wales
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Gassowski M, Nielsen S, Bannert N, Bock CT, Bremer V, Ross RS, Wenz B, Marcus U, Zimmermann R. History of detention and the risk of hepatitis C among people who inject drugs in Germany. Int J Infect Dis 2019; 81:100-106. [PMID: 30658167 DOI: 10.1016/j.ijid.2019.01.015] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2018] [Revised: 01/07/2019] [Accepted: 01/08/2019] [Indexed: 11/29/2022] Open
Abstract
OBJECTIVES The aim of this study was to investigate the association between detention experience and hepatitis C virus (HCV) status, the role of duration and frequency of detention, and whether risk behaviours practiced in detention could explain an observed increase in risk. METHODS Current drug injectors (injecting in the last 12 months) were recruited to participate in a sero-behavioural, cross-sectional survey using respondent-driven sampling in eight German cities during the years 2011-2014. Using multivariable logistic regression, the association between HCV status and reported detention experience was investigated. RESULTS A total of 1998 participants were included in the analysis. Of these, 19.9% reported no detention experience, 28.6% short and rare experience (≤3.5 years in total, ≤3 times), 12.1% short but frequent experience, 7.1% long but rare experience, and 32.4% long and frequent experience. After correcting for HCV risk factors, the association between detention experience and HCV status remained statistically significant. By adjusting the model for intramural risk behaviours, the odds ratios of detention experience were reduced but remained significant. CONCLUSIONS The proportion of people who inject drugs positive for HCV increased with both frequency and duration of their detention experience. As intramural risk behaviours could not fully explain this increase, it appears that transfers between community and custody may confer additional risks.
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Affiliation(s)
- Martyna Gassowski
- Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.
| | - Stine Nielsen
- Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany; Charité University of Medicine, Berlin, Germany.
| | - Norbert Bannert
- Department of Infectious Diseases, Division for HIV and other Retroviruses, Robert Koch Institute, Berlin, Germany.
| | - Claus-Thomas Bock
- Department of Infectious Diseases, Division for Viral Gastroenteritis and Hepatitis Pathogens and Enteroviruses, Robert Koch Institute, Berlin, Germany.
| | - Viviane Bremer
- Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.
| | - R Stefan Ross
- Institute of Virology, National Reference Centre for Hepatitis C, University Hospital Essen, University of Duisburg-Essen, Essen, Germany.
| | - Benjamin Wenz
- Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.
| | - Ulrich Marcus
- Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.
| | - Ruth Zimmermann
- Department for Infectious Disease Epidemiology, Division for HIV/AIDS, STI and Blood-borne Infections, Robert Koch Institute, Berlin, Germany.
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Moazen B, Saeedi Moghaddam S, Silbernagl MA, Lotfizadeh M, Bosworth RJ, Alammehrjerdi Z, Kinner SA, Wirtz AL, Bärnighausen TW, Stöver HJ, Dolan KA. Prevalence of Drug Injection, Sexual Activity, Tattooing, and Piercing Among Prison Inmates. Epidemiol Rev 2018; 40:58-69. [PMID: 29860343 DOI: 10.1093/epirev/mxy002] [Citation(s) in RCA: 40] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Accepted: 01/17/2018] [Indexed: 12/14/2022] Open
Abstract
Prisoners engage in a range of risk behaviors that can lead to the transmission of viral infections, such as HIV, hepatitis B and hepatitis C. In this review, we summarize the epidemiologic literature from 2007 to 2017 on 4 key risk behaviors for human immunodeficiency virus and hepatitis C virus among prisoners globally: drug injection, sexual activity, tattooing, and piercing. Of 9,303 peer-reviewed and 4,150 gray literature publications, 140 and 14, respectively, met inclusion criteria covering 53 countries (28%). Regions with high levels of injection drug use were Asia Pacific (20.2%), Eastern Europe and Central Asia (17.3%), and Latin America and the Caribbean (11.3%), although the confidence interval for Latin America was high. Low levels of injection drug use in prison were found in African regions. The highest levels of sexual activity in prison were in Europe and North America (12.1%) and West and Central Africa (13.6%); low levels were reported from the Middle East and North African regions (1.5%). High levels of tattooing were reported from Europe and North America (14.7%), Asia Pacific (21.4%), and Latin America (45.4%). Prisons are burdened with a high prevalence of infectious diseases and risk behaviors for transmission of these diseases, and, commonly, a striking lack of evidence-based infection control measures, even when such measures are available in the surrounding community. Given that most prisoners return to these communities, failure to implement effective responses has repercussions not only prisoner health but also for public health.
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Affiliation(s)
- Babak Moazen
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran.,Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Sahar Saeedi Moghaddam
- Non-Communicable Diseases Research Center, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran
| | | | - Masoud Lotfizadeh
- Social Determinants of Health Research Center, Shahrekord University of Medical Sciences, Shahrekord, Iran.,Department of Community Health, Shahrekord University of Medical Sciences, Shahrekord, Iran
| | - Rebecca J Bosworth
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Zahra Alammehrjerdi
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Stuart A Kinner
- Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Australia
| | - Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland
| | - Till W Bärnighausen
- Institute of Public Health, University of Heidelberg, Heidelberg, Germany.,Department of Global Health and Population, Harvard T.H. Chan School of Public Health, Boston, Massachusetts.,Africa Health Research Institute, KwaZulu-Natal, South Africa
| | - Heino J Stöver
- Department of Health and Social Work, Institute of Addiction Research
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Curtis M, Dietze P, Aitken C, Kirwan A, Kinner SA, Butler T, Stoové M. Acceptability of prison-based take-home naloxone programmes among a cohort of incarcerated men with a history of regular injecting drug use. Harm Reduct J 2018; 15:48. [PMID: 30241532 PMCID: PMC6497216 DOI: 10.1186/s12954-018-0255-5] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2018] [Accepted: 09/07/2018] [Indexed: 01/18/2023] Open
Abstract
Background Take-home naloxone (THN) programmes are an evidence-based opioid overdose prevention initiative. Elevated opioid overdose risk following prison release means release from custody provides an ideal opportunity for THN initiatives. However, whether Australian prisoners would utilise such programmes is unknown. We examined the acceptability of THN in a cohort of male prisoners with histories of regular injecting drug use (IDU) in Victoria, Australia. Methods The sample comprised 380 men from the Prison and Transition Health (PATH) Cohort Study; all of whom reported regular IDU in the 6 months prior to incarceration. We asked four questions regarding THN during the pre-release baseline interview, including whether participants would be willing to participate in prison-based THN. We describe responses to these questions along with relationships between before- and during-incarceration factors and willingness to participate in THN training prior to release from prison. Results Most participants (81%) reported willingness to undertake THN training prior to release. Most were willing to resuscitate a friend using THN if they were trained (94%) and to be revived by a trained peer (91%) using THN. More than 10 years since first injection (adjusted odds ratio [AOR] 2.22, 95%CI 1.03–4.77), having witnessed an opioid overdose in the last 5 years (AOR 2.53, 95%CI 1.32–4.82), having ever received alcohol or other drug treatment in prison (AOR 2.41, 95%CI 1.14–5.07) and injecting drugs during the current prison sentence (AOR 4.45, 95%CI 1.73–11.43) were significantly associated with increased odds of willingness to participate in a prison THN programme. Not specifying whether they had injected during their prison sentence (AOR 0.37, 95%CI 0.18–0.77) was associated with decreased odds of willingness to participate in a prison THN training. Conclusion Our findings suggest that male prisoners in Victoria with a history of regular IDU are overwhelmingly willing to participate in THN training prior to release. Factors associated with willingness to participate in prison THN programmes offer insights to help support the implementation and uptake of THN programmes to reduce opioid-overdose deaths in the post-release period.
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Affiliation(s)
- Michael Curtis
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.
| | - Paul Dietze
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Campbell Aitken
- Disease Elimination, Burnet Institute, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
| | - Amy Kirwan
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia
| | - Stuart A Kinner
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia
| | - Tony Butler
- Kirby Institute, University of New South Wales, Sydney, Australia
| | - Mark Stoové
- Behaviours and Health Risks, Burnet Institute, 85 Commercial Road, Melbourne, Victoria, 3004, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia
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22
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Walker S, Higgs P, Stoové M, Wilson M. Narratives of Young Men With Injecting Drug Use Histories Leaving Adult Prison. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2018; 62:3681-3707. [PMID: 29284377 DOI: 10.1177/0306624x17747829] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
This research focuses on an under-examined aspect of the post-release prison trajectory for a seldom-researched cohort. Narratives of the immediate days/weeks surrounding release were gathered from young men with histories of injecting drug use (IDU). Twenty-eight participants (aged 19-24) released from adult prisons in Victoria, Australia, participated in face-to-face in-depth qualitative interviews after release. Analysis of findings through the lens of a "risk environment" framework reveals how their experiences were compromised by risk factors embedded in the physical spaces and social situations they inhabited, as well as the multi-sectoral policy environments under which they were governed. A complex interplay between these factors, young men's drug use and broader issues of structural vulnerability, including institutionalization and social disadvantage, combined to limit young men's chances of "success"1 on the outside. Narratives provide evidence for interventions that transform risk environments into enabling environments, thereby promoting a more successful transition from prison to community for young men with IDU histories.
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Affiliation(s)
- Shelley Walker
- 1 Curtin University, Fitzroy, Victoria, Australia
- 2 Burnet Institute, Melbourne, Victoria, Australia
| | - Peter Higgs
- 2 Burnet Institute, Melbourne, Victoria, Australia
- 3 La Trobe University, Bundoora, Victoria, Australia
| | - Mark Stoové
- 2 Burnet Institute, Melbourne, Victoria, Australia
| | - Mandy Wilson
- 4 Curtin University, Perth, Western Australia, Australia
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23
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Puljević C, Coomber R, Kinner SA, de Andrade D, Mitchell C, White A, Cresswell SL, Bowman J. 'Teabacco': Smoking of nicotine-infused tea as an unintended consequence of prison smoking bans. Drug Alcohol Rev 2018; 37:912-921. [PMID: 30051520 DOI: 10.1111/dar.12848] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2018] [Revised: 06/21/2018] [Accepted: 06/29/2018] [Indexed: 01/15/2023]
Abstract
INTRODUCTION AND AIMS Following the introduction of smoke-free policies in prisons in several countries, there have been anecdotal reports of prisoners creating cigarettes by mixing nicotine patches or lozenges with tea leaves ('teabacco'). Among a sample of people recently released from smoke-free prisons in Queensland, Australia, the aims of this study were to explore the perceived popularity of teabacco use, motivations for its use and describe the process of creating teabacco to identify potential associated health risks. DESIGN AND METHODS This study used a mixed-methods design. Eighty-two people recently released from prison in Queensland, Australia completed surveys at parole offices measuring teabacco use while incarcerated. Twenty-one teabacco smokers took part in follow-up, qualitative interviews to explore survey responses in greater depth. RESULTS The majority of survey participants (57%) reported smoking teabacco while incarcerated, with 37% smoking teabacco frequently (> once per week). Teabacco use was primarily motivated by cigarette cravings. Participants described the perceived inevitability of prisoners finding substitutes for tobacco. Multivariate analyses found that self-rated poor physical health, having been incarcerated five or more times, experiencing cigarette cravings while incarcerated, and use of illicit drugs while incarcerated were positively associated with frequent teabacco use in prison. DISCUSSION AND CONCLUSIONS Our findings suggest that teabacco use has become common practice in Queensland's smoke-free prisons. Correctional smoking bans are an important public health initiative but should be complemented with demand and harm reduction measures cognisant of the risk environment.
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Affiliation(s)
- Cheneal Puljević
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.,The Institute for Social Science Research, The University of Queensland, Brisbane, Australia
| | - Ross Coomber
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Department of Sociology, Social Policy and Criminology, University of Liverpool, Liverpool, UK
| | - Stuart A Kinner
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,Centre for Adolescent Health, Murdoch Children's Research Institute, Melbourne, Australia.,Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Australia.,School of Public Health and Preventive Medicine, Monash University, Melbourne, Australia.,Mater Research Institute-UQ, University of Queensland, Brisbane, Australia
| | - Dominique de Andrade
- Griffith Criminology Institute, Griffith University, Brisbane, Australia.,School of Psychology, University of Queensland, Brisbane, Australia.,Centre for Youth Substance Abuse Research, School of Psychology and Counselling, Institute of Health and Biomedical Innovation, Centre for Children's Health Research, Queensland University of Technology, Brisbane, Australia
| | - Courtney Mitchell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Alan White
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Sarah L Cresswell
- School of Environment and Science, Griffith University, Brisbane, Australia
| | - Jasper Bowman
- School of Environment and Science, Griffith University, Brisbane, Australia
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24
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Ranapurwala SI, Shanahan ME, Alexandridis AA, Proescholdbell SK, Naumann RB, Edwards D, Marshall SW. Opioid Overdose Mortality Among Former North Carolina Inmates: 2000-2015. Am J Public Health 2018; 108:1207-1213. [PMID: 30024795 DOI: 10.2105/ajph.2018.304514] [Citation(s) in RCA: 105] [Impact Index Per Article: 17.5] [Reference Citation Analysis] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES To examine differences in rates of opioid overdose death (OOD) between former North Carolina (NC) inmates and NC residents and evaluate factors associated with postrelease OOD. METHODS We linked NC inmate release data to NC death records, calculated OOD standardized mortality ratios to compare former inmates with NC residents, and calculated hazard ratios to identify predictors of time to OOD. RESULTS Of the 229 274 former inmates released during 2000 to 2015, 1329 died from OOD after release. At 2-weeks, 1-year, and complete follow-up after release, the respective OOD risk among former inmates was 40 (95% confidence interval [CI] = 30, 51), 11 (95% CI = 9.5, 12), and 8.3 (95% CI = 7.8, 8.7) times as high as general NC residents; the corresponding heroin overdose death risk among former inmates was 74 (95% CI = 43, 106), 18 (95% CI = 15, 21), and 14 (95% CI = 13, 16) times as high as general NC residents, respectively. Former inmates at greatest OOD risk were those within the first 2 weeks after release, aged 26 to 50 years, male, White, with more than 2 previous prison terms, and who received in-prison mental health and substance abuse treatment. CONCLUSIONS Former inmates are highly vulnerable to opioids and need urgent prevention measures.
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Affiliation(s)
- Shabbar I Ranapurwala
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
| | - Meghan E Shanahan
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
| | - Apostolos A Alexandridis
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
| | - Scott K Proescholdbell
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
| | - Rebecca B Naumann
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
| | - Daniel Edwards
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
| | - Stephen W Marshall
- Shabbar I. Ranapurwala, Apostolos A. Alexandridis, Rebecca B. Naumann, and Stephen W. Marshall are with the Department of Epidemiology and the Injury Prevention Research Center, University of North Carolina, Chapel Hill. Meghan E. Shanahan is with the Injury Prevention Research Center and the Department of Maternal and Child Health, University of North Carolina, Chapel Hill. Scott K. Proescholdbell is with the Injury and Violence Prevention Branch, North Carolina Division of Public Health, Raleigh, NC. Daniel Edwards Jr is with the Division of Adult Correction & Juvenile Justice, North Carolina Department of Public Safety, Raleigh
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25
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Report from the International Viral Hepatitis Elimination Meeting (IVHEM), 17–18 November 2017, Amsterdam, the Netherlands: gaps and challenges in the WHO 2030 hepatitis C elimination framework. J Virus Erad 2018. [DOI: 10.1016/s2055-6640(20)30264-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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Abstract
Utilizing Bacchi’s poststructuralist approach, “What’s the problem represented to be?,” we critically examine how the “problem” of drug use in prison is represented within a key initiative—the Identified Drug User program (IDUP)—of prison drug policy in one Australian jurisdiction. We use two data sources for our analysis: interview transcripts of recently incarcerated young men (aged 19–24) with histories of injecting drug use and selected prison drug policy and program documents. We examine how the “problem” of drug use in prison is problematized within the IDUP and question commonly accepted ways of thinking that underpin the program. We explore the discursive and subjectification effects of problem representations which produce young men as “rational” and “choosing” and, at the same time, as “untrustworthy” and “deserving of punishment.” We highlight how these effects have consequences for young men’s connections to family while incarcerated which can work against the very issues the IDUP is trying to address. We make two claims in particular: that the IDUP produces harmful effects for young men and their families and that the harmful effects produced are, paradoxically, those the IDUP aims to avoid. Our analysis offers insights into how drug use in prison could be thought about differently, including suggestions that might reduce at least some of its adverse effects.
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Affiliation(s)
- Shelley Walker
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Melbourne, Victoria, Australia
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Kari Lancaster
- Centre for Social Research in Health, Faculty of Arts and Social Sciences, University of New South Wales, Kensington, New South Wales, Australia
| | - Mark Stoové
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
| | - Peter Higgs
- Behaviours and Health Risks Program, Burnet Institute, Melbourne, Victoria, Australia
- Department of Public Health, La Trobe University, Bundoora, Victoria, Australia
| | - Mandy Wilson
- National Drug Research Institute, Faculty of Health Sciences, Curtin University, Melbourne, Victoria, Australia
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27
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Lafferty L, Rance J, Treloar C. Who goes first? Understanding hepatitis C risk among injecting networks in the prison setting. Drug Alcohol Depend 2018; 183:96-101. [PMID: 29245104 DOI: 10.1016/j.drugalcdep.2017.10.030] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/29/2017] [Revised: 10/06/2017] [Accepted: 10/29/2017] [Indexed: 12/20/2022]
Abstract
BACKGROUND Hepatitis C (HCV) is a blood-borne virus that is most commonly transmitted through shared injecting equipment. Due to the criminalisation of injecting drug use, HCV is highly prevalent among those incarcerated. Using a risk environment framework, this qualitative study sought to understand the role of HCV risk within injecting networks in the prison setting. METHODS Thirty-two adult prisoners (n=24 men; n=8 women) with a history of injecting drug use participated in this qualitative sub-study. Participants were recruited across four correctional centres. RESULTS Social, economic, and environmental risk factors contributed to injecting practices within prison. Commonly, the person supplying the drugs injected first, with the person who owns the injecting equipment going next. HCV did not regularly factor into determining order of injection within networks (i.e., first, second, third), although it was reported that some prisoners claimed not to have HCV in efforts to "jump the queue". CONCLUSION Social, economic, and environmental risk factors contribute to negotiation of injecting order among people who inject drugs in prison. Risk of HCV exposure rarely influenced the injecting order. Harm reduction strategies should consider the social factors influencing injecting drug use in the prison setting especially to optimise the population benefits of the roll-out of highly effective HCV treatments.
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Affiliation(s)
- Lise Lafferty
- Centre for Social Research in Health, University of New South Wales, Sydney NSW 2052, Australia.
| | - Jake Rance
- Centre for Social Research in Health, University of New South Wales, Sydney NSW 2052, Australia.
| | - Carla Treloar
- Centre for Social Research in Health, University of New South Wales, Sydney NSW 2052, Australia.
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28
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Cunningham EB, Hajarizadeh B, Amin J, Bretana N, Dore GJ, Degenhardt L, Larney S, Luciani F, Lloyd AR, Grebely J. Longitudinal injecting risk behaviours among people with a history of injecting drug use in an Australian prison setting: The HITS-p study. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 54:18-25. [PMID: 29367011 DOI: 10.1016/j.drugpo.2017.12.013] [Citation(s) in RCA: 43] [Impact Index Per Article: 7.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2017] [Revised: 12/12/2017] [Accepted: 12/16/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND HCV transmission remains high in prisons globally. Understanding injecting risk behaviours in prisons is crucial to effectively develop and implement HCV prevention programs in this setting including treatment as prevention. METHODS HITS-p is a cohort study which enrolled people with a history of injecting drug use in prisons in NSW, Australia from 2005 to 2013. Participants completed an interview at enrolment and follow-up visits to determine injecting behaviours. Generalized estimating equation (GEE) and logistic regression methods were used to assess injecting risk behaviours prior to and following prison entry and to investigate injecting risk behaviours in prison. RESULTS Overall, 499 participants with a history of injecting drug use were included (median age, 26 years; 65% male). Participants were significantly less likely to inject drugs following incarceration. Among injectors, participants were less likely to inject ≥weekly but more likely to share a needle/syringe. At enrolment, the proportion reporting any injecting, ≥weekly injecting, and needle/syringe sharing in prison was highest among younger individuals. Younger age was associated with both re-initiation and continuation of injecting drug use following prison entry. Among those continuously imprisoned, younger age was associated with increased odds of any injecting, ≥weekly injecting, and sharing a needle/syringe. CONCLUSIONS Upon entry to prison, injecting drug use decreased but syringe sharing increased among injectors. Younger individuals are most likely to exhibit high-risk injecting behaviours in prison. These data highlight the need for improved HCV prevention strategies (including improved needle/syringe access and scale up of HCV therapy) for those at increased risk of HCV transmission in prison, including younger individuals.
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Affiliation(s)
| | | | - Janaki Amin
- The Kirby Institute, UNSW Sydney, Sydney, Australia
| | - Neil Bretana
- The Kirby Institute, UNSW Sydney, Sydney, Australia; Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, Australia
| | | | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Sarah Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, Australia
| | - Fabio Luciani
- The Kirby Institute, UNSW Sydney, Sydney, Australia; Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, Australia
| | - Andrew R Lloyd
- The Kirby Institute, UNSW Sydney, Sydney, Australia; Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, Australia
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29
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Age-Specific Global Prevalence of Hepatitis B, Hepatitis C, HIV, and Tuberculosis Among Incarcerated People: A Systematic Review. J Adolesc Health 2018; 62:S18-S26. [PMID: 29455713 PMCID: PMC7413042 DOI: 10.1016/j.jadohealth.2017.09.030] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2017] [Revised: 09/16/2017] [Accepted: 09/18/2017] [Indexed: 01/07/2023]
Abstract
PURPOSE This study aims to compare the global prevalence of hepatitis B, hepatitis C, HIV, and tuberculosis in incarcerated adolescents and young adults (AYAs) and older prisoners. METHODS This study is a systematic review and meta-analysis of studies reporting the age-specific prevalence of each infection in prisoners. We grouped age-specific prevalence estimates into three overlapping age categories: AYA prisoners (<25 years), older prisoners (≥25 years), and mixed category (spanning age 25 years). We used random effects meta-analysis to estimate the relative risk (RR) of each infection in AYAs versus older prisoners. RESULTS Among 72 studies, there was marked heterogeneity in prevalence estimates among AYA prisoners for all infections: hepatitis B (.4%-25.2%), hepatitis C (.0%-70.6%), HIV (.0%-15.8%), and active tuberculosis (.0%-3.7%). The pooled prevalence of HIV (RR = .39, 95% confidence interval .29-.53, I2 = 79.2%) and hepatitis C (RR = .51, 95% confidence interval .33-.78, I2 = 97.8%) was lower in AYAs than in older prisoners. CONCLUSIONS The prevalence of HIV and hepatitis C is lower in AYA prisoners than in older prisoners. Despite lower prevalence, acquisition begins early among incarcerated populations. There is an urgent need for targeted, age-appropriate prevention, treatment, and harm reduction measures in and beyond custodial settings to reduce the incidence of infection in these extremely vulnerable young people.
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30
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Michel L, Trouiller P, Chollet A, Molinier M, Duchesne L, Jauffret-Roustide M. Self-reported injection practices among people who use drugs in French prisons: Public health implications (ANRS-Coquelicot survey 2011-2013). Drug Alcohol Rev 2017; 37 Suppl 1:S268-S276. [PMID: 29105203 DOI: 10.1111/dar.12620] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 09/07/2017] [Accepted: 09/12/2017] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND AIMS The aims of this study were to describe the prevalences of injection practices and needle/syringe sharing in people who use drugs in French prisons, and to investigate associated factors. DESIGN AND METHODS Using the ANRS-Coquelicot survey (2011-2013), a random sample of 1718 people who used drugs in free society was included. Information regarding a history of incarceration, drug-injection practices inside prison and needle/syringe sharing was collected during interviews. RESULTS In our sample, 65.5% reported a history of injection and 57.4% had been incarcerated at least once. Among those who reported both of these conditions, 14% reported injection practices inside prison, 40.5% of whom had shared needles/syringes. In the multivariable model, the following variables were associated with injection practices inside prison: being a Russian-speaking detainee, having spent more time in prison, and having started to inject before 1996 and especially before 1987. Being Russian speaking was also associated with needle/syringe sharing in prison. DISCUSSION AND CONCLUSIONS The prevalences of injection practices and needle/syringe sharing in prisons are alarmingly high. Effective interventions to prevent the transmission of infectious diseases among people who use drugs in the prison setting are essential. The implementation of international recommendations on the principle of equivalence between prisons and the community is still very limited in most countries, and should be complemented with tailored interventions for the most vulnerable prison populations, especially Russian-speaking detainees.
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Affiliation(s)
- Laurent Michel
- CESP/Inserm U1018, Paris, France.,Paris-Sud University and Paris Descartes University, Paris, France.,Centre Pierre Nicole, Paris, France
| | - Philippe Trouiller
- Centre Pierre Nicole, Paris, France.,Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), Paris, France
| | - Aude Chollet
- Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), Paris, France
| | - Marie Molinier
- Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), Paris, France
| | - Lucie Duchesne
- Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), Paris, France
| | - Marie Jauffret-Roustide
- Cermes 3 (Inserm U988/UMR CNRS 8211/EHESS/Paris Descartes University), Paris, France.,French National Institute for Public Health and Surveillance, Saint-Maurice, France
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Borschmann R, Young JT, Moran P, Spittal MJ, Snow K, Mok K, Kinner SA. Accuracy and predictive value of incarcerated adults' accounts of their self-harm histories: findings froman Australian prospective data linkage study. CMAJ Open 2017; 5:E694-E701. [PMID: 28893844 PMCID: PMC5621944 DOI: 10.9778/cmajo.20170058] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
BACKGROUND Self-harm is prevalent in prison populations and is a well-established risk factor for suicide. Researchers typically rely on self-report to measure self-harm, yet the accuracy and predictive value of self-report in prison populations is unclear. Using a large, representative sample of incarcerated men and women, we aimed to examine the level of agreement between self-reported self-harm history and historical medical records, and investigate the association between self-harm history and medically verified self-harm after release from prison. METHODS During confidential interviews with 1315 adults conducted within 6 weeks of expected release from 1 of 7 prisons in Queensland, Australia, participants were asked about the occurrence of lifetime self-harm. Responses were compared with prison medical records and linked both retrospectively and prospectively with ambulance, emergency department and hospital records to identify instances of medically verified self-harm. Follow-up interviews roughly 1, 3 and 6 months after release covered the same domains assessed in the baseline interview as well as self-reported criminal activity and contact with health care, social and criminal justice services since release. RESULTS Agreement between self-reported and medically verified history of self-harm was poor, with 64 (37.6%) of 170 participants with a history of medically verified self-harm disclosing a history of self-harm at baseline. Participants with a medically verified history of self-harm were more likely than other participants to self-harm during the follow-up period. Compared to the unconfirmed-negative group, the true-positive (adjusted hazard ratio [HR] 6.2 [95% confidence interval (CI) 3.3-10.4]), false-negative (adjusted HR 4.0 [95% CI 2.2-6.7]) and unconfirmed-positive (adjusted HR 2.2 [95% CI 1.2-3.9]) groups were at increased risk for self-harm after release from prison. INTERPRETATION Self-reported history of self-harm should not be considered a sensitive indicator of prior self-harm or of future self-harm risk in incarcerated adults. To identify those who should be targeted for preventive strategies, triangulation of data from multiple verifiable sources should be performed whenever possible.
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Affiliation(s)
- Rohan Borschmann
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
| | - Jesse T Young
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
| | - Paul Moran
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
| | - Matthew J Spittal
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
| | - Kathryn Snow
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
| | - Katherine Mok
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
| | - Stuart A Kinner
- Affiliations: Department of Psychiatry (Borschmann), The University of Melbourne, Melbourne;Centre for Adolescent Health (Borschmann, Kinner), Murdoch Childrens Research Institute, Parkville; Melbourne School of Population and Global Health (Borschmann, Young, Snow, Kinner), The University of Melbourne, Melbourne, Australia; Department of Health Service and Population Research (Borschmann), Institute of Psychiatry, Psychology & Neuroscience, King's College London, London, UK; Centre for Health Services Research (Young), School of Population and Global Health, The University of Western Australia, Perth; National Drug Research Institute (Young), Curtin University, Perth, Australia; Centre for Academic Mental Health (Moran), University of Bristol, Bristol, UK; Centre for Mental Health (Spittal), Melbourne School of Population and Global Health, The University of Melbourne, Melbourne; Centre for International Child Health (Snow), Department of Paediatrics, The University of Melbourne, Melbourne; The Black Dog Institute (Mok), Randwick; Mater Research Institute (Kinner), The University of Queensland, South Brisbane; Griffith Criminology Institute (Kinner), Griffith University, Brisbane; School of Public Health and Preventive Medicine (Kinner), Monash University, Melbourne, Australia; Netherlands Institute for the Study of Crime and Law Enforcement (Kinner), Amsterdam, The Netherlands
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Cunningham EB, Hajarizadeh B, Bretana NA, Amin J, Betz-Stablein B, Dore GJ, Luciani F, Teutsch S, Dolan K, Lloyd AR, Grebely J. Ongoing incident hepatitis C virus infection among people with a history of injecting drug use in an Australian prison setting, 2005-2014: The HITS-p study. J Viral Hepat 2017; 24:733-741. [PMID: 28256027 DOI: 10.1111/jvh.12701] [Citation(s) in RCA: 53] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2016] [Accepted: 01/30/2017] [Indexed: 12/12/2022]
Abstract
Hepatitis C virus (HCV) transmission is high in prisons. This study investigated trends in HCV incidence and associated factors among a cohort of prisoners with a history of injecting drug use in New South Wales, Australia. Data were available from the Hepatitis C Incidence and Transmission Study-prisons (HITS-p) from 2005 to 2014. Temporal trends in HCV incidence were evaluated. Factors associated with time to HCV seroconversion among people with ongoing injecting was assessed using Cox proportional hazards. Among 320 antibody-negative participants with a history of injecting drug use (mean age 26; 72% male), 62% (n=197) reported injecting drug use during follow-up. Overall, 93 infections were observed. HCV incidence was 11.4/100 person-years in the overall population and 6.3/100 person-years among the continually imprisoned population. A stable trend in HCV incidence was observed. Among the overall population with ongoing injecting during follow-up, ≥weekly injecting drug use frequency was independently associated with time to HCV seroconversion. Among continuously imprisoned injectors with ongoing injecting during follow-up, needle/syringe sharing was independently associated with time to HCV seroconversion. This study demonstrates that prison is a high-risk environment for acquisition of HCV infection. Needle and syringe sharing was associated with HCV infection among continually imprisoned participants, irrespective of frequency of injecting or the type of drug injected. These findings highlight the need for the evaluation of improved HCV prevention strategies in prison, including needle/syringe programmes and HCV treatment.
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Affiliation(s)
- E B Cunningham
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - B Hajarizadeh
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - N A Bretana
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - J Amin
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - B Betz-Stablein
- Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - G J Dore
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
| | - F Luciani
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - S Teutsch
- Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - K Dolan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, NSW, Australia
| | - A R Lloyd
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia.,Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Sydney, Sydney, NSW, Australia
| | - J Grebely
- The Kirby Institute, UNSW Sydney, Sydney, NSW, Australia
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Graham S, Maher L, Wand H, Doyle M, Iversen J. Trends in hepatitis C antibody prevalence among Aboriginal and Torres Strait Islander people attending Australian Needle and Syringe Programs, 1996-2015. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 47:69-76. [PMID: 28735774 DOI: 10.1016/j.drugpo.2017.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2017] [Revised: 05/29/2017] [Accepted: 06/13/2017] [Indexed: 01/18/2023]
Abstract
BACKGROUND Research indicates that hepatitis C antibody (anti-HCV) prevalence is higher among Australian Aboriginal and Torres Strait Islander (Aboriginal) than non-Aboriginal people who inject drugs (PWID). We examined trends in demographic and drug use characteristics and anti-HCV prevalence among Australian Needle and Syringe Program Survey (ANSPS) respondents by Aboriginal status from 1996 to 2015. METHODS The ANSPS survey involved collecting demographic, behavioural data and a dried blood spot for anti-HCV testing. We used logistic regression to determine demographic and behavioural factors associated with testing anti-HCV positive in the following time-periods (1996-2000, 2001-2005, 2006-2010, 2011-2015) among Aboriginal and non-Aboriginal PWID respondents. RESULTS Overall, there were 16,948 PWID, with 11% identifying as Aboriginal. The proportion of Aboriginal respondents increased from 7% in 1996-2000 to 16% in 2011-2015. Overall anti-HCV prevalence was significantly higher among Aboriginal (60%) than non-Aboriginal PWID (52%, p<0.01). Receptive syringe sharing (RSS) declined among non-Aboriginal PWID (p<0.001) over time, however among Aboriginal PWID, RSS remained stable (p=0.619). Factors independently associated with testing positive for anti-HCV among Aboriginal PWID in 2011-2015 were 16 or more years since first injection (adjusted odds ratio [AOR] 6.04, p<0.001), history of incarceration (AOR: 1.74, p=0.010) and currently or previously on opioid substitution therapy (AOR: 1.89, p=0.003). Compared to 1996-2000, testing anti-HCV positive was significantly associated with the time-periods: 2001-2005 (unadjusted odds ratio [OR]: 1.39, p<0.001), 2006-2010 (OR: 1.38, p<0.001) and 2011-2015 (OR: 1.25, p<0.001) among non-Aboriginal PWID; however this increase did not occur among Aboriginal PWID. CONCLUSION The proportion of Aboriginal PWID attending Needle Syringe Programs appears to have increased. Overall, the prevalence of anti-HCV has remained higher among Aboriginal than non-Aboriginal PWID. Coupling increased access to NSPs with new interferon-free HCV treatments and culturally appropriate education and counselling services could influence new HCV infections among Aboriginal PWID.
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Affiliation(s)
- Simon Graham
- Center for HIV Educational Studies & Training, Hunter College of the City University of New York, NY 10018, United States; Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria 3052, Australia
| | - Lisa Maher
- The Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Handan Wand
- The Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Michael Doyle
- The Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia
| | - Jenny Iversen
- The Kirby Institute, UNSW Australia, Sydney, New South Wales 2052, Australia.
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Snow KJ, Richards AH, Kinner SA. Use of multiple data sources to estimate hepatitis C seroprevalence among prisoners: A retrospective cohort study. PLoS One 2017; 12:e0180646. [PMID: 28686715 PMCID: PMC5501572 DOI: 10.1371/journal.pone.0180646] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Accepted: 06/19/2017] [Indexed: 01/13/2023] Open
Abstract
Hepatitis C is a major cause of preventable morbidity and mortality. Prisoners are a key population for hepatitis C control programs, and with the advent of highly effective therapies, prisons are increasingly important sites for hepatitis C diagnosis and treatment. Accurate estimates of hepatitis C prevalence among prisoners are needed in order to plan and resource service provision, however many prevalence estimates are based on surveys compromised by limited and potentially biased participation. We aimed to compare estimates derived from three different data sources, and to assess whether the use of self-report as a supplementary data source may help researchers assess the risk of selection bias. We used three data sources to estimate the prevalence of hepatitis C antibodies in a large cohort of Australian prisoners-prison medical records, self-reported status during a face-to-face interview prior to release from prison, and data from a statewide notifiable conditions surveillance system. Of 1,315 participants, 33.8% had at least one indicator of hepatitis C seropositivity, however less than one third of these (9.5% of the entire cohort) were identified by all three data sources. Among participants of known status, self-report had a sensitivity of 80.1% and a positive predictive value of 97.8%. Any one data source used in isolation would have under-estimated the prevalence of hepatitis C in this cohort. Using multiple data sources in studies of hepatitis C seroprevalence among prisoners may improve case detection and help researchers assess the risk of selection bias due to non-participation in serological testing.
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Affiliation(s)
- Kathryn J. Snow
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Centre for International Child Health, University of Melbourne Department of Paediatrics and Murdoch Childrens Research Institute, Royal Children’s Hospital, Melbourne, Australia
| | - Alun H. Richards
- Communicable Diseases Branch, Prevention Division, Department of Health, Queensland Government, Brisbane, Queensland, Australia
| | - Stuart A. Kinner
- Melbourne School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Griffith Criminology Institute, Griffith University, Brisbane, Queensland, Australia
- Mater Research Institute, University of Queensland, Brisbane, Queensland, Australia
- School of Public Health and Preventive Medicine, Monash University, Melbourne, Victoria, Australia
- Centre for Adolescent Health, Murdoch Childrens Research Institute, Melbourne, Victoria, Australia
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Mokhtari M, Basirkazeruni H, Rostami M. The Correlation between Different Risk Factors of Hepatitis C and Different Genotypes. Adv Biomed Res 2017; 6:45. [PMID: 28503500 PMCID: PMC5414405 DOI: 10.4103/2277-9175.204588] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND Hepatitis C infection is one of the health problems in the world. Several known risk factors are responsible in transmission of this infection. We are going to study the prevalence of these risk factors for different genotypes of hepatitis C and if possible, specify probable relations between each risk factor and transmission of each genotype. MATERIALS AND METHODS This is a cross-sectional study done on 270 people who had positive anti-hepatitis C virus (HCV) antibody and HCV RNA. Demographic specificity and possible risk factors were collected using a questionnaire, and statistical analysis was done by SPSS software (version 20). Chi-square test used to estimate the prevalence and relation between each qualitative risk factor and HCV genotype transmitted. Analysis of variance was used for studying the prevalence and relation between quantitative risk factors and HCV genotypes. RESULTS The sample size was 270 persons. Of these, 217 (80.4%) were men and 185 (68.5%) were infected with genotype Type III. Most people were in age range of 31-40 years old 92 (34%). Single people were 126 (46.7%) and 169 (62.6%) were high school and university graduated. Tattooing as a risk factor had a meaningful relation with hepatitis C genotype (P < 0.001). CONCLUSIONS According to the findings, most people in central provinces of Iran with hepatitis C are carrying genotype III, with most prevalent risk factors such as intravenous drug use and unsafe sexual activity. Besides, tattooing had a significant association with hepatitis C genotype, so that in these groups of people, genotype I was more frequent isolated virus.
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Affiliation(s)
- Mozhgan Mokhtari
- Department of Pathology, Faculty of Medicine, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Hanieh Basirkazeruni
- Department of Pathology, Isfahan Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
| | - Mojtaba Rostami
- Department of Infectious Disease, Isfahan Research Center, Isfahan University of Medical Sciences, Isfahan, Iran
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HCV prevalence and risk behaviours among injectors of new psychoactive substances in a risk environment in Hungary-An expanding public health burden. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2016; 41:1-7. [PMID: 27984762 DOI: 10.1016/j.drugpo.2016.11.006] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2016] [Revised: 10/31/2016] [Accepted: 11/15/2016] [Indexed: 12/12/2022]
Abstract
BACKGROUND In Hungary a large increase in injecting new psychoactive substances (NPS) coincided with decreasing harm reduction efforts and rising HCV infection. We describe these, and assess changes in HCV prevalence and risk behaviours, 2011-2014, among NPS injectors, using 2011-2015 syringe exchange programme (SEP) data as a key contextual ('risk environment') variable. METHODS We conducted repeated national sero-behavioural surveys in people who inject drugs (PWID) injecting in the last month and attending SEPs or drug treatment centres (n=399, 2011; 384, 2014), using face-to-face interviews and dried blood-spot samples. Prevalence of injected drugs and SEP coverage (2011-2015) were assessed through our national SEP monitoring system and using population size estimates. RESULTS NPS injecting tripled among PWID attending SEPs in Hungary (2011: 26%; 2015: 80%). Among NPS injectors, HCV prevalence, sharing syringes and sharing any injecting equipment (last month), doubled (2011-2014: 37%-74%, 20%-48%, 42%-71%, respectively), significantly exceeding prevalence in other PWID groups. Among young NPS injectors (aged<25), HCV prevalence increased 7-fold (12%-76%), among new injectors (injecting<2years) 4-fold (13%-42%), coupled with high levels of equipment sharing (79% and 72% respectively). Not using a condom at last intercourse (79%), ever-imprisonment (65%) and last-year homelessness (57%) were highly prevalent among NPS injectors (2014). The number of syringes distributed per estimated PWID nationally fell from 114 to 81 (2011-2014) and dropped to 28 in 2015. CONCLUSION NPS injectors in Hungary are at severe risk of blood-borne infections due to high levels of injecting and sexual risk behaviours within a high-risk environment, including continuously low SEP provision, imprisonment and homelessness. An HIV outbreak cannot be excluded. Stronger investment in evidence-based prevention measures, with special focus on young and new injectors, and expansion of hepatitis C treatment are urgently needed.
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Sturman N, Saiepour N. Eligibility for opiate substitution therapy in recently released prisoners with high-risk amphetamine use, and their perceptions of its effectiveness. JOURNAL OF SUBSTANCE USE 2016. [DOI: 10.1080/14659891.2016.1246622] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
Affiliation(s)
- Nancy Sturman
- Discipline of General Practice, School of Medicine, Royal Brisbane Hospital, University of Queensland, Herston, Brisbane, Australia
| | - Nargess Saiepour
- School of Public Health, Royal Brisbane Hospital, University of Queensland, Herston, Brisbane, Australia
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38
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Altice FL, Azbel L, Stone J, Brooks-Pollock E, Smyrnov P, Dvoriak S, Taxman FS, El-Bassel N, Martin NK, Booth R, Stöver H, Dolan K, Vickerman P. The perfect storm: incarceration and the high-risk environment perpetuating transmission of HIV, hepatitis C virus, and tuberculosis in Eastern Europe and Central Asia. Lancet 2016; 388:1228-48. [PMID: 27427455 PMCID: PMC5087988 DOI: 10.1016/s0140-6736(16)30856-x] [Citation(s) in RCA: 172] [Impact Index Per Article: 21.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
Despite global reductions in HIV incidence and mortality, the 15 UNAIDS-designated countries of Eastern Europe and Central Asia (EECA) that gained independence from the Soviet Union in 1991 constitute the only region where both continue to rise. HIV transmission in EECA is fuelled primarily by injection of opioids, with harsh criminalisation of drug use that has resulted in extraordinarily high levels of incarceration. Consequently, people who inject drugs, including those with HIV, hepatitis C virus, and tuberculosis, are concentrated within prisons. Evidence-based primary and secondary prevention of HIV using opioid agonist therapies such as methadone and buprenorphine is available in prisons in only a handful of EECA countries (methadone or buprenorphine in five countries and needle and syringe programmes in three countries), with none of them meeting recommended coverage levels. Similarly, antiretroviral therapy coverage, especially among people who inject drugs, is markedly under-scaled. Russia completely bans opioid agonist therapies and does not support needle and syringe programmes-with neither available in prisons-despite the country's high incarceration rate and having the largest burden of people with HIV who inject drugs in the region. Mathematical modelling for Ukraine suggests that high levels of incarceration in EECA countries facilitate HIV transmission among people who inject drugs, with 28-55% of all new HIV infections over the next 15 years predicted to be attributable to heightened HIV transmission risk among currently or previously incarcerated people who inject drugs. Scaling up of opioid agonist therapies within prisons and maintaining treatment after release would yield the greatest HIV transmission reduction in people who inject drugs. Additional analyses also suggest that at least 6% of all incident tuberculosis cases, and 75% of incident tuberculosis cases in people who inject drugs are due to incarceration. Interventions that reduce incarceration itself and effectively intervene with prisoners to screen, diagnose, and treat addiction and HIV, hepatitis C virus, and tuberculosis are urgently needed to stem the multiple overlapping epidemics concentrated in prisons.
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Affiliation(s)
- Frederick L Altice
- School of Medicine and School Public Health, Yale University, New Haven, CT, USA.
| | - Lyuba Azbel
- Public Health and Policy, London School of Hygiene & Tropical Medicine, London, UK
| | - Jack Stone
- School of Social and Community Medicine, Bristol University, Bristol, UK
| | | | - Pavlo Smyrnov
- ICF International Alliance for Public Health, Kiev, Ukraine
| | - Sergii Dvoriak
- Ukrainian Institute on Public Health Policy, Kiev, Ukraine
| | - Faye S Taxman
- Department of Criminology, Law and Society, George Mason University, Fairfax, VA, USA
| | | | - Natasha K Martin
- School of Social and Community Medicine, Bristol University, Bristol, UK; Division of Global Public Health, University of California San Diego, San Diego, CA, USA
| | - Robert Booth
- Department of Psychiatry, University of Colorado, Denver, CO, USA
| | - Heino Stöver
- Institute of Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Kate Dolan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Peter Vickerman
- School of Social and Community Medicine, Bristol University, Bristol, UK
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Kamarulzaman A, Reid SE, Schwitters A, Wiessing L, El-Bassel N, Dolan K, Moazen B, Wirtz AL, Verster A, Altice FL. Prevention of transmission of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis in prisoners. Lancet 2016; 388:1115-1126. [PMID: 27427456 DOI: 10.1016/s0140-6736(16)30769-3] [Citation(s) in RCA: 132] [Impact Index Per Article: 16.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
The prevalence of HIV, hepatitis B virus, hepatitis C virus, and tuberculosis are higher in prisons than in the general population in most countries worldwide. Prisons have emerged as a risk environment for these infections to be further concentrated, amplified, and then transmitted to the community after prisoners are released. In the absence of alternatives to incarceration, prisons and detention facilities could be leveraged to promote primary and secondary prevention strategies for these infections to improve prisoners health and reduce risk throughout incarceration and on release. Effective treatment of opioid use disorders with opioid agonist therapies (eg, methadone and buprenorphine) prevents blood-borne infections via reductions in injection in prison and after release. However, large gaps exist in the implementation of these strategies across all regions. Collaboration between the criminal justice and public health systems will be required for successful implementation of these strategies.
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Affiliation(s)
- Adeeba Kamarulzaman
- Centre of Excellence for Research in AIDS, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Yale School of Medicine, New Haven, CT, USA.
| | - Stewart E Reid
- Centre for Infectious Disease Research in Zambia, Lusaka, Zambia; University of Alabama at Birmingham, Birmingham, AL, USA
| | | | - Lucas Wiessing
- European Monitoring Centre for Drugs and Drug Addiction, Lisbon, Portugal
| | | | - Kate Dolan
- National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW, Australia
| | - Babak Moazen
- Non-Communicable Diseases Research Centre, Endocrinology and Metabolism Population Sciences Institute, Tehran University of Medical Sciences, Tehran, Iran; Institute of Public Health, University of Heidelberg, Heidelberg, Germany
| | - Andrea L Wirtz
- Center for Public Health and Human Rights, Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | | | - Frederick L Altice
- Centre of Excellence for Research in AIDS, Faculty of Medicine, University Malaya, Kuala Lumpur, Malaysia; Yale School of Medicine, New Haven, CT, USA
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McIsaac KE, Farrell MacDonald S, Chong N, Moser A, Moineddin R, Colantonio A, Nathens A, Matheson FI. Creating a Powerful Platform to Explore Health in a Correctional Population: A Record Linkage Study. PLoS One 2016; 11:e0161173. [PMID: 27532612 PMCID: PMC4988706 DOI: 10.1371/journal.pone.0161173] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2016] [Accepted: 08/01/2016] [Indexed: 11/18/2022] Open
Abstract
We used record linkage to create a data repository of health information of persons who were federally incarcerated in Ontario and Canada. We obtained records from 56,867 adults who were federally incarcerated between January 1, 1998 and December 31, 2011 from the Correctional Service of Canada; 15,248 records belonged to individuals residing in Ontario, Canada. We linked these records to the Registered Persons Database (RPDB) which contained records from 18,116,996 individuals eligible for health care in Ontario. Out of 56,867 OMS records, 22,844 (40.2%) were linked to the RPDB. Looking only at those incarcerated in Ontario, 98%, (14 953 of 15248) records were linked to RPDB. Most records of persons in Ontario-based facilities were linked deterministically. Linkage rates were lower for women, minority groups, and substance users. In conclusion, record linkage enabled the creation of a valuable data repository: there are no electronic medical records for correctional populations in Canada, making it more difficult to profile their health.
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Affiliation(s)
- Kathryn E. McIsaac
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
| | | | - Nelson Chong
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
| | - Andrea Moser
- Correctional Service Canada, Ottawa, Ontario, Canada
| | - Rahim Moineddin
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- Department of Family and Community Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Angela Colantonio
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- Rehabilitation Sciences Institute, University of Toronto, Toronto, Ontario, Canada
- Department of Occupational Science and Occupational Therapy, University of Toronto, Toronto, Ontario, Canada
| | - Avery Nathens
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- Department of Surgery, University of Toronto, Toronto, Ontario, Canada
| | - Flora I. Matheson
- Dalla Lana School of Public Health, University of Toronto, Toronto, Ontario, Canada
- Centre for Urban Health Solutions, St. Michael’s Hospital, Toronto, Ontario, Canada
- Institute for Clinical Evaluative Sciences, Sunnybrook Hospital, Toronto, Ontario, Canada
- * E-mail:
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Graham S, Harrod ME, Iversen J, Simone Hocking J. Prevalence of Hepatitis C Among Australian Aboriginal and Torres Strait Islander people: A Systematic Review and Meta-Analysis. HEPATITIS MONTHLY 2016; 16:e38640. [PMID: 27651805 PMCID: PMC5020402 DOI: 10.5812/hepatmon.38640] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/21/2016] [Revised: 05/14/2016] [Accepted: 06/13/2016] [Indexed: 12/11/2022]
Abstract
CONTEXT Aboriginal and Torres Strait Islanders (Aboriginal) account for approximately 3% of the Australian population. They have the poorest health, economic and social outcomes. Higher notification rates of hepatitis C antibodies (anti-HCV) have been reported among Aboriginal compared with non-Aboriginal people. The identification of Aboriginal people in national surveillance has some weaknesses, with only four of the eight jurisdictions included in national reporting. To address some of these limitations, we aim to estimate the pooled prevalence of anti-HCV among Aboriginal people in Australia. EVIDENCE ACQUISITION We searched the databases: Pubmed, Web of Science and Informit, and the New South Wales and Northern Territory Public Health Bulletins. A study was included if it reported the number of Aboriginal people testing positive for anti-HCV and the number tested for anti-HCV. A meta-analysis by population-group was conducted if three or more studies reported a prevalence estimate. Variables included: author, year of publication, study design, study period, gender (female, male), age, population group (Aboriginal people in prison, Aboriginal people who inject drugs), number testing anti-HCV positive, number tested for anti-HCV and prevalence (%). Due to a long time period, we separated the studies estimating the prevalence anti-HCV among Aboriginal people in prison into two time periods, 1994 - 2004 and 2005 - 2012. RESULTS Overall, 15 studies met our inclusion criteria. Among Aboriginal people in prison, the pooled prevalence of anti-HCV was 18.1% (95%CI: 6.6 - 29.7). The pooled prevalence among Aboriginal people in prison was 25.7% (95%CI: 4.1-47.3) in studies published between 1994 - 2004 and 14.5% (95%CI: 1.7 - 27.3) in studies published from 2005 - 2012. The pooled prevalence of anti-HCV was 58.7% (95%CI: 53.9 - 63.5) among Aboriginal people who inject drugs and 2.9% (95%CI: 0.30 - 6.1) among Aboriginal people who did not inject drugs, however there was significant heterogeneity (I(2) > 90.0%, P < 0.01). There was significant selection bias in the studies as most included individuals who inject drugs. CONCLUSIONS Our analysis shows that the overall prevalence of anti-HCV was significantly biased towards people who inject drugs; resulting in an over-estimation of anti-HCV prevalence among Aboriginal people. Our review highlights that unsafe injecting is the main transmission route for HCV infection among Aboriginal people in Australia.
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Affiliation(s)
- Simon Graham
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
- Corresponding Author: Simon Graham, Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia. Tel: +61-383445515, E-mail:
| | - Mary-Ellen Harrod
- New South Wales Users and AIDS Association, Sydney, New South Wales, Australia
| | - Jenny Iversen
- Kirby Institute, University of New South Wales, Sydney, New South Wales, Australia
| | - Jane Simone Hocking
- Centre for Epidemiology and Biostatistics, School of Population and Global Health, University of Melbourne, Melbourne, Victoria, Australia
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Keten D, Emin Ova M, Sirri Keten H, Keten A, Gulderen E, Tumer S, Caliskan A, Kulotu S. The Prevalence of Hepatitis B and C Among Prisoners in Kahramanmaras, Turkey. Jundishapur J Microbiol 2016; 9:e31598. [PMID: 27127594 PMCID: PMC4842253 DOI: 10.5812/jjm.31598] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2015] [Revised: 12/08/2015] [Accepted: 12/16/2015] [Indexed: 01/06/2023] Open
Abstract
Background Hepatitis B virus (HBV) and hepatitis C virus (HCV) infections are among the most important health issues in Turkey. Human immunodeficiency virus (HIV) infections are less frequently observed in the country. The individuals who had blood transfusions, patients undergoing hemodialysis, and intravenous drug addicted individuals, people who had tattoos/piercings, communal living environments, contamination of a family member, and prisoners are the main risk groups. Objectives The current study aimed to discuss the prevalence and the genotypes of hepatitis and HIV infections among a specific group, namely individuals incarcerated in prisons. Patients and Methods Two-hundred and sixty-six prisoners sentenced for crimes such as robbery, sexual assault, assault substance abuse or selling drugs in the Kahramanmaras closed prison were recruited for the study. Demographic data and the presence of hepatitis B, hepatitis C and HIV were investigated in the study subjects. Results Out of the 266 cases included in the study, 89.5% were male, 10.5% were female and the mean age was 31.21 ± 8.99 years. Risk factors were detected in 27.4% of the subjects. Out of the 73 subjects, among whom the risk factors were detected, 20.3% had intravenous substance use, 3.8% had a history of operation/transfusion, 1.9% had a history of indentation and 1.5% had unprotected sexual contact. The rate of hepatitis B surface antigen (HBsAg) positivity was 2.6%, the ratio of anti-HBs positive subjects was 35.0% and immunity was achieved with vaccination in 43% of the subjects. Anti-HCV was positive in 17.7% of the prisoners and the genotype 3 and genotype 1 were 68.1% (n = 32) and 2.1% (n = 1), respectively. Conclusions Continued substance abuse among most of the drug addicted individuals in prisons, common use of injection materials, tattoos and other circumstances that cause blood contact increase the risk of blood-borne infections.
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Affiliation(s)
- Derya Keten
- Department of Clinical Microbiology and Infectious Diseases, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Mehmet Emin Ova
- Kahramanmaras Closed Prison, General Practice, Kahramanmaras, Turkey
| | - Hamit Sirri Keten
- Department of Family Medicine, Kurtul Family Health Center, Kahramanmaras, Turkey
- Corresponding author: Hamit Sirri Keten, Department of Family Medicine, Kurtul Family Health Center, TR-46100 Kahramanmaras, Turkey. Tel: +90-5535385501, Fax: +90-3442212371, E-mail:
| | - Alper Keten
- Council of Forensic Medicine, Kahramanmaras Branch, Kahramanmaras, Turkey
| | - Evrim Gulderen
- Department of Clinical Microbiology and Infectious Diseases, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Seray Tumer
- Department of Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Ahmet Caliskan
- Department of Microbiology, Necip Fazil City Hospital, Kahramanmaras, Turkey
| | - Suleyman Kulotu
- Department of Clinical Microbiology and Infectious Diseases, Necip Fazil City Hospital, Kahramanmaras, Turkey
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Abstract
BACKGROUND The United States of America currently has the highest incarceration rate in the world, and approximately 80% of incarcerated individuals have a history of illicit drug use. Despite institutional prohibitions, drug use continues in prison, and is associated with a range of negative outcomes. OBJECTIVES To assess the relationship between prison drug use, duration of incarceration, and a range of covariates. RESULTS Most participants self-reported a history of illicit drug use (77.5%). Seven percent reportedly used drugs during the previous six months of incarceration (n = 100). Participants who had been incarcerated for more than a year were less likely than those incarcerated for longer than a year to report using drugs (OR = 0.50; 95% CI = 0.26-0.98). Participants aged 37-89 were less likely than younger prisoners to use drugs (OR = 0.39; 95% CI = 0.19-0.80). Heroin users were twice as likely as nonheroin users to use drugs (OR = 2.28; 95% CI = 1.04-5.03); crack cocaine users were also twice as likely as participants with no history of crack cocaine usage to report drug use (OR = 2.53; 95% CI = 1.13-5.69). CONCLUSIONS Correctional institutions should be used as a resource to offer evidence-based services to curb drug usage. Drug treatment programs for younger prisoners, heroin and crack cocaine users, and at the beginning of a prisoner's sentence should be considered for this population.
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Affiliation(s)
| | - Stephen A Sampong
- a School of Nursing , Columbia University , New York , New York , USA
| | - Montina Befus
- a School of Nursing , Columbia University , New York , New York , USA
| | | | - Elaine L Larson
- a School of Nursing , Columbia University , New York , New York , USA
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Bretaña NA, Boelen L, Bull R, Teutsch S, White PA, Lloyd AR, Luciani F. Transmission of Hepatitis C Virus among Prisoners, Australia, 2005-2012. Emerg Infect Dis 2016; 21:765-74. [PMID: 25897788 PMCID: PMC4414091 DOI: 10.3201/eid2105.141832] [Citation(s) in RCA: 36] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Ongoing transmission is associated with drug injection. Hepatitis C virus (HCV) is predominantly transmitted between persons who inject drugs. For this population, global prevalence of HCV infection is high and incarceration is common and an independent risk factor for HCV acquisition. To explore HCV transmission dynamics in incarcerated populations, we integrated virus sequences with risk behavior and spatiotemporal data and analyzed transmission clusters among prisoners in Australia. We detected 3 clusters of recent HCV transmission consisting of 4 likely in-custody transmission events involving source/recipient pairs located in the same prison at the same time. Of these 4 events, 3 were associated with drug injecting and equipment sharing. Despite a large population of prisoners with chronic HCV, recent transmission events were identified in the prison setting. This ongoing HCV transmission among high-risk prisoners argues for expansion of prevention programs to reduce HCV transmission in prisons.
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45
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Degenhardt L, Larney S, Gisev N, Trevena J, Burns L, Kimber J, Shanahan M, Butler T, Mattick RP, Weatherburn D. Imprisonment of opioid-dependent people in New South Wales, Australia, 2000–2012: a retrospective linkage study. Aust N Z J Public Health 2015; 38:165-70. [PMID: 25874282 DOI: 10.1111/1753-6405.12123] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
There are few data about the incarceration of opioid-dependent people involving large representative cohorts. We aimed to determine the prevalence and duration of incarceration in a large cohort of opioid-dependent people in Australia using data linkage methods, and estimate the costs associated with their incarceration.Method: Retrospective linkage study of all entrants to opioid substitution therapy (OST) for the treatment of opioid dependence in NSW, 1985–2010, with data on incarceration, 2000-2012. The number and duration of incarcerations were calculated. The average daily cost of incarceration was applied to days of incarceration in the cohort.Results: Among 47,196 opioid-dependent people, 37% (43% of men and 24% of women) had at least one episode of incarceration lasting one or more days. Men had a median of three(ranging between 1-47) incarcerations, and women, two (1-35). Indigenous men spent 23% of follow-up time incarcerated, compared with 8% for non-Indigenous men; similarly, Indigenous women spent a substantially greater proportion of time incarcerated than non-Indigenous women (8% vs. 2%). Costs of incarceration of this cohort between 2000 and 2012 totalled nearly AUD $3 billion.Conclusions: This is the first study to examine incarceration of opioid-dependent people across an entire population of such users. Our findings suggest that a substantial minority of opioid-dependent people experience incarceration, usually on multiple occasions and at significant cost. Treatment for opioid dependence, inside and outside prisons, may help reduce incarceration of this cohort.
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Affiliation(s)
- Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales; 2. Melbourne School of Population and Global Health, University of Melbourne, Victoria.
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White N, Ali R, Larance B, Zador D, Mattick RP, Degenhardt L. The extramedical use and diversion of opioid substitution medications and other medications in prison settings in Australia following the introduction of buprenorphine-naloxone film. Drug Alcohol Rev 2015; 35:76-82. [DOI: 10.1111/dar.12317] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2015] [Accepted: 06/28/2015] [Indexed: 11/28/2022]
Affiliation(s)
- Nancy White
- Discipline of Pharmacology; School of Medical Sciences; University of Adelaide; Adelaide Australia
| | - Robert Ali
- Discipline of Pharmacology; School of Medical Sciences; University of Adelaide; Adelaide Australia
| | - Briony Larance
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Deborah Zador
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Richard P. Mattick
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre; University of New South Wales; Sydney Australia
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Grewal HK, Ti L, Hayashi K, Dobrer S, Wood E, Kerr T. Illicit drug use in acute care settings. Drug Alcohol Rev 2015; 34:499-502. [PMID: 25944526 DOI: 10.1111/dar.12270] [Citation(s) in RCA: 42] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 02/08/2015] [Indexed: 11/28/2022]
Abstract
INTRODUCTION AND AIMS While persons with addiction are often hospitalised, hospitals typically employ abstinence-based policies specific to illicit drug use. Although illicit drug use is known to occur within hospitals, this problem has not been well characterised. Therefore, we sought to investigate the prevalence of and factors associated with having ever used drugs in hospital among people who use drugs in Vancouver, Canada. DESIGN AND METHODS Data were derived from prospective cohort studies of people who use drugs between December 2012 and May 2013. Multivariable logistic regression was used to identify demographic and behavioural factors associated with having ever used illicit drugs in hospital. RESULTS Among 1028 participants who had experienced ≥1 hospitalisation, 43.9% reported having ever used drugs while hospitalised. In multivariable analyses, factors positively associated with having ever used drugs in hospital included daily cocaine injection and daily crack non-injection (both P < 0.05). Factors negatively associated with the outcome included older age and male gender (both P < 0.05). The most common reasons for drug use in hospital were 'wanting to use' and 'being in withdrawal'. Drugs were most commonly used in patient washrooms. DISCUSSION AND CONCLUSIONS Our findings demonstrate that an abstinence-based approach to drug use in hospitals may be ineffective at prohibiting drug consumption. High-risk drug use behaviours arising from ongoing drug use may pose risks for further harm and illness. Efforts to minimise the harms associated with using drugs in hospital are urgently needed. [Grewal HK, Ti L, Hayashi K, Dobrer S, Wood E, Kerr T. Illicit drug use in acute care settings. Drug Alcohol Rev 2015;34:499-502].
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Affiliation(s)
- Harjot Kaur Grewal
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
| | - Lianping Ti
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,School of Population and Public Health, University of British Columbia, Vancouver, Canada
| | - Kanna Hayashi
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
| | - Sabina Dobrer
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada
| | - Evan Wood
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
| | - Thomas Kerr
- British Columbia Centre for Excellence in HIV/AIDS, St. Paul's Hospital, Vancouver, Canada.,Department of Medicine, St. Paul's Hospital, University of British Columbia, Vancouver, Canada
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Treloar C, McCredie L, Lloyd AR. Acquiring hepatitis C in prison: the social organisation of injecting risk. Harm Reduct J 2015; 12:10. [PMID: 25903401 PMCID: PMC4413553 DOI: 10.1186/s12954-015-0045-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2015] [Accepted: 03/19/2015] [Indexed: 01/10/2023] Open
Abstract
Aim The potential for transmission of hepatitis C virus (HCV) in prison settings is well established and directly associated with sharing of injecting and tattooing equipment, as well as physical violence. This study is one of the first to examine the circumstances surrounding the acquisition of HCV in the prison setting via inmates’ own accounts. Method This is a sub-study of a cohort of prison inmates in New South Wales, Australia. Cohort participants were inmates who had reported ever injecting drugs and who had a negative HCV serological test within 12 months prior to enrolment. Cohort participants were monitored every 3 to 6 months for HCV antibodies and viraemia and via behavioural risk practices questionnaire. Participants with a documented HCV seroconversion were eligible to participate in in-depth interviews with a research nurse known to them. Results Participants included six inmates (four men, two women) with documented within-prison HCV seroconversion. Participants reported few changes to their injecting practices or circumstances that they attributed to HCV acquisition. Participants believed that they were sharing syringes with others who were HCV negative and trusted that others would have declared their HCV status if positive. Some participants described cleaning equipment with water, but not with disinfectant. In a departure from usual routine, one participant suggested that he may have acquired HCV as a result of using a syringe pre-loaded with drugs that was given to him in return for lending a syringe to another inmate. Participants described regret at acquiring HCV and noted a number of pre- and post-release plans that this diagnosis impacted upon. Conclusions Acquiring hepatitis C was not a neutral experience of participants but generated significant emotional reactions for some. Decisions to share injecting equipment were influenced by participants’ assumptions of the HCV status of their injecting partners. The social organisation of injecting, in trusted networks, is a challenge for HCV prevention programs and requires additional research.
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Affiliation(s)
- Carla Treloar
- Centre for Social Research in Health, UNSW Australia, Sydney, NSW, Australia.
| | - Luke McCredie
- Centre for Health Research in Criminal Justice, Sydney, Australia.
| | - Andrew R Lloyd
- Inflammation and Infection Research Centre, School of Medical Sciences, UNSW Australia, Sydney, Australia.
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Gisev N, Gibson A, Larney S, Kimber J, Williams M, Clifford A, Doyle M, Burns L, Butler T, Weatherburn DJ, Degenhardt L. Offending, custody and opioid substitution therapy treatment utilisation among opioid-dependent people in contact with the criminal justice system: comparison of Indigenous and non-Indigenous Australians. BMC Public Health 2014; 14:920. [PMID: 25192713 PMCID: PMC4168057 DOI: 10.1186/1471-2458-14-920] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2014] [Accepted: 07/29/2014] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Although Indigenous Australians are over-represented among heroin users, there has been no study examining offending, time in custody, and opioid substitution therapy (OST) treatment utilisation among Indigenous opioid-dependent (including heroin) people at the population level, nor comparing these to non-Indigenous opioid-dependent people. The aims of this study were to compare the nature and types of charges, time in custody and OST treatment utilisation between opioid-dependent Indigenous and non-Indigenous Australians in contact with the criminal justice system. METHODS This was a population-based, retrospective data linkage study using records of OST entrants in New South Wales, Australia (1985-2010), court appearances (1993-2011) and custody episodes (2000-2012). Charge rates per 100 person-years were compared between Indigenous and non-Indigenous Australians by sex, age and calendar year. Statistical comparisons were made for variables describing the cumulative time and percentage of follow-up time spent in custody, as well as characteristics of OST initiation and overall OST treatment utilisation. RESULTS Of the 34,962 people in the cohort, 6,830 (19.5%) were Indigenous and 28,132 (80.5%) non-Indigenous. Among the 6,830 Indigenous people, 4,615 (67.6%) were male and 2,215 (32.4%) female. The median number of charges per person against Indigenous people (25, IQR 31) was significantly greater than non-Indigenous people (9, IQR 16) (p < 0.001). Overall, Indigenous people were charged with 33.2% of the total number of charges against the cohort and 44.0% of all violent offences. The median percentage of follow-up time that Indigenous males and females spent in custody was twice that of non-Indigenous males (21.7% vs. 10.1%, p < 0.001) and females (6.0% vs. 2.9%, p < 0.001). The percentage of Indigenous people who first commenced OST in prison (30.2%) was three times that of non-Indigenous people (11.2%) (p < 0.001). Indigenous males spent less time in OST compared to non-Indigenous males (median percentage of follow-up time in treatment: 40.5% vs. 43.1%, p < 0.001). CONCLUSIONS Compared to non-Indigenous opioid-dependent people, Indigenous opioid-dependent people in contact with the criminal justice system are charged with a greater number of offences, spend longer in custody and commonly initiate OST in prison. Hence, contact with the criminal justice system provides an important opportunity to engage Indigenous people in OST.
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Affiliation(s)
- Natasa Gisev
- />National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales Australia
| | - Amy Gibson
- />Centre for Health Research, University of Western Sydney, Sydney, New South Wales Australia
| | - Sarah Larney
- />National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales Australia
- />Alpert Medical School, Brown University, Providence, Rhode Island USA
| | - Jo Kimber
- />National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales Australia
| | - Megan Williams
- />School of Public Health and Community Medicine, UNSW Australia, Sydney, New South Wales Australia
| | - Anton Clifford
- />School of Population Health, University of Queensland, Brisbane, Queensland Australia
| | - Michael Doyle
- />The Kirby Institute, UNSW Australia, Sydney, New South Wales Australia
| | - Lucy Burns
- />National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales Australia
| | - Tony Butler
- />The Kirby Institute, UNSW Australia, Sydney, New South Wales Australia
| | - Don J Weatherburn
- />New South Wales Bureau of Crime Statistics and Research (BOCSAR), Sydney, NSW Australia
| | - Louisa Degenhardt
- />National Drug and Alcohol Research Centre, UNSW Australia, Sydney, New South Wales Australia
- />School of Population and Global Health, The University of Melbourne, Melbourne, Victoria Australia
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50
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Horyniak D, Dietze P, Degenhardt L, Agius P, Higgs P, Bruno R, Alati R, Burns L. Age-related differences in patterns of criminal activity among a large sample of polydrug injectors in Australia. JOURNAL OF SUBSTANCE USE 2014. [DOI: 10.3109/14659891.2014.950700] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Affiliation(s)
- Danielle Horyniak
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
| | - Paul Dietze
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
| | - Louisa Degenhardt
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia,
- School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia,
| | - Paul Agius
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
| | - Peter Higgs
- Centre for Population Health, Burnet Institute, Melbourne, Victoria, Australia,
- Department of Epidemiology and Preventive Medicine, Monash University, Melbourne, Victoria, Australia,
- National Drug Research Institute (Melbourne Office), Curtin University, Victoria, Australia,
| | - Raimondo Bruno
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia,
- School of Psychology, University of Tasmania, Hobart, Tasmania, Australia,
| | - Rosa Alati
- Queensland Alcohol and Drug Research and Education Centre, School of Population Health, University of Queensland, Herston, Queensland, Australia, and
- Centre for Youth Substance Abuse Research, University of Queensland, Queensland, Australia
| | - Lucy Burns
- National Drug and Alcohol Research Centre, University of New South Wales, New South Wales, Australia,
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