, Volume 14, Issue 4, pp 327-331

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

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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.