Predictive factors of HIV-infection in injecting drug users upon incarceration

V. Martín, J. A. Caylà, M. L. Morís, L. E. Alonso, R. Perez

Research output: Contribution to journalArticle

Abstract

Objective: To identify predictors of HIV-infection in injecting drug users upon incarceration. Patients and methods: We studied 639 IDU or ex-IDU prisoners admitted to a provincial prison of Northwestern Spain between 1 January 1991 and 31 December 1995. Each was interviewed by health personnel and tested for HIV-infection (ELISA followed by immunoblot confirmation in positive cases). Statistical analysis was based on logistic regression. Results: The prevalence of HIV-infection was 46.9% (95% CI: 43.1%-50.8%). No decreasing tendency in annual prevalence of HIV-infection was observed (p = 0.88); however, for those incarcerated for the first time prevalence fell from 38% in 1991 to 19% in 1995 (p = 0.20). Gypsies (OR: 0.43; 95% CI: 0.23- 0.80) and prisoners who were older upon first incarceration (OR: 0.94; 95% CI: 0.90-0.99) were associated with lesser risk of HIV-infection. Women (OR: 2.17; 95% CI: 1.29-3.65), older prisoners (OR: 1.06; 95% CI: 1.02-1.11), those with multiple incarceration histories (OR: 1.06; 95% CI: 1.01-1.11) and long-term prisoners (OR: 1.01; 95% CI: 1.00-1.02) were associated with higher risk. Conclusions: The high prevalence of HIV-infection, especially in women, younger prisoners, repeat offenders and long-term prisoners, suggests that prevention measures directed toward the most marginal IDU have not been very effective. Harm-reduction programs must be made to reach the IDU population, both in and outside prison walls.

Original languageEnglish (US)
Pages (from-to)327-331
Number of pages5
JournalEuropean Journal of Epidemiology
Volume14
Issue number4
DOIs
StatePublished - 1998
Externally publishedYes

Fingerprint

Prisoners
Drug Users
HIV Infections
Prisons
Roma
Harm Reduction
Health Personnel
Spain
Logistic Models
Enzyme-Linked Immunosorbent Assay
Population

Keywords

  • Drug users
  • Epidemiology
  • Human immunodeficiency virus (HIV)
  • Predictive factors
  • Prisons

ASJC Scopus subject areas

  • Epidemiology

Cite this

Predictive factors of HIV-infection in injecting drug users upon incarceration. / Martín, V.; Caylà, J. A.; Morís, M. L.; Alonso, L. E.; Perez, R.

In: European Journal of Epidemiology, Vol. 14, No. 4, 1998, p. 327-331.

Research output: Contribution to journalArticle

Martín, V. ; Caylà, J. A. ; Morís, M. L. ; Alonso, L. E. ; Perez, R. / Predictive factors of HIV-infection in injecting drug users upon incarceration. In: European Journal of Epidemiology. 1998 ; Vol. 14, No. 4. pp. 327-331.
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AU - Caylà, J. A.

AU - Morís, M. L.

AU - Alonso, L. E.

AU - Perez, R.

PY - 1998

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N2 - Objective: To identify predictors of HIV-infection in injecting drug users upon incarceration. Patients and methods: We studied 639 IDU or ex-IDU prisoners admitted to a provincial prison of Northwestern Spain between 1 January 1991 and 31 December 1995. Each was interviewed by health personnel and tested for HIV-infection (ELISA followed by immunoblot confirmation in positive cases). Statistical analysis was based on logistic regression. Results: The prevalence of HIV-infection was 46.9% (95% CI: 43.1%-50.8%). No decreasing tendency in annual prevalence of HIV-infection was observed (p = 0.88); however, for those incarcerated for the first time prevalence fell from 38% in 1991 to 19% in 1995 (p = 0.20). Gypsies (OR: 0.43; 95% CI: 0.23- 0.80) and prisoners who were older upon first incarceration (OR: 0.94; 95% CI: 0.90-0.99) were associated with lesser risk of HIV-infection. Women (OR: 2.17; 95% CI: 1.29-3.65), older prisoners (OR: 1.06; 95% CI: 1.02-1.11), those with multiple incarceration histories (OR: 1.06; 95% CI: 1.01-1.11) and long-term prisoners (OR: 1.01; 95% CI: 1.00-1.02) were associated with higher risk. Conclusions: The high prevalence of HIV-infection, especially in women, younger prisoners, repeat offenders and long-term prisoners, suggests that prevention measures directed toward the most marginal IDU have not been very effective. Harm-reduction programs must be made to reach the IDU population, both in and outside prison walls.

AB - Objective: To identify predictors of HIV-infection in injecting drug users upon incarceration. Patients and methods: We studied 639 IDU or ex-IDU prisoners admitted to a provincial prison of Northwestern Spain between 1 January 1991 and 31 December 1995. Each was interviewed by health personnel and tested for HIV-infection (ELISA followed by immunoblot confirmation in positive cases). Statistical analysis was based on logistic regression. Results: The prevalence of HIV-infection was 46.9% (95% CI: 43.1%-50.8%). No decreasing tendency in annual prevalence of HIV-infection was observed (p = 0.88); however, for those incarcerated for the first time prevalence fell from 38% in 1991 to 19% in 1995 (p = 0.20). Gypsies (OR: 0.43; 95% CI: 0.23- 0.80) and prisoners who were older upon first incarceration (OR: 0.94; 95% CI: 0.90-0.99) were associated with lesser risk of HIV-infection. Women (OR: 2.17; 95% CI: 1.29-3.65), older prisoners (OR: 1.06; 95% CI: 1.02-1.11), those with multiple incarceration histories (OR: 1.06; 95% CI: 1.01-1.11) and long-term prisoners (OR: 1.01; 95% CI: 1.00-1.02) were associated with higher risk. Conclusions: The high prevalence of HIV-infection, especially in women, younger prisoners, repeat offenders and long-term prisoners, suggests that prevention measures directed toward the most marginal IDU have not been very effective. Harm-reduction programs must be made to reach the IDU population, both in and outside prison walls.

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KW - Epidemiology

KW - Human immunodeficiency virus (HIV)

KW - Predictive factors

KW - Prisons

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