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Hussain HU, Kumar KA, Rehan ST, Khan Z, Hashmi MR, Khabir Y, Fatir CA, Tahir MJ, Ahmed A, Shrateh ON, Huda MN. Odds of HIV among incarcerated drug users: a systematic review and meta-analysis of Asian countries. Ann Med Surg (Lond) 2023; 85:5584-5592. [PMID: 37915701 PMCID: PMC10617921 DOI: 10.1097/ms9.0000000000001242] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 08/16/2023] [Indexed: 11/03/2023] Open
Abstract
Background HIV makes up a large portion of infectious diseases globally. People injecting drugs in prisons are at high risk for contracting HIV infection. Prisons house ~10.2 million people globally, making them a high-risk setting for HIV transmission. This systematic review summarizes the available data on the odds of developing HIV infection among imprisoned people who inject drugs (PWIDs) in Asian regions. Methods The authors electronically assessed published studies from January, 2000 to December, 2022, including studies that investigated the odds of HIV in imprisoned PWIDs. We extensively searched PubMed, ERIC, and Cochrane Central and Google Scholar with no constraints in language or time. All the observational studies evaluating the chances of HIV in Asian prisoners with an exposure group of PWIDs and a control group of non-injecting-drug users were included in our analysis. Results The databases search yielded 254 potential studies, 10 observational studies of which having a total of 17 333 participants were included. A low or moderate risk of bias was reported in all the studies except one case-control. The pooled analysis showed a significant association between PWIDs and the chances of contracting HIV infection (Odds ratio=6.40; 95% CI=3.89-10.52; P<0.00001; I2=53%). Conclusion This study found a vital correlation between injecting-drug usage during imprisonment and HIV transmission speed. The results of this meta-analysis support the need to prevent HIV and conducting treatment programs in high-risk settings like prisons.
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Affiliation(s)
| | | | | | | | | | | | | | | | - Ali Ahmed
- School of Pharmacy, Monash University, Jalan Lagoon Selatan, Bandar Sunway, Selangor, Malaysia
| | - Oadi N. Shrateh
- Faculty of Medicine, Al-Quds University, Jerusalem, Palestine
| | - Md. Nazmul Huda
- School of Medicine
- Translational Health Research Institute, School of Medicine, Western Sydney University, Campbelltown, Australia
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Carrasco-Navarro R, Ríos-Cataño C. Factors associated with sexually transmitted diseases amongst female prison inmates in Peru. REVISTA ESPANOLA DE SANIDAD PENITENCIARIA 2023; 25:62-69. [PMID: 37552275 PMCID: PMC10366705 DOI: 10.18176/resp.00069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/16/2022] [Accepted: 03/01/2023] [Indexed: 08/09/2023]
Abstract
OBTECTIVES The number of women in prison is rapidly increasing every year and it is important to establish what factors are related to the probability of presenting STDs in this population to enable health control policies to be established. MATERIAL AND METHOD An analysis was carried out on the open database of the national prison population survey conducted in 2016 in all Peruvian prisons. The study was based on the census and all female and male adults in prison were surveyed using a validated questionnaire. RESULTS The sample consisted of 4,574 inmates in 67 institutions, covering 98.8% of the inmate population. It was found that presenting tuberculosis (PR: 2.64; CI 95%, 1.32-5.26), HIV/AIDS (PR 6.54, CI 95% 1.52-28.18), hepatitis (PR: 4.01; CI 95%, 1.23-13.11) and drug use (PR: 2.44; CI 95%, 1.32-4.52), are statistically related (P ≤0.05) are factors associated with the presence of STDs in the multivariate model with a P ≤0.05. DISCUSSION The inclusion of associated factors (tuberculosis, HIV/AIDS, hepatitis and drug use) should be part of the strategy to control and treat STD in women's prisons in Peru.
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Affiliation(s)
| | - Claudia Ríos-Cataño
- Universidad Continental. Huancayo. Junín. Perú.Universidad ContinentalHuancayoJunínPerú
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Lindsay B, Nyirongo N, Mwango L, Toeque MG, Masumba C, Litongola JP, Sikanyika J, Kabombo H, Moyo M, Siachibila S, Mudenda J, Tembo K, Olowski P, Olufunso A, Muchinda E, Musonda B, Okuku J, Mwila A, Moonga CN, Herce ME, Claassen CW. Initial implementation of HIV pre-exposure prophylaxis for people who are incarcerated in Zambia: a cross-sectional observational study. Lancet HIV 2023; 10:e24-e32. [PMID: 36243018 DOI: 10.1016/s2352-3018(22)00220-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2022] [Revised: 07/22/2022] [Accepted: 07/25/2022] [Indexed: 11/08/2022]
Abstract
BACKGROUND There are over 23 000 incarcerated people in Zambia, a population which has higher HIV prevalence than the general population yet has no access to HIV prevention. To evaluate the feasibility of HIV pre-exposure prophylaxis (PrEP) implementation in Zambian criminal justice facilities, we offered PrEP services to incarcerated people and aimed to describe early implementation outcomes. METHODS In this cross-sectional observational study, we implemented a PrEP programme between Oct 1, 2020, and March 31, 2021, supporting 16 criminal justice facilities in four Zambian provinces. Before implementation, we held stakeholder engagement meetings with Zambia Correctional Service officials to discuss PrEP benefits, and trained Zambia Correctional Service health-care workers in PrEP management using the national PrEP training package. People who were incarcerated and screened positive for substantial HIV risk by use of a standardised HIV risk assessment tool were offered voluntary HIV testing and counselling. Those who tested positive were linked to antiretroviral therapy, and those who tested negative and met national HIV prevention eligibility criteria were offered PrEP. We assessed PrEP uptake and used descriptive statistics to characterise programme beneficiaries and the cascade of PrEP services. FINDINGS During the study period, we reached 12 367 people older than 15 years with HIV risk assessment and counselling, including 11 794 (95·4%) men and 573 (4·6%) women. Of these, 2610 people received HIV testing, with 357 (13·7%) testing HIV positive; positivity was significantly higher in women (20·6%) than men (13·2%, p=0·011). 1276 people were identified as HIV negative and PrEP eligible. Of these, 1190 (93·3%) initiated PrEP. The age group with the highest proportion reached and initiated on PrEP was those aged 25-29 years, representing 19·2% (2377 of 12 367) of all people reached and 24·1% (287 of 1190) of those who initiated PrEP. INTERPRETATION Delivery of PrEP to people who are incarcerated is feasible with adequate resourcing and support to the criminal justice health system, and can result in high uptake among eligible individuals. Further assessment is needed of PrEP persistence and adherence, and the perceptions of people who are incarcerated regarding their HIV risk and preferences for combination HIV prevention services. FUNDING US President's Emergency Plan for AIDS Relief through the US Centers for Disease Control and Prevention.
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Affiliation(s)
- Brianna Lindsay
- Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia; Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA.
| | - Nasho Nyirongo
- Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia
| | | | - Mona Gekanju Toeque
- Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia; Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA
| | | | | | | | | | | | | | | | - Kalima Tembo
- Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia
| | - Pawel Olowski
- Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia
| | | | | | - Bupe Musonda
- Department of Public Health, Ministry of Health, Lusaka, Zambia
| | - Jackson Okuku
- US Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Annie Mwila
- US Centers for Disease Control and Prevention, Lusaka, Zambia
| | - Clement N Moonga
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia
| | - Michael E Herce
- Centre for Infectious Disease Research in Zambia (CIDRZ), Lusaka, Zambia; Institute for Global Health and Infectious Diseases, University of North Carolina, Chapel Hill, NC, USA
| | - Cassidy W Claassen
- Maryland Global Initiatives Corporation Zambia, Lusaka, Zambia; Center for International Health, Education, and Biosecurity, University of Maryland School of Medicine, Baltimore, MD, USA
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O'Hara GL, Liberman AR, Polonsky M, Azbel L, Marcus R, Doltu S, Cugut S, Altice FL. Multi-level implementation factors that influence scale-up of methadone maintenance treatment in Moldovan prisons: A qualitative study. J Subst Abuse Treat 2022; 136:108660. [PMID: 34801282 PMCID: PMC10879837 DOI: 10.1016/j.jsat.2021.108660] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2021] [Revised: 09/22/2021] [Accepted: 11/10/2021] [Indexed: 11/26/2022]
Abstract
INTRODUCTION People who inject drugs (PWID) are overrepresented in prison populations, especially in the Eastern European and Central Asian region (EECA), where HIV incidence and mortality continue to rise. Modeling data suggest that methadone maintenance treatment (MMT) scale-up in prison with continuation after release could substantially reduce new HIV infections. Moldova, one of four countries in the EECA to have introduced MMT in prisons, has faced challenges with its scale-up. METHOD To improve implementation of MMT in Moldovan prisoners, we analyzed the qualitative interviews of 44 recently released Moldovan prisoners with opioid use disorder who either accepted or rejected MMT while incarcerated; these 44 were among a subset of 56 participants in a quantitative survey who had complete interview data. After translating and back-translating interviews, we used content analysis to identify key barriers and facilitators to MMT uptake. RESULTS Our qualitative analyses revealed that positive attitudes toward methadone facilitated treatment uptake, yet the study identified three thematic barriers as to why PWID do not accept MMT while in prison, including: 1) negative personal attitudes toward MMT; 2) stigmatization of MMT by informal hierarchies within prison; and 3) distrust of the formal prison hierarchy (i.e., administration), which provides MMT. CONCLUSION Overall, the social forces of the two prisoner hierarchies and distrust between them appeared to outweigh the perceived benefits of MMT and impacted MMT uptake. Here we provide strategies to promote MMT more effectively in prison settings.
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Affiliation(s)
- George L O'Hara
- Yale University School of Medicine, Section of Infectious Diseases, 333 Cedar St, New Haven, CT 06510, USA
| | - Amanda R Liberman
- Yale University School of Medicine, Section of Infectious Diseases, 333 Cedar St, New Haven, CT 06510, USA.
| | - Maxim Polonsky
- Yale University School of Medicine, Section of Infectious Diseases, 333 Cedar St, New Haven, CT 06510, USA
| | - Lyuba Azbel
- London School of Hygiene and Tropical Medicine, Keppel St, Bloomsbury, London WC1E 7HT, UK
| | - Ruthanne Marcus
- Yale University School of Medicine, Section of Infectious Diseases, 333 Cedar St, New Haven, CT 06510, USA.
| | - Svetlana Doltu
- Act for Involvement (AFI) Nongovernmental organization, Varșovia St 2060, Chișinău 2060, Republic of Moldova
| | - Sergiu Cugut
- Act for Involvement (AFI) Nongovernmental organization, Varșovia St 2060, Chișinău 2060, Republic of Moldova.
| | - Frederick L Altice
- Yale University School of Medicine, Section of Infectious Diseases, 333 Cedar St, New Haven, CT 06510, USA; Yale University School of Public Health, Division of Epidemiology of Microbial Diseases, 60 College St, New Haven, CT 06510, USA.
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Harnpariphan W, Han WM, Supanun R, Ubolyam S, Sophonphan J, Ueaphongsukkit T, Gatechompol S, Tangkijvanich P, Thanprasertsuk S, Khwairakpam G, Ruxrungthan K, Phanuphak P, Matthews GV, Avihingsanon A. High Proportion of Blood-Borne and Sexually Transmitted Infections Among People Deprived of Liberty in a Central Male Prison in Thailand: A Cross-Sectional Study 2018-2019. AIDS Res Hum Retroviruses 2022; 38:370-377. [PMID: 35262414 DOI: 10.1089/aid.2021.0134] [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: 11/13/2022] Open
Abstract
Data are lacking or outdated on burden of HIV, viral hepatitis infection, and sexually transmitted infections such as syphilis among people deprived of liberty in the Asia-Pacific region. We aimed to evaluate the proportion of viral hepatitis B (HBV), hepatitis C (HCV), HIV, and syphilis infections, and factors associated with HCV, HBV, and HIV infection in a central male prison. A cross-sectional study was performed among 1,028 people deprived of liberty from a central male prison in Bangkok, Thailand. People deprived of liberty were screened for HIV, HBV, HCV, and syphilis infections during 2018-2019. HBV and HCV were defined as positive hepatitis B surface antigen and positive anti-HCV antibody, respectively. Proportions (95% confidence interval [CI]) of infections were calculated based on the binomial distribution. HBV proportion was reported for different age groups. Risk factors associated with HCV infections were evaluated by logistic regression model. The median age was 38 (interquartile range, 32-50) years, and 6.9% reported use of injection drugs. The proportion of HIV, HBV, anti-HCV, HCV RNA, and syphilis was 2.9% (95% CI, 1.9-4.1), 6.4% (5-8.1), 5.9% (4.6-7.6), 4.2% (3-5.6), and 4.8% (3.5-6.3), respectively. One (0.1%), 7 (0.6%), and 2 (3%) were co-infected with HIV/HBV, HIV/HCV, and HDV/HBV, respectively. HBV proportion differed across age groups: 3.7% in <30 years, 7% in 31-40 years, 9.7% in 41-50 years, and 5.5% in >50 years. Factors associated with HCV infection were older age, lower education level, previous incarceration, and injection drug use. In multivariable models, older age was associated with HBV infection, and men having sex with men was associated with HIV infection. The proportion of blood-borne infections was higher among males than among the general population. HBV vaccination, routine HCV screening, and treatment with pan-genotypic direct-acting antivirals with minimal specialist requirements should be implemented in Thai prisons.
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Affiliation(s)
| | - Win Min Han
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
| | | | | | | | | | - Sivaporn Gatechompol
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Pisit Tangkijvanich
- Center of Excellence in Hepatitis and Liver Cancer, Department of Biochemistry, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - Sombat Thanprasertsuk
- Preventive Medicine, Department of Disease Control, Ministry of Public Health, Nonthaburi, Thailand
| | - Giten Khwairakpam
- TREAT Asia/amfAR—The Foundation for AIDS Research, Bangkok, Thailand
| | | | | | | | - Anchalee Avihingsanon
- HIV-NAT, Thai Red Cross AIDS Research Centre, Bangkok, Thailand
- Center of Excellence in Tuberculosis, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
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Fenomanana J, Randriatsarafara FM, Ranampy FF, Randriamanantany ZA. A behavioural and HIV serological survey among detainees of Ankazondrano jail in Fianarantsoa, Madagascar. AFRICAN JOURNAL OF AIDS RESEARCH : AJAR 2021; 20:324-328. [PMID: 34905458 DOI: 10.2989/16085906.2021.2008459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
Aims: The prevalence of HIV in the general population of Madagascar is 0.3%. Some population groups, especially detainees are vulnerable to this infection. Our study was the first combined HIV survey of the detainees of Ankazondrano jail in Fianarantsoa. The study aims to determine the serological status of the detainees related to HIV infection and their risky behaviours for this infection.Methods: A descriptive cross-sectional survey of the detainees 18 years old and over was carried out in Ankazondrano jail in Fianarantsoa during September 2020.Results: The prevalence of HIV in the sample was zero; 89.43% of the detainees reported to have heard about HIV; only 15.45% had a general knowledge about it; 76.42% of them knew that a condom is a way of protection against HIV infection; however, they had wrong responses about protection against this infection. In fact, 47.97% of the surveyed detainees thought that HIV is transmitted by mosquito bites and 65.04% thought that it is transmitted by shaking hands. Almost one quarter of the detainees reported that there is no risk of HIV contraction in jail.Conclusion: In this study, nevertheless, the prevalence of HIV is zero; detainees of Ankazondrano jail are a vulnerable group to HIV due to their lack of knowledge of this infection and the fact that they undertook risky behaviours.
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Affiliation(s)
- Jocia Fenomanana
- Laboratory Service of CHU at Andrainjato Fianarantsoa Madagascar, Faculty of Medicine, University of Fianarantsoa, Madagascar
| | | | - Fabien Florian Ranampy
- Laboratory Service of CHU at Andrainjato Fianarantsoa Madagascar, Faculty of Medicine, University of Fianarantsoa, Madagascar
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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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Huang K, Yu C, Chen X, Hao Y, Ding Y, Wu Z, Wang X. A Quasi-Experimental Study on the Effectiveness of Compulsory and Voluntary Treatment Settings for 1,299 Drug Abusers in Hunan, China. Front Psychiatry 2021; 12:613665. [PMID: 34512405 PMCID: PMC8429503 DOI: 10.3389/fpsyt.2021.613665] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/03/2020] [Accepted: 07/29/2021] [Indexed: 11/20/2022] Open
Abstract
Background: Although the type and structure of substance abuse treatment have changed, the overall approaches of drug rehabilitation in China has remained largely unchanged. Evidence of effectiveness for compulsory drug rehabilitation centers (CRCs) and voluntary drug rehabilitation centers (VRCs) remains mixed. The main objective of our study is to reveal the outcomes of CRCs and VRCs and examine the factors associated with relapse in these two centers. Methods: In this cross-sectional study, we recruited a total of 1,299 drug abusers in Hunan Province, 709 from CRCs and 590 from VRC, respectively. We used Pearson chi-squared test and t-test to examine the differences in demographics and drug-related characteristics. Binary logic regression was used to examine the relationship between important factors and relapse in CRCs and VRC. Results: Patients from CRCs and VRC significantly differed in age, sex, types of drug used, medical illness, education, occupation, mental illness, and marital status. After drug rehabilitation, both groups both had improved in occupation, family support, and social function (p < 0.05). In addition, employment and family support were significantly associated with a decreased risk of relapse (p < 0.05). Conclusion: This study revealed that compulsory rehabilitation is as effective as voluntary rehabilitation in (1) getting jobs and increasing monthly income, (2) having a good relationship with family, and (3) becoming more satisfied with their spared time. The components of these two settings were very different and may imply the necessity of these two approaches in China. In addition, employment and family support may prevent relapse.
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Affiliation(s)
- Kai Huang
- Second Xiangya Hospital, Central South University, Changsha, China
- Division of Research on Stress and Addiction Research, Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
| | - Caihua Yu
- Second Xiangya Hospital, Central South University, Changsha, China
- Division of Research on Stress and Addiction Research, Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xinxin Chen
- Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yuzhu Hao
- Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Yudan Ding
- Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Zhenzhen Wu
- Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
| | - Xuyi Wang
- Second Xiangya Hospital, Central South University, Changsha, China
- Division of Research on Stress and Addiction Research, Second Xiangya Hospital, Central South University, Changsha, China
- Department of Psychiatry, Second Xiangya Hospital, Central South University, Changsha, China
- Key Laboratory of Psychiatry and Mental Health of Hunan Province, Central South University, Changsha, China
- Mental Health Institute, Second Xiangya Hospital, Central South University, Changsha, China
- National Clinical Research Center for Mental Disorders, and Department of Psychaitry, The Second Xiangya Hospital of Central South University, Changsha, China
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Chimoyi L, Hoffmann CJ, Hausler H, Ndini P, Rabothata I, Daniels-Felix D, Olivier AJ, Fielding K, Charalambous S, Chetty-Makkan CM. HIV-related stigma and uptake of antiretroviral treatment among incarcerated individuals living with HIV/AIDS in South African correctional settings: A mixed methods analysis. PLoS One 2021; 16:e0254975. [PMID: 34329311 PMCID: PMC8323907 DOI: 10.1371/journal.pone.0254975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Accepted: 07/07/2021] [Indexed: 11/26/2022] Open
Abstract
Background Stigma affects engagement with HIV healthcare services. We investigated the prevalence and experience of stigma among incarcerated people living with HIV (PLHIV) in selected South African correctional settings during roll-out of universal test and treat. Methods A cross-sectional mixed-methods study design included 219 incarcerated PLHIV and 30 in-depth interviews were conducted with four different types of PLHIV. HIV-related stigma was assessed through survey self-reporting and during the interviews. A descriptive analysis of HIV-related stigma was presented, supplemented with a thematic analysis of the interview transcripts. Results ART uptake was high (n = 198, 90.4%) and most reported HIV-related stigma (n = 192, 87.7%). The intersectional stigma occurring due to individual and structural stigma around provision of healthcare in these settings mostly contributed to perceived stigma through involuntary disclosure of HIV status. Interpersonal and intrapersonal factors led to negative coping behaviours. However, positive self-coping strategies and relationships with staff encouraged sustained engagement in care. Conclusion We encourage continuous peer support to reduce stigmatization of those infected with HIV and whose status may be disclosed inadvertently in the universal test and treat era.
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Affiliation(s)
- Lucy Chimoyi
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- * E-mail:
| | - Christopher J. Hoffmann
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- Department of Medicine, Johns Hopkins University, Baltimore, Maryland, United States of America
| | | | - Pretty Ndini
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
| | - Israel Rabothata
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
| | | | | | - Katherine Fielding
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Department of Infectious Disease Epidemiology, London School of Hygiene and Tropical Medicine, London, United Kingdom
| | - Salome Charalambous
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
| | - Candice M. Chetty-Makkan
- Implementation Research Division, The Aurum Institute, Johannesburg, South Africa
- School of Public Health, University of the Witwatersrand, Johannesburg, South Africa
- Health Economics and Epidemiology Research Office, Johannesburg, South Africa
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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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Gondwe A, Amberbir A, Singogo E, Berman J, Singano V, Theu J, Gaven S, Mwapasa V, Hosseinipour MC, Paul M, Chiwaula L, van Oosterhout JJ. Prisoners' access to HIV services in southern Malawi: a cross-sectional mixed methods study. BMC Public Health 2021; 21:813. [PMID: 33910547 PMCID: PMC8080321 DOI: 10.1186/s12889-021-10870-1] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/16/2020] [Accepted: 04/19/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The prevalence of Human Immunodeficiency Virus (HIV) among prisoners remains high in many countries, especially in Africa, despite a global decrease in HIV incidence. Programs to reach incarcerated populations with HIV services have been implemented in Malawi, but the success of these initiatives is uncertain. We explored which challenges prisoners face in receiving essential HIV services and whether HIV risk behavior is prevalent in prisons. METHODS We conducted a mixed-methods (qualitative and quantitative), cross-sectional study in 2018 in six prisons in Southern Malawi, two large central prisons with on-site, non-governmental organization (NGO) supported clinics and 4 smaller rural prisons. Four hundred twelve prisoners were randomly selected and completed a structured questionnaire. We conducted in-depth interviews with 39 prisoners living with HIV, which we recorded, transcribed and translated. We used descriptive statistics and logistic regression to analyze quantitative data and content analysis for qualitative data. RESULTS The majority of prisoners (93.2%) were male, 61.4% were married and 63.1% were incarcerated for 1-5 years. Comprehensive services were reported to be available in the two large, urban prisons. Female prisoners reported having less access to general medical services than males. HIV risk behavior was reported infrequently and was associated with incarceration in urban prisons (adjusted odds ratio [aOR] 18.43; 95% confidence interval [95%-CI] 7.59-44.74; p = < 0.001) and not being married (aOR 17.71; 95%-CI 6.95-45.13; p = < 0.001). In-depth interviews revealed that prisoners living with HIV experienced delays in referrals for more severe illnesses. Prisoners emphasized the detrimental impact of poor living conditions on their personal health and their ability to adhere to antiretroviral therapy (ART). CONCLUSIONS Malawian prisoners reported adequate knowledge about HIV services albeit with gaps in specific areas. Prisoners from smaller, rural prisons had suboptimal access to comprehensive HIV services and female prisoners reported having less access to health care than males. Prisoners have great concern about their poor living conditions affecting general health and adherence to ART. These findings provide guidance for improvement of HIV services and general health care in Malawian institutionalized populations such as prisoners.
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Affiliation(s)
- Austrida Gondwe
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi.
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA.
| | | | - Emmanuel Singogo
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Joshua Berman
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Victor Singano
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Joe Theu
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Steven Gaven
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
| | - Victor Mwapasa
- College of Medicine, P/Bag 360, Chichiri, Blantyre, Malawi
| | - Mina C Hosseinipour
- University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA
- University of North Carolina-Malawi Project, Tidziwe Centre, P/Bag A-104, Lilongwe, Malawi
| | - Magren Paul
- Chichiri Prison, P/Bag 30117, Blantyre 3, Blantyre, Malawi
| | | | - Joep J van Oosterhout
- Dignitas International, P. O Box 1071, C/O Box 333, Zomba, Malawi
- David Geffen School of Medicine, University of California Los Angeles, Los Angeles, USA
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Uzoeghelu U, Bogart LM, Mahoney T, Ghebremichael MS, Kerr J, Ojikutu BO. HIV Risk-Related Behaviors and Willingness to Use Pre-Exposure Prophylaxis Among Black Americans with an Arrest History. J Racial Ethn Health Disparities 2021; 9:498-504. [PMID: 33544327 DOI: 10.1007/s40615-021-00980-2] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2020] [Revised: 01/18/2021] [Accepted: 01/27/2021] [Indexed: 12/17/2022]
Abstract
OBJECTIVE Black individuals in the USA are arrested and incarcerated at a significantly higher rate than White individuals, and incarceration is associated with increased HIV vulnerability. Pre-exposure prophylaxis (PrEP) reduces the risk for HIV transmission, but little is known about the relationship between HIV risk behavior and willingness to use PrEP among Black individuals with an arrest history. METHOD A total of 868 individuals completed a nationally representative survey and provided baseline data on sexual risk. Participants were grouped as those with a history of arrest (N = 226) and those with no history of arrest (N=619) based on self-reported arrest history. Our study examined HIV risk behaviors associated with willingness to use PrEP between those with arrest history and those without arrest history. RESULTS Participants with an arrest history were more likely to have a lifetime history of anal sex (p<0.0001) and sexually transmitted diseases (p=0.0007). A history of multiple sexual partners in the past 3 months was associated with PrEP willingness in individuals with an arrest history [aPR 2.61 (1.77, 3.85), p<0.0001], adjusting for other covariates in the model. CONCLUSIONS Differences in risk behavior and willingness to use PrEP exist by arrest history. Understanding these risk behaviors are necessary to increase access to PrEP. PrEP uptake and adherence interventions, when recommended and made available for individuals at substantive risk of HIV infection at the time of arrest and during incarceration, are essential to reducing the spread of HIV in correctional facilities and in communities to which they return.
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Affiliation(s)
- Ugochukwu Uzoeghelu
- Department of Postgraduate Education, Harvard Medical School, 25 Shattuck St, Boston, MA, 02215, USA.
| | | | - Taylor Mahoney
- Boston University School of Public Health, Boston, MA, USA
| | | | - Jelani Kerr
- University of Louisville, Louisville, KY, USA
| | - Bisola O Ojikutu
- Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA
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Marotta PL, Terlikbayeva A, Gilbert L, Davis A, Wu E, Metsch L, Feaster D, El-Bassel N. Dyadic analysis of criminal justice involvement and hiv risks among couples who inject drugs and their intimate partners in almaty, kazakhstan. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2021; 87:102950. [PMID: 33099160 PMCID: PMC8694887 DOI: 10.1016/j.drugpo.2020.102950] [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] [Received: 01/14/2020] [Revised: 09/02/2020] [Accepted: 09/08/2020] [Indexed: 11/23/2022]
Abstract
BACKGROUND Incarceration increases HIV risk behaviors and strains intimate partnerships of couples of people who inject drugs (PWID) in Kazakhstan. Studies are yet to examine dyadic relationships between criminal justice involvement and injection drug and sexual HIV risk behaviors of couples who inject drugs in Kazakhstan. This study examined associations between individual and partner level criminal justice involvement and injection drug and sexual HIV risk behaviors among 216 intimate dyads (n = 432) of PWID in Almaty, Kazakhstan. METHODS The Actor Partner Interdependence Model (APIM) using structural equation modeling examined individual (actor), partner and dyadic patterns (actor-partner) of associations between arrest, incarceration and drug crime conviction of dyads of male and female intimate partners of PWID using baseline data from Project Renaissance, a couples-focused HIV prevention intervention for PWID and their intimate partners. RESULTS Results from the APIM identified significant associations between lifetime (β=0.10, CI95%=0.01.20, p=.021) and recent (β=0.12, CI95%=0.01.26, p=.045) arrest and increased risk of injection drug use with any partner for female partners. Partner-only effects were identified in which male PWID's recent arrest was associated with an increase in their study partners' injection drug risk behaviors (β=0.10 CI95%=0.02, 0.20, p=.044). For female partners, prior incarceration was associated with increased engagement in injection drug risk behaviors (β=0.10 CI95% =0.02, 0.20, p=.035) with any partner. For male partners' prior incarceration was associated with injection drug risk behaviors with their study partners (β=0.10 CI95%= 0.02, 0.20. p<.05). Female partners prior drug crime conviction was associated with their own (β=0.14 CI95%=0.01, 0.28, p=.048) and their intimate partners' (β=0.18, CI95%=0.03, 0.33, p=.024) engagement in injection drug risk behaviors with any injecting partner. Recent drug crime conviction (β=0.12, CI95%=0.01, 0.24, p=.038) and arrest (β=0.13, CI95%, p=.022) was associated with increased engagement in sexual risk behaviors among female partners. CONCLUSION Findings from this study identified differences in how criminal justice involvement impacts sexual and injection drug and sexual risk behaviors between male and female partners of PWID. Future research must investigate how structural interventions at the dyadic level could address the negative impact of criminal justice involvement on sexual and injection drug HIV risks within the contexts of couples who are PWID.
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Affiliation(s)
| | - Assel Terlikbayeva
- Global Health Research Center of Central Asia, Almaty, Kazakhstan; School of Social Work, Columbia University, New York, New York United States of America
| | - Louisa Gilbert
- Global Health Research Center of Central Asia, Almaty, Kazakhstan; School of Social Work, Columbia University, New York, New York United States of America
| | - Alissa Davis
- Global Health Research Center of Central Asia, Almaty, Kazakhstan; School of Social Work, Columbia University, New York, New York United States of America
| | - Elwin Wu
- Global Health Research Center of Central Asia, Almaty, Kazakhstan; School of Social Work, Columbia University, New York, New York United States of America
| | - Lisa Metsch
- Global Health Research Center of Central Asia, Almaty, Kazakhstan; Sociomedical Sciences, Mailman School of Public Health Columbia University New York, United States of America
| | - Dan Feaster
- Biostatistics Division, Department of Public Health Sciences, Miller School of Medicine University of Miami, Miami, FL, United States of America
| | - Nabila El-Bassel
- Biostatistics Division, Department of Public Health Sciences, Miller School of Medicine University of Miami, Miami, FL, United States of America
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Ale-Ebrahim J, Janani L, SeyedAlinaghi SA, Farhoudi B, Abbasi-Ghahramanloo A, Sajadipour M, Motevalian SA. Patterns of high-risk behaviors associated with HIV among male prisoners: A latent class analysis. Med J Islam Repub Iran 2020; 34:109. [PMID: 33316009 PMCID: PMC7722948 DOI: 10.34171/mjiri.34.109] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2019] [Indexed: 02/05/2023] Open
Abstract
Background: Acquired Immunodeficiency Syndrome (AIDS) is one of the most important health challenges worldwide. Moreover, the prevalence of the Human Immunodeficiency Virus (HIV) infection differs among Iranian prisoners and the general population. The present study aimed to identify the patterns of HIV-related high-risk behaviors in male prisoners. Methods: In this cross-sectional study, 2832 inmates were examined for HIV-related high-risk behaviors. The required data were collected using a questionnaire on high-risk behaviors, including a history of heterosexual and homosexual intercourse, and a history of drug use disorders. A Latent Class Analysis (LCA) was performed to analyze the obtained data in WinLTA software. Results: Five latent classes were defined for the male prisoners, as follows: low-risk (20%), moderate-risk (23%), Injection Drug Use (IDU) (8%), heterosexual intercourse/methamphetamine use (38%), and high-risk (11%). The LCA results revealed that high-risk sexual behaviors, IDU, and sharing injection equipment in prisons significantly influence the classification. The obtained data suggested that a history of imprisonment was not frequent in class 2 (OR=1.0033, %95CI:0.9936-1.01) and class 4 members (OR=1.0053, %95CI:0.9929-1.0179). However, it was more prevalent in class 3 (OR=1.0164, %95CI:1.0068-1.0262), and 5 (OR=1.0211, %95CI:1.0129-1.0293). Heterosexual contact had the highest prevalence (75%) in this regard. The results showed that the lowest prevalence of high-risk behaviors was associated with morphine use (0.3%). Among illicit drugs, methamphetamine was the most prevalent drug (42%) in the studied subjects. Conclusion: The present study indicated a high prevalence of high-risk sexual behaviors and methamphetamine use in the investigated participants. We observed the co-occurrence of HIV-related high-risk behaviors in male prisoners. Thus, providing safe sex education for prisoners is highly recommended. It is also necessary to pursue care programs about IDU as a key risk factor for HIV transmission in prisons.
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Affiliation(s)
- Jalal Ale-Ebrahim
- Department of Epidemiology, School of Health, Iran University of Medical Sciences, Tehran, Iran
| | - Leila Janani
- Department of Biostatistics, School of Public Health, Iran University of Medical Sciences, Tehran, Iran
| | - Seyed Ahmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High-Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Farhoudi
- Social Determinants of Health Research Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Abbas Abbasi-Ghahramanloo
- Department of Public Health, School of Health, Ardabil University of Medical Sciences, Ardabil, Iran
| | | | - Seyed Abbas Motevalian
- Research Center for Addiction and High-Risk Behaviors (ReCARB), Psychosocial Health Research Institute, Iran University of Medical Sciences, Tehran, Iran
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15
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Mohamed Z, Scott N, Al-Kurdi D, Selvapatt N, Thursz MR, Lemoine M, Brown AS, Nayagam S. Cost-effectiveness of strategies to improve HCV screening, linkage-to-care and treatment in remand prison settings in England. Liver Int 2020; 40:2950-2960. [PMID: 32750192 DOI: 10.1111/liv.14628] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2020] [Revised: 07/13/2020] [Accepted: 07/20/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND A simplified cascade-of-care may improve screening and treatment uptake among incarcerated individuals. We assessed the cost-effectiveness of traditional and simplified screening and treatment in a London remand prison. METHODS Using empirical data from Her Majesty's Prison (HMP) Wormwood Scrubs, London, we designed a decision tree and Markov transition state model using national average data for HCV screening and treatment for the base-case scenario. This compared two alternative strategies; (a) general prison population screening and treatment and (b) prioritising screening and treatment among people who inject drugs (PWID) combined with general prison population screening and treatment. Strategies varied the rates of screening (47%-90%), linkage-to-care (60%-86%) and treatment (21%-85%). Cost, utility and disease transition rates were obtained from existing literature. Outcome measures were as follows: screening, treatment and disease-related costs per admitted individual, quality-adjusted life years (QALYs). Incremental cost-effectiveness ratios (ICERs) were calculated for each intervention. All costs and utilities were discounted at a rate of 3.5% per annum. Both univariate and probabilistic sensitivity analyses have been conducted. RESULTS In our cohort of 5239 incarcerated individuals with an estimated chronic HCV prevalence of 2.6%, all strategy ICER values (£3565-10 300) fell below the national willingness to pay threshold (£30 000). Increased successful treatment (7%-54%) was observed by an optimising cascade-of-care. A robust sensitivity analysis identified treatment cost of, QALY for mild liver disease and probability of completing treatment as important factors that impact the ICER value. CONCLUSION In our remand setting, optimising adherence to the cascade-of-care is cost-effective. Where universal screening is not practical, a stratified approach focused on intensive screening and treatment of PWID also results in increased treatment uptake and is highly cost-effective.
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Affiliation(s)
- Zameer Mohamed
- Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK
| | - Nick Scott
- Disease Elimination Program, Burnet Institute, Melbourne, Victoria, Australia
| | | | - Nowlan Selvapatt
- Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK
| | - Mark R Thursz
- Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK
| | - Maud Lemoine
- Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK
| | - Ashley S Brown
- Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK
| | - Shevanthi Nayagam
- Department of Hepatology, Imperial College London, St Mary's Hospital, London, UK.,Department of Infectious Disease Epidemiology, School of Public Health, Imperial College, London, UK
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Blumenkrans E, Socías ME, Richardson L, Kerr T, Shoveller J, Montaner J, Milloy MJ. Longitudinal Factors Associated with Used Syringe Lending Among HIV-Positive Antiretroviral Therapy-Naïve People Who Inject Drugs in a Canadian Setting. AIDS Behav 2020; 24:2163-2168. [PMID: 32026249 DOI: 10.1007/s10461-020-02781-w] [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: 10/25/2022]
Abstract
Sharing used syringes is an important route of HIV transmission, however, factors shaping used syringe-lending among antiretroviral therapy (ART)-naïve HIV-positive people who inject drugs (PWID) are not well-characterized. Multivariable logistic regression analyses using generalized estimating equations (GEE) were employed to investigate correlates of used syringe lending among ART-naïve PWID. Data was drawn from ACCESS, a prospective community-recruited cohort of HIV-positive illicit drug users in Vancouver, Canada, from 1996 to 2015. The analysis included 482 ART-naïve PWID, of which 116 (24.1%) reported ≥ 1 periods of used syringe lending. In longitudinal analyses, incarceration (Adjusted Odds Ratio [AOR] = 2.18, 95% Confidence Interval [CI] 1.48-3.20), daily cocaine injection (AOR= 1.97, 95% CI 1.33-2.90), and sex work (AOR = 1.61, 95% CI 1.02-2.55) during the 180-day observation period were positively associated with used syringe lending, while having a high school diploma (AOR = 0.63, 95% CI 0.43-0.93) and holding formal employment (AOR = 0.20, 95% CI 0.05-0.82) were negatively associated. We found a high prevalence of used syringe lending among ART-naïve HIV-positive PWID, particularly among those recently incarcerated, involved in sex work or who injected cocaine frequently. Conversely, markers of higher socio-economic status were negatively associated with used syringe lending. These findings highlight the critical need for policies and interventions to decrease socio-economic marginalization and criminalization among PWID living with HIV alongside the scale up of access to harm reduction services.
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Bayani A, Ghiasvand H, Rezaei O, Fattah Moghaddam L, Noroozi A, Ahounbar E, Higgs P, Armoon B. Factors associated with HIV testing among people who inject drugs: a meta-analysis. J Addict Dis 2020; 38:361-374. [DOI: 10.1080/10550887.2020.1771235] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Affiliation(s)
- Azadeh Bayani
- Student Research Committee, School of Allied Medical Sciences, Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | - Hesam Ghiasvand
- Health Management and Economics Research Center, Iran University of Medical Sciences, Tehran, Iran
- Health Economics Group, Medical School, Saint Luke's Campus, University of Exeter, Exeter, UK
| | - Omid Rezaei
- Fellowship of Psychosomatic, Department of Psychiatry, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Ladan Fattah Moghaddam
- Department of nursing, faculty of nursing and midwifery, Tehran medical sciences, Islamic Azad University, Tehran, Iran
| | - Alireza Noroozi
- Psychiatrist, Iranian National Center for Addiction Studies (INCAS), Tehran University of Medical Sciences, Tehran, Iran
| | - Elahe Ahounbar
- Substance Abuse and Dependence Research Center, University of Social Welfare and Rehabilitation Sciences, Tehran, Iran
| | - Peter Higgs
- Department of Public Health, La Trobe University, Melbourne, Australia
| | - Bahram Armoon
- Social Determinants of Health Research Center, Saveh University of Medical Sciences, Saveh, Iran
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Ohringer AR, Ezer T, Serota DP. Prison-based harm reduction services are needed to address the dual substance use disorder and infectious disease epidemics in US prisons. EClinicalMedicine 2020; 22:100367. [PMID: 32455342 PMCID: PMC7235622 DOI: 10.1016/j.eclinm.2020.100367] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2020] [Accepted: 04/22/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Alison R. Ohringer
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Don Soffer Clinical Research Building, 1120 NW 14th Street, Miami, FL 33136, United States
- Corresponding author.
| | - Tamar Ezer
- Human Rights Clinic, University of Miami School of Law, Miami, Florida, United States
| | - David P. Serota
- Division of Infectious Diseases, Department of Medicine, University of Miami Miller School of Medicine, Don Soffer Clinical Research Building, 1120 NW 14th Street, Miami, FL 33136, United States
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Erickson M, Pick N, Ranville F, Braschel M, Kestler M, Kinvig K, Krüsi A, Shannon K. Recent Incarceration as a Primary Barrier to Virologic Suppression Among Women Living with HIV: Results from a Longitudinal Community-Based Cohort in a Canadian Setting. AIDS Behav 2020; 24:1243-1251. [PMID: 31321640 DOI: 10.1007/s10461-019-02606-5] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
Women living with HIV (WLWH) are disproportionately represented among incarcerated populations yet there is a paucity of research on how incarceration shapes HIV treatment outcomes for women. Data is drawn from SHAWNA (Sexual health and HIV/AIDS: Women's Longitudinal Needs Assessment), a longitudinal community-based open research cohort with cis and trans WLWH in Metro Vancouver, Canada (2010-2017). Multivariable logistic regression using generalized estimating equations (GEE) longitudinally modeled the effect of incarceration on virologic suppression (HIV plasma VL < 50 copies/mL), adjusting for potential confounders. Amongst 292 WLWH, the majority (74%) had been incarcerated in their lifetime and 17% were incarcerated over the study period. Exposure to recent incarceration was independently correlated with reduced odds of virologic suppression (AOR: 0.42, 95% CI 0.22-0.80). This study suggests critical need for research and interventions to better address factors shaping ART adherence and retention in care for WLWH, both within correctional centres and following release from prison.
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Affiliation(s)
| | - Neora Pick
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | - Flo Ranville
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
| | | | - Mary Kestler
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | - Karen Kinvig
- Oak Tree Clinic, BC Women's Hospital, Vancouver, Canada
| | - Andrea Krüsi
- Centre for Gender and Sexual Health Equity, Vancouver, Canada
- Faculty of Medicine, University of British Columbia, Vancouver, Canada
| | - Kate Shannon
- Centre for Gender and Sexual Health Equity, Vancouver, Canada.
- Faculty of Medicine, University of British Columbia, Vancouver, Canada.
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Toegel F, Holtyn AF, Pollock S, Rodewald AM, Leoutsakos JM, Fingerhood M, Silverman K. Effects of incentivizing viral suppression in previously incarcerated adults living with HIV. HIV Res Clin Pract 2020; 21:1-10. [PMID: 32133931 PMCID: PMC7259460 DOI: 10.1080/25787489.2020.1735816] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2019] [Accepted: 02/12/2020] [Indexed: 12/21/2022]
Abstract
Background: The amount of HIV in a person's blood can be suppressed to an undetectable level through antiretroviral therapy medications (ART). Adhering to an ART regimen can improve a person's health and reduce HIV transmission. Despite these benefits, many people with HIV do not maintain the level of adherence required to achieve an undetectable viral load. This problem is particularly common among people who have been incarcerated.Objective: To determine effects of incentivizing viral suppression in previously incarcerated adults with HIV.Methods: Adults with HIV (N = 102) and detectable viral load (>200 copies/mL) were randomly assigned to a Usual Care or Incentive group. Usual Care participants did not earn incentives for viral suppression. Incentive participants earned incentives ($10/day maximum) for providing blood samples with a reduced or undetectable (<200 copies/mL) viral load. Assessments were conducted every 3 months. Results collected during the first year were aggregated and compared based on group assignment and incarceration history.Results: Previously incarcerated participants in the Incentive group provided more (OR: 2.9; CI: 1.3-6.8; p <.05) blood samples with an undetectable viral load (69%) than those in the Usual Care group (41%). Never-incarcerated participants in the Incentive group provided more (OR: 6.8; CI: 2.2-21.0; p <.01) blood samples with an undetectable viral load (78%) than those in the Usual Care group (36%). Effects of incentives did not differ by incarceration history.Conclusions: Incentivizing viral suppression can increase viral suppression (undetectable viral load) in people who have been incarcerated.
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Affiliation(s)
- Forrest Toegel
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - August F. Holtyn
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Sarah Pollock
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Andrew M. Rodewald
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jeannie-Marie Leoutsakos
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Michael Fingerhood
- Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Kenneth Silverman
- Department of Psychiatry and Behavioral Sciences, Center for Learning and Health, Johns Hopkins University School of Medicine, Baltimore, MD, USA
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Tielbeek JJ, Boutwell BB. Exploring the Genomic Architectures of Health, Physical Traits and Antisocial Behavioral Outcomes: A Brief Report. Front Psychiatry 2020; 11:539. [PMID: 32670102 PMCID: PMC7330713 DOI: 10.3389/fpsyt.2020.00539] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2019] [Accepted: 05/26/2020] [Indexed: 11/13/2022] Open
Abstract
A widely replicated finding across the behavioral sciences is that antisocial behaviors correlate with an array of health problems. Less clear, however, is the precise nature of this association. There is reason to suspect that a direct causal link exists between incarceration-a consequence of some antisocial behaviors-and certain negative health outcomes, for instance. However, it might be the case that broader phenotypes like antisocial behavior may correlate with certain health and physiological traits at a genomic level. We explore this possibility from a theoretical vantage point, while also presenting some preliminary data from existing secondary sources. Tentatively, no significant genetic correlations emerged across a host of health, physiological, and wellbeing outcomes after correction for multiple testing. However, more work is needed exploring this topic. We propose that future studies should make use of larger, more diverse samples and examine the genetic overlap between homogeneous clusters of antisocial behavioral subtypes and disease traits or symptoms.
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Affiliation(s)
- Jorim J Tielbeek
- Department of Complex Trait Genetics, Center for Neurogenomics and Cognitive Research, Amsterdam Neuroscience, Vrije Universiteit Amsterdam, Amsterdam, Netherlands
| | - Brian B Boutwell
- Department of Criminal Justice and Legal Studies, School of Applied Sciences, University of Mississippi, University, MS, United States.,John D. Bower School of Population Health, University of Mississippi Medical Center, Jackson, MS, United States
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Pitcher AB, Borquez A, Skaathun B, Martin NK. Mathematical modeling of hepatitis c virus (HCV) prevention among people who inject drugs: A review of the literature and insights for elimination strategies. J Theor Biol 2019; 481:194-201. [PMID: 30452959 PMCID: PMC6522340 DOI: 10.1016/j.jtbi.2018.11.013] [Citation(s) in RCA: 31] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 11/13/2018] [Accepted: 11/15/2018] [Indexed: 02/07/2023]
Abstract
In 2016, the World Health Organization issued global elimination targets for hepatitis C virus (HCV), including an 80% reduction in HCV incidence by 2030. The vast majority of new HCV infections occur among people who inject drugs (PWID), and as such elimination strategies require particular focus on this population. As governments urgently require guidance on how to achieve elimination among PWID, mathematical modeling can provide critical information on the level and targeting of intervention are required. In this paper we review the epidemic modeling literature on HCV transmission and prevention among PWID, highlight main differences in mathematical formulation, and discuss key insights provided by these models in terms of achieving WHO elimination targets among PWID. Overall, the vast majority of modeling studies utilized a deterministic compartmental susceptible-infected-susceptible structure, with select studies utilizing individual-based network transmission models. In general, these studies found that harm reduction alone is unlikely to achieve elimination targets among PWID. However, modeling indicates elimination is achievable in a wide variety of epidemic settings with harm reduction scale-up combined with modest levels of HCV treatment for PWID. Unfortunately, current levels of testing and treatment are generally insufficient to achieve elimination in most settings, and require further scale-up. Additionally, network-based treatment strategies as well as prison-based treatment and harm reduction provision could provide important additional population benefits. Overall, epidemic modeling has and continues to play a critical role in informing HCV elimination strategies worldwide.
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Affiliation(s)
| | - Annick Borquez
- Division of Infectious Diseases and Global Public Health, University of California San Diego, CA, USA
| | - Britt Skaathun
- Division of Infectious Diseases and Global Public Health, University of California San Diego, CA, USA
| | - Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, CA, USA.
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Mgolozeli SE, Duma SE. "As I Was Walking Down the Street, Four Strange Guys Came and Took Me Under the Bridge, Where They All Raped Me": An Interpretative Phenomenological Analysis of the Types of Rape Experienced by Men in South Africa. Am J Mens Health 2019; 13:1557988319882589. [PMID: 31779511 PMCID: PMC6886282 DOI: 10.1177/1557988319882589] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2019] [Revised: 09/10/2019] [Accepted: 09/23/2019] [Indexed: 12/04/2022] Open
Abstract
Globally, rape is regarded as the most demoralizing type of trauma, and it has negative implications for victims and their families. Although rape affects the community in general, there is a paucity of literature on rape victimization of men. As a result, the types of rape experienced by them are not understood, and thus it is often difficult to develop contextually relevant interventions to prevent male rape and to support male rape victims. The objective of this study was to first determine and then describe, the types of rape experienced by men. An interpretative phenomenological analysis (IPA) qualitative approach was used to collect and analyze data from a purposive sample of 11 participants, using semistructured individual interviews. The findings of the study reveal six themes and related subthemes as six types and related subtypes of rape experienced by men as follows: acquaintance rape, including familial rape; stranger rape; gang rape, including corrective-gang rape, drug-facilitated gang rape, pack-hunting rape, women retributive rape (or women vengeance) for violence experienced from men; homophobic rape; prison rape, including transactional rape and gang initiation rape; and armed rape. The findings reveal the different contexts or settings where men are vulnerable to rape. This highlights the possibilities for the development of context-specific sexual violence prevention interventions for men, which include self-defense training and awareness campaigns specific to rape victimization of men. Furthermore, future studies are recommended to expose this pandemic. Activism is advocated to stop the silence around this public and social health issue.
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Affiliation(s)
- Siyabulela Eric Mgolozeli
- Discipline of Nursing, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, KwaZulu-Natal Province, South Africa
| | - Sinegugu Evidence Duma
- Discipline of Nursing, School of Nursing & Public Health, College of Health Sciences, University of KwaZulu-Natal, Howard College Campus, Durban, KwaZulu-Natal Province, South Africa
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Kayomo MK, Hasker E, Aloni M, Nkuku L, Kazadi M, Kabengele T, Muteteke D, Kapita F, Lufulwabo A, Mukadi YD, Muyembe-Tamfum JJ, Ieven M, de Jong BC, Boelaert M. Outbreak of Tuberculosis and Multidrug-Resistant Tuberculosis, Mbuji-Mayi Central Prison, Democratic Republic of the Congo. Emerg Infect Dis 2019; 24:2029-2035. [PMID: 30334730 PMCID: PMC6199999 DOI: 10.3201/eid2411.180769] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
After an alert regarding ≈31 tuberculosis (TB) cases, 3 of which were rifampin-resistant TB cases, in Mbuji-Mayi Central Prison, Democratic Republic of the Congo, we conducted an outbreak investigation in January 2015. We analyzed sputum of presumptive TB patients by using the Xpert MTB/RIF assay. We also assessed the Mycobacterium tuberculosis isolates' drug-susceptibility patterns and risk factors for TB infection. Among a prison population of 918 inmates, 29 TB case-patients were already undergoing treatment. We found an additional 475 presumptive TB case-patients and confirmed TB in 170 of them. In March 2015, the prevalence rate of confirmed TB was 21.7% (199/918 inmates). We detected an additional 14 cases of rifampin-resistant TB and initiated treatment in all 14 of these case-patients. Overcrowded living conditions and poor nutrition appeared to be the driving factors behind the high TB incidence in this prison.
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Shrestha G, Mulmi R, Yadav DK, Baral D, Yadav BK, Chakravartty A, Pokharel PK, Sapkota N. Health needs and risky behaviours among inmates in the largest prison of eastern Nepal. Int J Prison Health 2019; 14:254-267. [PMID: 30468108 DOI: 10.1108/ijph-10-2017-0049] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
PURPOSE The purpose of this paper is to assess the health status and risky behaviours of inmates in Nepal. DESIGN/METHODOLOGY/APPROACH This cross-sectional study was conducted in Jhumka Regional Prison, the largest male prison in eastern Nepal from September 2014 to August 2015. Data were collected through face-to-face interviews from 434 randomly selected incarcerated participants using semi-structured questionnaires. FINDINGS The mean age of 434 participants was 35.7 years (SD 13.3). The majority (84 per cent) had at least one current health problem, of which the commonest were respiratory (50 per cent), skin (38 per cent) and digestive (26 per cent). Alcohol (73 per cent) and cigarettes (71 per cent) were the most commonly used substances prior to imprisonment. Approximately, 27 and 11 per cent reported illicit drug use and injectable drug use prior to incarceration, respectively. A total of 204 inmates reported having intercourse with sex workers. Of these, 49 per cent did not use a condom in their last intercourse with a sex worker. RESEARCH LIMITATIONS/IMPLICATIONS This paper illustrates that a wide range of physical and mental health problems exist among incarcerated people in Nepal. The study may lack generalisability, however, as it was conducted in a single male prison. PRACTICAL IMPLICATIONS The paper suggests a need for medical, psychiatric and substance abuse care in correctional settings to improve the health status of the prison population. It is also important to develop screening policies for blood-borne viral and other infectious diseases in the prison. ORIGINALITY/VALUE This is the first study of its kind drawn from prisons in Nepal.
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Affiliation(s)
- Gambhir Shrestha
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Rashmi Mulmi
- Department of Cancer Prevention, Control and Research, B.P. Koirala Memorial Cancer Hospital, Bharatpur, Nepal
| | - Deepak Kumar Yadav
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Dharanidhar Baral
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Birendra Kumar Yadav
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Avaniendra Chakravartty
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Paras Kumar Pokharel
- School of Public Health and Community Medicine, B.P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Nidesh Sapkota
- B.P. Koirala Institute of Health Sciences, Dharan, Nepal
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26
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Jalali F, Hasani A, Hashemi SF, Kimiaei SA, Babaei A. Cognitive Group Therapy Based on Schema-Focused Approach for Reducing Depression in Prisoners Living With HIV. INTERNATIONAL JOURNAL OF OFFENDER THERAPY AND COMPARATIVE CRIMINOLOGY 2019; 63:276-288. [PMID: 29938557 DOI: 10.1177/0306624x18784185] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Depression is one the most common mental disorders in prisons. People living with HIV are more likely to develop psychological difficulties when compared with the general population. This study aims to determine the efficacy of cognitive group therapy based on schema-focused approach in reducing depression in prisoners living with HIV. The design of this study was between-groups (or "independent measures"). It was conducted with pretest, posttest, and waiting list control group. The research population comprised all prisoners living with HIV in a men's prison in Iran. Based on voluntary desire, screening, and inclusion criteria, 42 prisoners living with HIV participated in this study. They were randomly assigned to an experimental group (21 prisoners) and waiting list control group (21 prisoners). The experimental group received 11 sessions of schema-focused cognitive group therapy, while the waiting list control group received the treatment after the completion of the study. The various groups were evaluated in terms of depression. ANCOVA models were employed to test the study hypotheses. Collated results indicated that depression was reduced among prisoners in the experimental group. Schema therapy (ST) could reduce depression among prisoners living with HIV/AIDS.
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Affiliation(s)
- Farzad Jalali
- 1 Negahe Mosbat Social Health Institute, Mashhad, Iran
| | | | | | | | - Ali Babaei
- 3 Educational and Research Centre, District VI of State Prisons, Mashhad, Iran
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Women, incarceration and HIV: a systematic review of HIV treatment access, continuity of care and health outcomes across incarceration trajectories. AIDS 2019; 33:101-111. [PMID: 30289811 DOI: 10.1097/qad.0000000000002036] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
OBJECTIVE The aim of this study was to systematically review the literature on gendered implications of incarceration for HIV outcomes and engagement in care for women living with HIV (WLWH). DESIGN We systematically searched seven bibliographic databases, for peer-reviewed English-language studies, published between 2007 and 2017 reporting on incarceration, women (transgender inclusive) and HIV. METHODS Articles were included for evaluation if they reported outcomes for at least one of three measures of interest: viral load, antiretroviral therapy (ART) adherence or engagement in care among WLWH along incarceration trajectories. RESULTS Out of 1119 studies, 24 (2%) met the inclusion criteria. Of these 24 studies, the majority (n = 23) were conducted in the USA, 19 included samples of women and men and seven studies were transgender inclusive. Our review did not reveal clear sex differences in HIV outcomes during periods of incarceration; however, studies reporting postincarceration outcomes demonstrated significant sex disparities in all three outcomes of interest. Following incarceration, women were less likely to be virally suppressed, less likely to achieve optimal ART adherence and less likely to be engaged in care. CONCLUSION Despite growing numbers of incarcerated WLWH globally, there is a substantial gap in research examining the impact of incarceration on HIV outcomes for WLWH. Significant sex disparities in HIV outcomes and engagement in care exist along incarceration trajectories for WLWH, especially postincarceration. For improved health outcomes, research is needed to examine the experiences of WLWH throughout incarceration trajectories to develop interventions tailored to the specific needs of WLWH both during and following incarceration.
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28
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Crowley D, Van Hout MC, Murphy C, Kelly E, Lambert JS, Cullen W. Hepatitis C virus screening and treatment in Irish prisons from a governor and prison officer perspective - a qualitative exploration. HEALTH & JUSTICE 2018; 6:23. [PMID: 30569249 PMCID: PMC6755610 DOI: 10.1186/s40352-018-0081-6] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/14/2018] [Accepted: 12/02/2018] [Indexed: 06/09/2023]
Abstract
BACKGROUND Prisons are a key location to access Hepatitis C Virus (HCV) infected people who inject drugs (PWID). Prison health care structures are complex and optimising health care delivery to this high need, marginalised and underserved population remains challenging. Despite international guidelines recommending that prisons are a priority location for HCV screening and treatment levels of prisoner engagement in HCV care remain low. Competing priorities between security and healthcare is a key feature of prison health care. A collaborative approach to health care delivery in prisons can maximise the benefits for prisoners, staff and the wider community. AIM To identify the barriers and enablers to HCV screening and treatment in Irish prisons and inform the implementation of a HCV screening program within the Irish Prison Services (IPS). METHODS Qualitative study using focus group methodology underpinned by grounded theory. RESULTS The following themes emerged from the analysis: priority of safety and security, staffing and resources, concerns about personal risk, lack of knowledge, concerns around confidentiality, prisoners' fear of treatment and stigma, timing of screening, use of peer workers, in-reach hepatology and fibroscanning services. The primary role of prison security is to ensure the safety of staff and prisoners with a secondary but important supporting role in health care delivery. Maintaining adequate staffing levels and the provision of training and education were seen as priorities and impacted on prison officers' fear for personal safety and risk of HCV transmission. Opt-out screening and peer support workers had high levels of support among participants. CONCLUSION Upscaling HCV management in prisons requires an in-depth understanding of all barriers and facilitators to HCV screening and treatment. Engaging prison officers in the planning and delivery of health care initiatives is a key strategy to optimising the public health opportunity that prisons provides.
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Affiliation(s)
- D. Crowley
- Irish College of General Practitioners, Lincoln Place, Dublin, Ireland
| | - M. C. Van Hout
- Public Health Institute, Liverpool John Moore’s University, Liverpool, UK
| | - C. Murphy
- Irish Prison Service, Mountjoy Prison, Dublin 7, Ireland
| | - E. Kelly
- Irish Prison Service, Mountjoy Prison, Dublin 7, Ireland
| | - J. S. Lambert
- Department of Infectious Diseases, School of Medicine, University College Dublin, Mater Misericordiae University Hospital, Dublin, Ireland
- School of Medicine, University College Dublin, Dublin, Ireland
| | - W. Cullen
- School of Medicine, University College Dublin, Dublin, Ireland
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29
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Bourey C, Stephenson R, Bautista-Arredondo S. Syndemic Vulnerability and Condomless Sex Among Incarcerated Men in Mexico City: A Latent Class Analysis. AIDS Behav 2018; 22:4019-4033. [PMID: 29968142 DOI: 10.1007/s10461-018-2216-0] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In order to address common statistical and population-based limitations in epidemiological literature applying syndemic theory, this study uses latent class analysis (LCA) to explore how health and social problems coalesce and shape sexual risk behaviors linked to HIV transmission in three Mexico City prisons. Among the studied male inmates, LCA identified four classes, defined by low syndemic risk (61.4%); marijuana (14.3%); depression, substances, and trauma (19.7%); and depression, substances, and marijuana (4.7%). In multinomial regression models, classes with a greater number of syndemic exposures were associated with increased odds of condomless anal sex during incarceration. In analyses stratified by pre-incarceration sexual risk behaviors, however, high syndemic burden classes were associated with condomless anal sex during incarceration differently. Overall, the study findings suggest that LCA has potential utility for syndemic analyses and highlight the need to attend to health and social adversities when addressing sexual risk behaviors and HIV transmission during incarceration.
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30
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Marotta PL, Terlikbayeva A, Gilbert L, Hunt T, Mandavia A, Wu E, El-Bassel N. Intimate relationships and patterns of drug and sexual risk behaviors among people who inject drugs in Kazakhstan: A latent class analysis. Drug Alcohol Depend 2018; 192:294-302. [PMID: 30304712 PMCID: PMC6415908 DOI: 10.1016/j.drugalcdep.2018.07.046] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/14/2018] [Revised: 06/28/2018] [Accepted: 07/26/2018] [Indexed: 12/27/2022]
Abstract
BACKGROUND Multiple drug and sexual risk behaviors among people who inject drugs (PWID) in intimate relationships increase the risk of HIV and HCV transmission. Using data on PWID in intimate partnerships in Almaty, Kazakhstan, this study performed latent class analysis (LCA) on drug and sexual risk behaviors and estimated associations between dyadic relationship factors and membership in latent classes. METHODS LCA was performed on a sample of 510 PWID (181-females/FWID, 321-males/MWID) to identify levels of drug and sexual risk behaviors. Generalized structural equation modeling with multinomial regressions estimated associations between relationship factors (length risk reduction communication, risk reduction self-efficacy) and class membership after adjusting for substance use severity, overdose, depression, binge drinking, intimate partner violence, structural factors, and sociodemographic characteristics. Models were sex-stratified to include FWID and PWID. RESULTS A 3-class model best fit the data and consisted of low, medium, and high-risk classes. GSEM found that greater injection self-efficacy was associated with a lower likelihood of membership in the high-risk class for PWID and FWID. For MWID, greater length of the relationship was associated with a lower likelihood of membership in the medium-risk class. Greater relationship communication was associated with increased risk of membership in the high-risk latent class for MWID. CONCLUSIONS Future research must investigate if increasing risk reduction and safe sex self-efficacy could reduce drug and sexual risk behaviors and HIV transmission among PWID and their intimate partners. Interventions are needed that reduce power inequities within relationships as a method of increasing self-efficacy, particularly among women.
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Affiliation(s)
- Phillip L. Marotta
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Social Intervention Group, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Global Research Center of Central Asia, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Assel Terlikbayeva
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Social Intervention Group, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Global Research Center of Central Asia, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Louisa Gilbert
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Social Intervention Group, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Global Research Center of Central Asia, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Tim Hunt
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Social Intervention Group, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Global Research Center of Central Asia, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Amar Mandavia
- Teachers College of Columbia University, Department of Counseling and Clinical Psychology, 428 Horace Mann, New York, NY, 10027, USA,Center for the Study of Social Difference, Columbia University, 1200 Amsterdam Avenue, 767 Schermerhorn Extension, MC 5508, New York, NY 10027, USA
| | - Elwin Wu
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Social Intervention Group, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Global Research Center of Central Asia, 1255 Amsterdam Avenue, New York, NY, 10027, USA
| | - Nabila El-Bassel
- Columbia University School of Social Work, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Social Intervention Group, 1255 Amsterdam Avenue, New York, NY, 10027, USA,Global Research Center of Central Asia, 1255 Amsterdam Avenue, New York, NY, 10027, USA
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Stewart AC, Cossar R, Dietze P, Armstrong G, Curtis M, Kinner SA, Ogloff JRP, Kirwan A, Stoové M. Lifetime prevalence and correlates of self-harm and suicide attempts among male prisoners with histories of injecting drug use. HEALTH & JUSTICE 2018; 6:19. [PMID: 30324532 PMCID: PMC6755595 DOI: 10.1186/s40352-018-0077-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/12/2018] [Accepted: 10/01/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND Histories of self-harm and suicide attempts are common among people in prison in Australia, and substance dependence is an established risk factor for these lifetime experiences. We describe the prevalence of self-reported history of non-suicidal self-injury (NSSI) and suicide attempts in a cohort of men with recent histories of injecting drug use (IDU) imprisoned in Victoria, Australia. Baseline interviews from the Prison and Transition Health (PATH) prospective cohort study were conducted in the weeks prior to release from prison among 400 incarcerated men who reported regular IDU in the six months prior to incarceration. RESULTS Participants completed a researcher-administered structured questionnaire that collected information on sociodemographics, substance use patterns, and physical and mental health indicators. More than one third (37%) reported a history of NSSI and almost half of participants (47%) reported a history of suicide attempts. In multivariable Poisson regression models, a history of NSSI was associated with: being aged 30-39 years; moving accommodation three or more times in the year prior to current sentence; self-reporting a history of mental illness diagnosis; current poor psychiatric well-being; and self-reporting three or more previous drug overdoses. History of suicide attempts was significantly associated with: self-reporting a history of mental illness diagnosis; current poor psychiatric well-being; and self-reporting a history of 1-2 and > 3 drug overdoses. CONCLUSION We observed a disconcertingly high lifetime prevalence of non-suicidal self-injury and suicide attempts among incarcerated males with a history of recent regular injecting drug use. Significant associations with indicators of mental illness and drug related harms support the need to prioritise in-prison screening and early intervention to reduce the risk of future harms for this population.
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Affiliation(s)
- Ashleigh C. Stewart
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC Australia
| | - Reece Cossar
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC Australia
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, VIC Australia
| | - Paul Dietze
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC Australia
| | - Gregory Armstrong
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC Australia
| | - Michael Curtis
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC Australia
| | - Stuart A. Kinner
- Nossal Institute for Global Health, Melbourne School of Population and Global Health, The University of Melbourne, Melbourne, VIC Australia
- Centre for Adolescent Health, Murdoch Children’s Research Institute, The Royal Children’s Hospital Melbourne, Parkville, VIC Australia
- Griffith Criminology Institute, Griffith University, Mt Gravatt, QLD Australia
- Mater Research Institute-UQ, The University of Queensland, QLD, Brisbane, Australia
| | - James R. P. Ogloff
- Centre for Forensic Behavioural Science, Swinburne University of Technology and Forensicare, Melbourne, VIC Australia
| | - Amy Kirwan
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC Australia
| | - Mark Stoové
- Behaviours and Health Risks, Burnet Institute, Melbourne, VIC Australia
- School of Public Health and Preventative Medicine, Monash University, Melbourne, VIC Australia
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32
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Marotta PL, Gilbert L, Terlikbayeva A, Wu E, El-Bassel N. Differences by sex in associations between injection drug risks and drug crime conviction among people who inject drugs in Almaty, Kazakhstan. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2018; 60:96-106. [PMID: 30219718 PMCID: PMC6340710 DOI: 10.1016/j.drugpo.2018.07.014] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/22/2017] [Revised: 06/15/2018] [Accepted: 07/16/2018] [Indexed: 01/18/2023]
Abstract
BACKGROUND The criminalization of drug use leads to high rates of drug crime convictions for engaging in injection drug use behaviors, introducing barriers to HIV prevention and drug treatment for PWID. Females (FWID) face unique vulnerabilities to HIV compared to males (MWID) in Kazakhstan. This study examined sex differences in associations between HIV/HCV infection, HIV knowledge, injection drug risk behaviors, and conviction for a drug crime in a sample of people who inject drugs (PWID) in Almaty, Kazakhstan. METHODS Analyses were performed on baseline data from 510 PWID and stratified by males (MWID) (329) and females (FWID) (181) from Kazakhstan in a couples-focused HIV prevention intervention. Logistic regression analyses using mixed effects (AOR) examined associations between HIV/HCV infection, HIV knowledge, injection drug risk behaviors, drug use severity, drug treatment history and conviction for a drug crime. RESULTS About three quarters of PWID reported drug crime conviction (73.92%, n = 377). HCV infection was associated with increased odds of drug crime conviction for FWID (AOR = 4.35, CI95 = 1.83-10.31, p < .01) and MWID (AOR = 3.62, CI95 = 1.09-12.07, p < .01). HIV transmission knowledge was associated with increased odds of conviction for MWID (AOR = 1.19, CI95 = 1.00-1.41, p < .05). Injection drug risk knowledge was associated with lower odds of conviction (AOR = .75, CI95 = .59-.94, p < .05) for FWID. Receptive syringe sharing (AOR = 3.48, CI95 = 1.65-7.31, p < .01), splitting drug solutions (AOR = 4.12, CI95 = 1.86-7.31, p < .05), and injecting with more than two partners (AOR = 1.89, CI95 = 1.06-3.34, p < .05) was associated with increased odds of conviction for FWID. Receptive syringe or equipment sharing with intimate partners was associated with conviction for both MWID (AOR = 1.90, CI95 = 1.03-3.92, p < .05) and FWID (AOR = 1.95, CI95 = 1.02-3.70, p < .05). For FWID, injection drug use in public spaces was associated with conviction (AORME = 3.25, CI95 = 1.31-7.39, p < .01). Drug use severity was associated with increased odds of conviction for FWID (AOR = 1.29, CI95 = 1.09-1.53, p < .001) and MWID (AOR = 1.24, CI95 = 1.09-1.41, p < .001). Ever receiving drug treatment was associated with conviction for MWID (AOR = 2.31, CI95 = 1.32-4.12, p < .01). CONCLUSION High-risk behaviors, HCV infection and more severe substance use disorders are associated with drug crime conviction for PWID, particularly FWID. Structural interventions are necessary to increase the engagement of PWID with drug crime convictions in HIV prevention and substance abuse treatment.
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Affiliation(s)
| | - Louisa Gilbert
- Columbia University, United States; Global Research Center of Central Asia, Kazakhstan; Social Intervention Group, United States
| | | | - Elwin Wu
- Columbia University, United States; Global Research Center of Central Asia, Kazakhstan; Social Intervention Group, United States
| | - Nabila El-Bassel
- Columbia University, United States; Global Research Center of Central Asia, Kazakhstan; Social Intervention Group, United States
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Golrokhi R, Farhoudi B, Taj L, Pahlaviani FG, Mazaheri-Tehrani E, Cossarizza A, SeyedAlinaghi S, Mohraz M, Voltarelli FA. HIV Prevalence and Correlations in Prisons in Different Regions of the World: A Review Article. Open AIDS J 2018; 12:81-92. [PMID: 30369993 PMCID: PMC6176549 DOI: 10.2174/1874613601812010081] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2018] [Revised: 08/10/2018] [Accepted: 08/20/2018] [Indexed: 02/08/2023] Open
Abstract
The prevalence of HIV is substantially higher among prisoners than the general population, while the incidence varies considerably in different regions around the world. If we consider Sub-Saharan Africa as one region with the highest prevalence of HIV, data on African prisoners would be limited. Despite the low prevalence of HIV in the Middle East and North Africa, its incidence is rising in these regions with a few exceptions; there are insufficient data on HIV prevalence in prisons. A similar situation is present in both Pacific and Central Asia as well as in Eastern Europe. A high rate of infection is mainly observed among prisoners in Western and Central parts of Europe, since the data from these are more available than other parts. Nowadays, the sexual transmission mode and tattooing are important ways in HIV risks among prisoners after injecting drug use as the most common route of HIV transmission in all regions. However, it is difficult to compare and analyze the prevalence of HIV among prisoners in different regions regarding the limited data and different methods which they used in collecting data. Eventually, it can certainly be said that prisons are one of the high-risk places for HIV transmission; on the other hand, can be a suitable place for implementing HIV case-finding, linkage to treatment and harm reduction programs.
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Affiliation(s)
- Raheleh Golrokhi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Behnam Farhoudi
- Clinical Research Development Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iran
| | - Leila Taj
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fatemeh Golsoorat Pahlaviani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Elham Mazaheri-Tehrani
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Andrea Cossarizza
- University of Modena and Reggio Emilia School of Medicine, Modena, Italy
| | - SeyedAhmad SeyedAlinaghi
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Minoo Mohraz
- Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran
| | - Fabrício Azevedo Voltarelli
- Federal University of Mato Grosso, Graduation Program in Health Sciences, Faculty of Medicine, Cuiabá, Brazil
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Keehn EN, Nevin A. Health, Human Rights, and the Transformation of Punishment: South African Litigation to Address HIV and Tuberculosis in Prisons. Health Hum Rights 2018; 20:213-224. [PMID: 30008564 PMCID: PMC6039737] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
South Africa experiences the world's highest HIV burden and one of the highest burdens for tuberculosis (TB). People in prison are particularly vulnerable to these diseases. Globally, and internally in South Africa, increased attention is being paid to HIV and TB treatment and prevention in prisons, with the public health community arguing for reforms that improve respect for the human rights of incarcerated people, for example, by calling for the reduction of overcrowding and unnecessary incarceration. Despite the retributive rhetoric that is popular among politicians and the public, the constitution mandates and recognizes the right of people in prison to humane and dignified conditions of detention. These values are diffused through law and policy, supported by an independent judiciary, and monitored by a small but vigilant prisons-focused human rights community. These factors enable the courts to make decisions that facilitate systemic improvements in prison conditions-counter to popular sentiment favoring punitive measures-and increase access to HIV and TB services in detention. This article examines a series of strategic litigation cases that illustrate this process of change to remedy disease-inducing and rights-violating conditions in South African prisons.
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Affiliation(s)
- Emily Nagisa Keehn
- Associate director of the Academic Program at Harvard Law School’s Human Rights Program in Cambridge, MA, USA
| | - Ariane Nevin
- National prisons specialist at Sonke Gender Justice in Cape Town, South Africa
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Bielen R, Stumo SR, Halford R, Werling K, Reic T, Stöver H, Robaeys G, Lazarus JV. Harm reduction and viral hepatitis C in European prisons: a cross-sectional survey of 25 countries. Harm Reduct J 2018; 15:25. [PMID: 29751763 PMCID: PMC5948815 DOI: 10.1186/s12954-018-0230-1] [Citation(s) in RCA: 44] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2018] [Accepted: 04/17/2018] [Indexed: 12/15/2022] Open
Abstract
Background Current estimates suggest that 15% of all prisoners worldwide are chronically infected with the hepatitis C virus (HCV), and this number is even higher in regions with high rates of injecting drug use. Although harm reduction services such as opioid substitution therapy (OST) and needle and syringe programs (NSPs) are effective in preventing the further spread of HCV and HIV, the extent to which these are available in prisons varies significantly across countries. Methods The Hep-CORE study surveyed liver patient groups from 25 European countries in 2016 and mid-2017 on national policies related to harm reduction, testing/screening, and treatment for HCV in prison settings. Results from the cross-sectional survey were compared to the data from available reports and the peer-reviewed literature to determine the overall degree to which European countries implement evidence-based HCV recommendations in prison settings. Results Patient groups in nine countries (36%) identified prisoners as a high-risk population target for HCV testing/screening. Twenty-one countries (84%) provide HCV treatment in prisons. However, the extent of coverage of these treatment programs varies widely. Two countries (8%) have NSPs officially available in prisons in all parts of the country. Eleven countries (44%) provide OST in prisons in all parts of the country without additional requirements. Conclusion Despite the existence of evidence-based recommendations, infectious disease prevention measures such as harm reduction programs are inadequate in European prison settings. Harm reduction, HCV testing/screening, and treatment should be scaled up in prison settings in order to progress towards eliminating HCV as a public health threat.
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Affiliation(s)
- Rob Bielen
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium
| | - Samya R Stumo
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer del Roselló, 132, 4th, ES-08036, Barcelona, Spain
| | | | - Klára Werling
- 2nd Department of Internal Medicine, Semmelweis University, Budapest, Hungary
| | - Tatjana Reic
- European Liver Patients' Association (ELPA), Brussels, Belgium
| | - Heino Stöver
- Institute for Addiction Research, Frankfurt University of Applied Sciences, Frankfurt, Germany
| | - Geert Robaeys
- Faculty of Medicine and Life Sciences, Hasselt University, Hasselt, Belgium.,Department of Gastroenterology and Hepatology, Ziekenhuis Oost Limburg, Genk, Belgium.,Department of Gastroenterology and Hepatology, University Hospitals KU Leuven, Leuven, Belgium
| | - Jeffrey V Lazarus
- Barcelona Institute for Global Health (ISGlobal), Hospital Clínic, University of Barcelona, Carrer del Roselló, 132, 4th, ES-08036, Barcelona, Spain. .,CHIP, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.
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36
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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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Marotta P. Exploring Relationships Between Delinquent Peer Groups, Participation in Delinquency, Substance Abuse, and Injecting Drug Use Among the Incarcerated: Findings From a National Sample of State and Federal Inmates in the United States. JOURNAL OF DRUG ISSUES 2017; 47:320-339. [PMID: 28966393 DOI: 10.1177/0022042617690234] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
The following study assesses the relationship between affiliating with delinquent peer groups, participation in delinquency, and several substance misuse and injecting drug use outcomes in a nationally representative sample of inmates in state and federal facilities in the United States. After controlling for potential confounders, affiliating with peers who engaged in deviant behaviors and participation in delinquency was associated with onset of alcohol and illicit drug use, substance dependence, alcohol dependence, types of substances used, and injecting drug use outcomes. Inmates who began engaging in delinquency at older ages reported initiating drug and alcohol use at older ages, and were less likely to meet the criteria for drug abuse or dependence, less likely to use substances daily or near daily, and less likely to report having ever injected or shared syringes. The implications of these findings for substance abuse, HIV, and crime prevention interventions are discussed.
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Harawa NT, Amani B, Rohde Bowers J, Sayles JN, Cunningham W. Understanding interactions of formerly incarcerated HIV-positive men and transgender women with substance use treatment, medical, and criminal justice systems. THE INTERNATIONAL JOURNAL OF DRUG POLICY 2017; 48:63-71. [PMID: 28804052 PMCID: PMC5620016 DOI: 10.1016/j.drugpo.2017.05.013] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2016] [Revised: 03/25/2017] [Accepted: 05/02/2017] [Indexed: 01/07/2023]
Abstract
BACKGROUND Low levels of medical care engagement have been noted for HIV-positive people leaving systems of incarceration in the United States. Substance misuse frequently co-occurs with criminal justice involvement in individuals who are living with HIV. METHODS We analyzed data from in-depth interviews with 19 HIV-positive individuals who were currently or formerly incarcerated in order to elucidate challenges faced in accessing care and maintaining HIV treatment regimens when cycling out of (and often back into) custody. Our thematic analysis used an ecosocial framework to describe participants' shifts between substance use treatment, medical care, and criminal justice systems. RESULTS Dominant themes included the dramatic increase in HIV-treatment-related autonomy required following release from jail because of differences in care delivery between custody-based and community-based care systems; the important, but temporary stabilization provided by residential substance use treatment programmes; and the inconsistency of substance use treatment approaches with chronic care models of disease management. CONCLUSION Enhanced integration of criminal justice, medical care, and substance use treatment institutions in planning for reentry of HIV populations may ease the impact of the dramatic shifts in context that often dissuade linkage and retention. This integration should include coordination with custody release processes, periodic assessments for active substance misuse in HIV treatment settings, support for (re)establishing health-promoting social networks, and options for long-term, residential substance use treatment programmes.
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Affiliation(s)
- Nina T Harawa
- David Geffen School of Medicine at UCLA, Department of Medicine; 911 Broxton Avenue, 1st Floor, Los Angeles, CA 90024, United States; Charles R. Drew University, Department of Psychiatry and Human Behavior, 1731 E. 120th Street, Los Angeles, CA 90059, United States.
| | - Bita Amani
- Charles R. Drew University, Masters of Public Health Program, 1731 E. 120th Street, Los Angeles, CA 90059, United States
| | - Jane Rohde Bowers
- County of Los Angeles, Department of Health Services, Division of HIV and STD Programs, 600 S. Commonwealth Ave., 19th Floor, Los Angeles, CA 90005, United States
| | - Jennifer N Sayles
- Inland Empire Health Plan, 10801 Sixth Street, Suite 120, Rancho Cucamonga, CA 91729, United States
| | - William Cunningham
- David Geffen School of Medicine at UCLA, Department of Medicine; 911 Broxton Avenue, 1st Floor, Los Angeles, CA 90024, United States; UCLA Fielding School of Public Health, Department of Health Policy and Management, 650 Charles E. Young Dr. South, 16-035 Center for Health Sciences, Los Angeles, CA 90095-1772, United States
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Lindbom SJA, Larsson M, Agardh A. The naked truth about HIV and risk taking in Swedish prisons: A qualitative study. PLoS One 2017; 12:e0182237. [PMID: 28759572 PMCID: PMC5536296 DOI: 10.1371/journal.pone.0182237] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/25/2016] [Accepted: 07/12/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND This qualitative study explores former prison inmates' perceptions and attitudes towards HIV risk inside Swedish prisons. METHOD In 2014, eight semi-structured interviews were conducted with former male prisoners to gain a deeper understanding of situations perceived to be associated with risk of HIV transmission. The material gathered from the interviews was analyzed by manifest and latent qualitative content analysis. RESULTS The findings revealed that risky behavioral practices, such as sharing needles, unprotected sexual activity, and lack of openness about HIV status represented potential health threats with regard to the risk of HIV transmission. CONCLUSIONS Evidence from the study indicates that educational interventions regarding HIV and the transmission routes are required for HIV prevention in Swedish prisons.
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Affiliation(s)
- Sigrid J. A. Lindbom
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Markus Larsson
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
- * E-mail:
| | - Anette Agardh
- Social Medicine and Global Health, Department of Clinical Sciences, Lund University, Malmö, Sweden
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Stone J, Martin NK, Hickman M, Hutchinson SJ, Aspinall E, Taylor A, Munro A, Dunleavy K, Peters E, Bramley P, Hayes PC, Goldberg DJ, Vickerman P. Modelling the impact of incarceration and prison-based hepatitis C virus (HCV) treatment on HCV transmission among people who inject drugs in Scotland. Addiction 2017; 112:1302-1314. [PMID: 28257600 PMCID: PMC5461206 DOI: 10.1111/add.13783] [Citation(s) in RCA: 74] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Revised: 10/05/2016] [Accepted: 02/01/2017] [Indexed: 01/02/2023]
Abstract
BACKGROUND AND AIMS People who inject drugs (PWID) experience high incarceration rates, and previous incarceration is associated with elevated hepatitis C virus (HCV) transmission risk. In Scotland, national survey data indicate lower HCV incidence in prison than the community (4.3 versus 7.3 per 100 person-years), but a 2.3-fold elevated transmission risk among recently released (< 6 months) PWID. We evaluated the contribution of incarceration to HCV transmission among PWID and the impact of prison-related prevention interventions, including scaling-up direct-acting antivirals (DAAs) in prison. DESIGN Dynamic mathematical modelling of incarceration and HCV transmission, using approximate Bayesian computation for model calibration. SETTING Scotland, UK. PARTICIPANTS A simulated population of PWID. MEASUREMENTS Population-attributable fraction (PAF) of incarceration to HCV transmission among PWID. Decrease in HCV incidence and chronic prevalence due to current levels of prison opiate substitution therapy (OST; 57% coverage) and HCV treatment, as well as scaling-up DAAs in prison and/or preventing the elevated risk associated with prison release. FINDINGS Incarceration contributes 27.7% [PAF; 95% credible interval (CrI) -3.1 to 51.1%] of HCV transmission among PWID in Scotland. During the next 15 years, current HCV treatment rates (10.4/6.8 per 1000 incarcerated/community PWID annually), with existing prison OST, could reduce incidence and chronic prevalence among all PWID by a relative 10.7% (95% CrI = 8.4-13.3%) and 9.7% (95% CrI = 7.7-12.1%), respectively. Conversely, without prison OST, HCV incidence and chronic prevalence would decrease by 3.1% (95% CrI = -28.5 to 18.0%) and 4.7% (95% CrI = -11.3 to 14.5%). Additionally, preventing the heightened risk among recently released PWID could reduce incidence and chronic prevalence by 45.0% (95% CrI = 19.7-57.5%) and 33.3% (95% CrI = 15.6-43.6%) or scaling-up prison HCV treatments to 80% of chronic PWID prison entrants with sufficient sentences (>16 weeks) could reduce incidence and prevalence by 45.6% (95% CrI = 38.0-51.3%) and 45.5% (95% CrI = 39.3-51.0%), respectively. CONCLUSIONS Incarceration and the elevated transmission risk following prison release can contribute significantly to hepatitis C virus transmission among people who inject drugs. Scaling-up hepatitis C virus treatment in prison can provide important prevention benefits.
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Affiliation(s)
- Jack Stone
- School of Social and Community MedicineUniversity of Bristol, BristolUK
| | - Natasha K. Martin
- School of Social and Community MedicineUniversity of Bristol, BristolUK,Division of Global Public HealthUniversity of California San DiegoSan DiegoCAUSA
| | - Matthew Hickman
- School of Social and Community MedicineUniversity of Bristol, BristolUK
| | - Sharon J. Hutchinson
- School of Health and Life SciencesGlasgow Caledonian University, GlasgowUK,Health Protection ScotlandGlasgowUK
| | - Esther Aspinall
- School of Health and Life SciencesGlasgow Caledonian University, GlasgowUK,Health Protection ScotlandGlasgowUK
| | - Avril Taylor
- School of Media, Culture and SocietyUniversity of the West of Scotland, PaisleyUK
| | - Alison Munro
- School of Media, Culture and SocietyUniversity of the West of Scotland, PaisleyUK
| | - Karen Dunleavy
- School of Media, Culture and SocietyUniversity of the West of Scotland, PaisleyUK
| | | | - Peter Bramley
- NHS Forth Valley Viral Hepatitis Service, StirlingUK
| | - Peter C. Hayes
- Division of Health SciencesRoyal Infirmary Edinburgh, EdinburghUK
| | - David J. Goldberg
- School of Health and Life SciencesGlasgow Caledonian University, GlasgowUK,Health Protection ScotlandGlasgowUK
| | - Peter Vickerman
- School of Social and Community MedicineUniversity of Bristol, BristolUK
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Hessou S, Dougnon V, Glele-Ahanhanzo Y, Imorou BCA, Ahoussinou C, Legba B, Zannou DM, Baba-Moussa L. A Behavioral and Serological Survey on HIV Prevalence Among Prisoners in Benin. J Public Health Afr 2017; 8:678. [PMID: 28878871 PMCID: PMC5575451 DOI: 10.4081/jphia.2017.678] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2017] [Accepted: 06/10/2017] [Indexed: 11/28/2022] Open
Abstract
Cases of HIV are common in Benin, with infection rates varying according to socioeconomic and cultural factors, and by region. Certain segments of the population, such as prison inmates, sex worker clients and truck drivers are at high risk for HIV/AIDS. The aim of this study is to identify which behavioral and serological indicators contribute to the spread of HIV among prisoners. A total of 496 inmates from prisons located in all major cities in Benin were surveyed. Data was collected through interview sessions carried out using a questionnaire and through blood samples. The results show that most inmates are Beninese (83.5%), and the average age is 33 years (range: 14-80 years). No prisoner reported using a condom the last time they engaged in sexual intercourse. Blood exposure was found in 14.6% of inmates and HIV was detected in 1.4% of cases. Our analysis indicates that the length of detention and gender are factors that influence HIV status. However, age, education, nationality and HIV awareness had no significant effect on HIV prevalence among inmates. The results highlight the need to raise awareness in prisons about HIV. This can be achieved by strengthening communication strategies and by organizing HIV and sexually transmitted diseases information sessions for both prison officers and inmates.
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Affiliation(s)
- S Hessou
- National Reference Center for the Research and Management of AIDS, Benin
| | - V Dougnon
- Research Unit, Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin
| | - Y Glele-Ahanhanzo
- Regional Institute of Public Health, University of Abomey-Calavi, Benin
| | - B C A Imorou
- National Program for the Fight Against AIDS in Benin, Ministry of Health, Benin
| | | | - B Legba
- Research Unit, Microbiology and Pharmacology of Natural Substances, Research Laboratory in Applied Biology, Polytechnic School of Abomey-Calavi, University of Abomey-Calavi, Benin.,Laboratory of Biology and Molecular Typing in Microbiology, University of Abomey-Calavi, Benin
| | - D M Zannou
- National Reference Center for the Research and Management of AIDS, Benin
| | - L Baba-Moussa
- Laboratory of Biology and Molecular Typing in Microbiology, University of Abomey-Calavi, Benin
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Augusto Â, Augusto O, Taquimo A, Nhachigule C, Siyawadya N, Tembe N, Bhatt N, Mbofana F, Gudo ES. First description of HTLV-1/2 seroprevalence in HIV-infected inmates in Mozambique. J Med Virol 2017; 89:1498-1502. [PMID: 28240367 DOI: 10.1002/jmv.24801] [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: 07/05/2016] [Accepted: 01/24/2017] [Indexed: 11/10/2022]
Abstract
No study has yet been conducted to estimate the burden of co-infection of HIV and HTLV-1/2 in inmates in sub-Saharan Africa. To investigate prevalence of co-infection in inmates in Mozambique, a total of 2140 inmates were screened for HIV, of which 515 were HIV seropositive. All HIV seropositive inmates were further screened for HTLV infection, and eight (1.55%) were co-infected. Co-infection was higher in females (3.45% [2/58; CI: 0.42-11.91]) as compared to males (1.35% [6/445; CI: 0.55-3.06]). Early screening of HTLV in prisons is urgently needed in Mozambique in order to improve the care provided to incarcerated individuals, including initiation of ART.
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Affiliation(s)
- Ângelo Augusto
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Orvalho Augusto
- Faculdade de Medicina, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Atija Taquimo
- Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Carina Nhachigule
- Departamento de Ciências Biológicas, Faculdade de Ciências, Universidade Eduardo Mondlane, Maputo, Mozambique
| | - Narcisa Siyawadya
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Nelson Tembe
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Nilesh Bhatt
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
| | - Francisco Mbofana
- Direcção Nacional de Saúde Pública, Ministério da Saúde, Maputo, Mozambique
| | - Eduardo Samo Gudo
- Instituto Nacional de Saúde, Ministério da Saúde, Maputo, Mozambique
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Koirala S, Deuba K, Nampaisan O, Marrone G, Ekström AM. Facilitators and barriers for retention in HIV care between testing and treatment in Asia-A study in Bangladesh, Indonesia, Lao, Nepal, Pakistan, Philippines and Vietnam. PLoS One 2017; 12:e0176914. [PMID: 28459881 PMCID: PMC5411091 DOI: 10.1371/journal.pone.0176914] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/29/2016] [Accepted: 04/06/2017] [Indexed: 11/18/2022] Open
Abstract
Introduction The need for efficient retention in HIV care is more evident than ever because of the expansion of earlier ART initiation and the shift towards ‘Test and Treat’. This study assesses factors affecting participation in the HIV care cascade among people living with HIV (PLHIV) in the Asia-Pacific Region. Methods A total of 7843 PLHIV aged 18–50 years were recruited using targeted and venue-based sampling between October 1, 2012, and May 31, 2013, across 59 sites in 7 countries (Bangladesh, Indonesia, Lao People's Democratic Republic (Lao PDR), Nepal, Pakistan, Philippines and Vietnam). Statistically significant associations between demographic and health system determinants, and various steps in the HIV care cascade were computed using a generalized structural equation model. Results A high proportion of PLHIV (40–51%) presented late for HIV care and delayed linkage to care in all seven countries. However, once PLHIV enrolled in care, retention in the various steps of the care cascade including adherence to antiretroviral treatment (ART) was satisfactory. The proportion still engaged in HIV care at 36 months post HIV diagnosis, varied from 78% in Nepal to >90% in Lao PDR. Similarly, the proportion of ART initiation who also were adherent to ART ranged from 91% in Bangladesh to >95% in Philippines/ Vietnam and from 70% in Lao PDR to 89% in the Philippines respectively. The following factors enhanced the likelihood of ART initiation and high adherence to HIV care and ART: good client-provider communication, high HIV treatment literacy, a referral from a health worker and TB/HIV co-infection. The following barriers were identified: young age, sex work, imprisonment, transgender identity, illiteracy, rural residence, alcohol/ injecting drug use, perceived poor health status, lack of health insurance, fear of confidentiality breach, self-referral for HIV testing, and public hospital as the place of HIV diagnosis. Conclusions HIV programme planners should ensure easy access to HIV testing and earlier linkage to HIV care among PLHIV. In addition, multiple socio-economic and health systems barriers need to be addressed along the HIV care cascade to reach the UNAIDS 90-90-90 target in the Asia-Pacific region.
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Affiliation(s)
- Sushil Koirala
- Asia Pacific Network of People Living with HIV/AIDS, Bangkok, Thailand
| | - Keshab Deuba
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- * E-mail:
| | - Oranuch Nampaisan
- Asia Pacific Network of People Living with HIV/AIDS, Bangkok, Thailand
| | - Gaetano Marrone
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
| | - Anna Mia Ekström
- Department of Public Health Sciences, Karolinska Institutet, Stockholm, Sweden
- Department of Infectious Diseases, Huddinge, Karolinska University Hospital, Stockholm, Sweden
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Handanagic S, Sevic S, Barbaric J, Dominkovic Z, Dakovic Rode O, Begovac J, Bozicevic I. Correlates of anti-hepatitis C positivity and use of harm reduction services among people who inject drugs in two cities in Croatia. Drug Alcohol Depend 2017; 171:132-139. [PMID: 28088084 DOI: 10.1016/j.drugalcdep.2016.11.028] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2016] [Revised: 11/21/2016] [Accepted: 11/21/2016] [Indexed: 01/10/2023]
Abstract
BACKGROUND We assessed correlates of anti-hepatitis C (anti-HCV) positivity and utilization of needle and syringe exchange programs (NSEP) and opioid agonist treatment (OAT) among people who inject drugs (PWID) in two Croatian cities. METHODS We conducted a cross-sectional study using respondent-driven (RDS) sampling among PWID in Rijeka (N=255) and Split (N=399). We used RDS-weighted population estimates and multivariable logistic regression to explore correlates of anti-HCV positivity and NSEP and OAT utilization. RESULTS Seventy-eight percent (78.0%) of PWID in Rijeka and 61.5% in Split had been tested previously for HCV, while 21.5% and 7.0%, respectively, were tested for HCV in the past 12 months. Among PWID who report being infected with HCV, 24.9% in Rijeka and 11.3% in Split received anti-HCV treatment. In Rijeka, PWID who utilized NSEP and, in Split, those who were ever imprisoned, had higher odds of anti-HCV positivity. In Rijeka, PWID on OAT were more likely to use non-sterile injecting equipment and to inject for longer than 10 years. PWID enrolled in NSEP were more likely to inject opioid agonist medication (OAM) and less likely to use non-sterile injecting equipment. More than half of PWID reported misuse of OAM in the past month, while out of PWID enrolled in OAT, 65.4% in Rijeka and 88.7% in Split injected OAM in the month prior to the survey. CONCLUSIONS Key findings of the paper point to the need to scale up HCV testing and treatment, improve access to NSEP and the quality of OAT provisions in order to prevent its misuse among PWID.
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Affiliation(s)
- Senad Handanagic
- WHO Collaborating Centre for HIV Strategic Information, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova ulica 4, 10000 Zagreb, Croatia.
| | - Sandra Sevic
- Department of Sociology, Faculty of Humanities and Social Sciences, University of Zagreb, Ivana Lucica 3, 10000 Zagreb, Croatia.
| | - Jelena Barbaric
- WHO Collaborating Centre for HIV Strategic Information, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova ulica 4, 10000 Zagreb, Croatia.
| | - Zoran Dominkovic
- Non-governmental Organization for Sexual and Gender Minorities Iskorak, Petrinjska ulica 27, 10000 Zagreb, Croatia.
| | - Oktavija Dakovic Rode
- University Hospital for Infectious Diseases "Dr. Fran Mihaljevic", School of Medicine, University of Zagreb, Mirogojska cesta 8, 10000 Zagreb, Croatia.
| | - Josip Begovac
- University Hospital for Infectious Diseases "Dr. Fran Mihaljevic", School of Medicine, University of Zagreb, Mirogojska cesta 8, 10000 Zagreb, Croatia.
| | - Ivana Bozicevic
- WHO Collaborating Centre for HIV Strategic Information, Andrija Stampar School of Public Health, School of Medicine, University of Zagreb, Rockefellerova ulica 4, 10000 Zagreb, Croatia.
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Valera P, Chang Y, Lian Z. HIV risk inside U.S. prisons: a systematic review of risk reduction interventions conducted in U.S. prisons. AIDS Care 2016; 29:943-952. [PMID: 28027663 DOI: 10.1080/09540121.2016.1271102] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
HIV prevalence in correctional populations is approximately five times that of the general adult population. This systematic review examines the broad question of HIV prevention and interventions to reduce inmate HIV-related risk behaviors in U.S. federal and state prisons. We conducted a systematic review of multiple databases and Google Scholar to identify behavioral, biomedical, social, and policy studies related to HIV among U.S. prison populations from 1980-2014. Studies were excluded if they did not focus on HIV, prison inmates, if they were conducted outside of the U.S., if they involved juvenile offenders, or if they included post-release outcomes. Twenty-seven articles met the study criteria. Evidence suggests that research related to the HIV care continuum, risk behaviors, gender, prevention (e.g., peer education), and policy are key topics to enhance HIV prevention interventions in the criminal justice system. This review provides a prison-specific overview of HIV in U.S. correctional populations and highlight effective interventions, including inmate peer education. There is an urgent need to continue to implement HIV prevention interventions across all prisons and improve the quality of life among those at heightened risk of HIV infection.
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Affiliation(s)
- Pamela Valera
- a Nathan Kline Institute for Psychiatric Research , Orangeburg , NY , USA.,b Department of Psychiatry , New York School of Medicine , New York , NY , USA
| | - Yvonne Chang
- c Department of Sociology , McGill University , Montreal , Quebec , Canada
| | - Zi Lian
- d Teachers College, Columbia University , New York , NY , USA
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Nelwan EJ, Isa A, Alisjahbana B, Triani N, Djamaris I, Djaja I, Pohan HT, Zwanikken P, van Crevel R, van der Ven A, Meheus A. Routine or targeted HIV screening of Indonesian prisoners. Int J Prison Health 2016; 12:17-26. [PMID: 26933989 DOI: 10.1108/ijph-04-2015-0012] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
PURPOSE Routine HIV screening of prisoners is generally recommended, but rarely implemented in low-resource settings. Targeted screening can be used as an alternative. Both strategies may provide an opportunity to start HIV treatment but no formal comparisons have been done of these two strategies. The paper aims to discuss these issues. DESIGN/METHODOLOGY/APPROACH The authors compared yield and costs of routine and targeted screening in a narcotic prison in Indonesia. Routine HIV screening was done for all incoming prisoners from August 2007-February 2009, after it was switched for budgetary reasons to targeted ("opt-out") HIV screening of inmates classified as people who inject drugs (PWIDs), and "opt-in" HIV testing for all non-PWIDs. FINDINGS During routine screening 662 inmates were included. All 115 PWIDs and 93.2 percent of non-PWIDs agreed to be tested, 37.4 percent and 0.4 percent respectively were HIV-positive. During targeted screening (March 2009-October 2010), of 888 inmates who entered prison, 107 reported injecting drug use and were offered HIV testing, of whom 31 (29 percent) chose not to be tested and 25.0 percent of those tested were HIV-positive. Of 781 non-PWIDs, 187 (24 percent) came for testing (opt-in), and 2.1 percent were infected. During targeted screening fewer people admitted drug use (12.0 vs 17.4 percent). Routine screening yielded twice as many HIV-infected subjects (45 vs 23). The estimated cost per detected HIV infection was 338 USD for routine and 263 USD for targeted screening. ORIGINALITY/VALUE In a resource limited setting like Indonesia, routine HIV screening in prison is feasible and more effective than targeted screening, which may be stigmatizing. HIV infections that remain unrecognized can fuel ongoing transmission in prison and lead to unnecessary disease progression and deaths.
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Affiliation(s)
- Erni Juwita Nelwan
- Division of Tropical and Infectious Disease, Department of Internal Medicine, Faculty of Medicine, University of Indonesia, Jakarta, Indonesia AND Medical Faculty, Padjadjaran University, Hasan Sadikin Hospital, Health Research Unit, Bandung, Indonesia
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Felisberto M, Saretto AA, Wopereis S, Treitinger A, Machado MJ, Spada C. Prevalence of human immunodeficiency virus infection and associated risk factors among prison inmates in the City of Florianópolis. Rev Soc Bras Med Trop 2016; 49:620-623. [PMID: 27812658 DOI: 10.1590/0037-8682-0187-2016] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2016] [Accepted: 07/08/2016] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION This study aimed to estimate the prevalence of human immunodeficiency virus (HIV) infection among prison inmates and to define the behavioral profile of infected individuals. METHODS: In total, 147 individuals were interviewed and provided biological material. The study population consisted of male individuals who presented at the health unit of the Florianopolis State Penitentiary. RESULTS: The prevalence of HIV infection was 2.1% (95% confidence interval, 0.4-5.8). With respect to the behavioral profile of individuals, no variable showed statistical significance. CONCLUSIONS: The prevalence of HIV infection among prison inmates was higher than that reported for the general population.
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Affiliation(s)
- Mariano Felisberto
- Programa de Pós-graduação em Farmácia, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Antonio Adalberto Saretto
- Unidade Básica de Saúde, Penitenciária Estadual de Florianópolis, Florianópolis, Santa Catarina, Brazil
| | - Sandro Wopereis
- Programa de Pós-graduação em Farmácia, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Arício Treitinger
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Marcos José Machado
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
| | - Celso Spada
- Departamento de Análises Clínicas, Centro de Ciências da Saúde, Universidade Federal de Santa Catarina, Florianópolis, Santa Catarina, Brazil
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Maggard KR, Hatwiinda S, Harris JB, Phiri W, Krüüner A, Kaunda K, Topp SM, Kapata N, Ayles H, Chileshe C, Henostroza G, Reid SE. Screening for tuberculosis and testing for human immunodeficiency virus in Zambian prisons. Bull World Health Organ 2016; 93:93-101. [PMID: 25883402 PMCID: PMC4339958 DOI: 10.2471/blt.14.135285] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 11/11/2014] [Accepted: 11/13/2014] [Indexed: 11/27/2022] Open
Abstract
OBJECTIVE To improve the Zambia Prisons Service's implementation of tuberculosis screening and human immunodeficiency virus (HIV) testing. METHODS For both tuberculosis and HIV, we implemented mass screening of inmates and community-based screening of those residing in encampments adjacent to prisons. We also established routine systems – with inmates as peer educators – for the screening of newly entered or symptomatic inmates. We improved infection control measures, increased diagnostic capacity and promoted awareness of tuberculosis in Zambia's prisons. FINDINGS In a period of 9 months, we screened 7638 individuals and diagnosed 409 new patients with tuberculosis. We tested 4879 individuals for HIV and diagnosed 564 cases of infection. An additional 625 individuals had previously been found to be HIV-positive. Including those already on tuberculosis treatment at the time of screening, the prevalence of tuberculosis recorded in the prisons and adjacent encampments – 6.4% (6428/100,000) – is 18 times the national prevalence estimate of 0.35%. Overall, 22.9% of the inmates and 13.8% of the encampment residents were HIV-positive. CONCLUSION Both tuberculosis and HIV infection are common within Zambian prisons. We enhanced tuberculosis screening and improved the detection of tuberculosis and HIV in this setting. Our observations should be useful in the development of prison-based programmes for tuberculosis and HIV elsewhere.
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Affiliation(s)
- Katie R Maggard
- Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia
| | - Sisa Hatwiinda
- Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia
| | - Jennifer B Harris
- University of Alabama at Birmingham, Birmingham, United States of America
| | - Winifreda Phiri
- Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia
| | - Annika Krüüner
- Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia
| | - Kaunda Kaunda
- Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia
| | - Stephanie M Topp
- University of Alabama at Birmingham, Birmingham, United States of America
| | - Nathan Kapata
- National Tuberculosis and Leprosy Control Programme, Ministry of Health, Lusaka, Zambia
| | - Helen Ayles
- Zambia AIDS Related Tuberculosis Project, Lusaka, Zambia
| | | | - German Henostroza
- University of Alabama at Birmingham, Birmingham, United States of America
| | - Stewart E Reid
- Centre for Infectious Disease Research in Zambia, 5032 Great North Road, PO Box 34681, Lusaka, 10101, Zambia
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Polonsky M, Rozanova J, Azbel L, Bachireddy C, Izenberg J, Kiriazova T, Dvoryak S, Altice FL. Attitudes Toward Addiction, Methadone Treatment, and Recovery Among HIV-Infected Ukrainian Prisoners Who Inject Drugs: Incarceration Effects and Exploration of Mediators. AIDS Behav 2016; 20:2950-2960. [PMID: 27011378 PMCID: PMC5035551 DOI: 10.1007/s10461-016-1375-0] [Citation(s) in RCA: 32] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
In this study, we use data from a survey conducted in Ukraine among 196 HIV-infected people who inject drugs, to explore attitudes toward drug addiction and methadone maintenance therapy (MMT), and intentions to change drug use during incarceration and after release from prison. Two groups were recruited: Group 1 (n = 99) was currently incarcerated and Group 2 (n = 97) had been recently released from prison. This paper's key finding is that MMT treatment and addiction recovery were predominantly viewed as mutually exclusive processes. Group comparisons showed that participants in Group 1 (pre-release) exhibited higher optimism about changing their drug use, were less likely to endorse methadone, and reported higher intention to recover from their addiction. Group 2 participants (post-release), however, reported higher rates of HIV stigma. Structural equation modeling revealed that in both groups, optimism about recovery and awareness of addiction mediated the effect of drug addiction severity on intentions to recover from their addiction.
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Affiliation(s)
- Maxim Polonsky
- Yale University School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Julia Rozanova
- Yale University School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
| | - Lyuba Azbel
- London School of Hygiene and Tropical Medicine, London, UK
| | | | - Jacob Izenberg
- University of California San Francisco School of Medicine, Department of Psychiatry, San Francisco, CA, USA
| | | | - Sergii Dvoryak
- Ukrainian Institute on Public Health Policy, Kyiv, Ukraine
| | - Frederick L. Altice
- Yale University School of Medicine, Section of Infectious Diseases, New Haven, CT, USA
- Yale School of Public health, Department of Epidemiology of Microbial Diseases, New Haven, CT, USA
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Topp SM, Moonga CN, Luo N, Kaingu M, Chileshe C, Magwende G, Heymann SJ, Henostroza G. Exploring the drivers of health and healthcare access in Zambian prisons: a health systems approach. Health Policy Plan 2016; 31:1250-61. [PMID: 27220354 PMCID: PMC5035781 DOI: 10.1093/heapol/czw059] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/12/2016] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Prison populations in sub-Saharan Africa (SSA) experience a high burden of disease and poor access to health care. Although it is generally understood that environmental conditions are dire and contribute to disease spread, evidence of how environmental conditions interact with facility-level social and institutional factors is lacking. This study aimed to unpack the nature of interactions and their influence on health and healthcare access in the Zambian prison setting. METHODS We conducted in-depth interviews of a clustered random sample of 79 male prisoners across four prisons, as well as 32 prison officers, policy makers and health care workers. Largely inductive thematic analysis was guided by the concepts of dynamic interaction and emergent behaviour, drawn from the theory of complex adaptive systems. RESULTS A majority of inmates, as well as facility-based officers reported anxiety linked to overcrowding, sanitation, infectious disease transmission, nutrition and coercion. Due in part to differential wealth of inmates and their support networks on entering prison, and in part to the accumulation of authority and material wealth within prison, we found enormous inequity in the standard of living among prisoners at each site. In the context of such inequities, failure of the Zambian prison system to provide basic necessities (including adequate and appropriate forms of nutrition, or access to quality health care) contributed to high rates of inmate-led and officer-led coercion with direct implications for health and access to healthcare. CONCLUSIONS This systems-oriented analysis provides a more comprehensive picture of the way resource shortages and human interactions within Zambian prisons interact and affect inmate and officer health. While not a panacea, our findings highlight some strategic entry-points for important upstream and downstream reforms including urgent improvement in the availability of human resources for health; strengthening of facility-based health services systems and more comprehensive pre-service health education for prison officers.
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Affiliation(s)
- Stephanie M Topp
- Centre for Infectious Disease Research in Zambia, PO Box 30346, Lusaka, Zambia; James Cook University, School of Public Health Medical and Veterinary Sciences, Douglas, QLD, 4810, Australia,
| | - Clement N Moonga
- Centre for Infectious Disease Research in Zambia, PO Box 30346, Lusaka, Zambia
| | - Nkandu Luo
- C/-CAPAH, National Assembly Parliament Buildings, PO Box 31299
| | - Michael Kaingu
- C/-CAPAH, National Assembly Parliament Buildings, PO Box 31299
| | | | | | - S Jody Heymann
- Fielding of Public Health, University of Los Angeles, CA, 90095-1772, USA
| | - German Henostroza
- Centre for Infectious Disease Research in Zambia, University of Alabama at Birmingham, PO Box 30346, Lusaka, Zambia
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