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.
Similar content being viewed by others
References
Harding TW. AIDS in prison. Lancet 1987; 2: 1260–1263.
European Centre for the Epidemiological Monitoring of AIDS. HIV/AIDS Surveillance in Europe: Quarterly Report no. 50, 30 June 1996.
Lardelli P, De la Fuente L, Alonso JM, López R, Bravo MJ, Delgado-Rodríguez M. Geographical variations in the prevalence of HIV-infection among drug users reciving ambulatory treatment in Spain. Int J Epidemiol 1993; 22: 306–314.
Bird AG, Gore SM, Jolliffe DW, Burns SM. Anonymous HIV surveillance in Saughton Prison, Edinburgh. AIDS 1992; 6: 725–733.
Mutter RC, Grimes RM, Labarthe D. Evidence of intraprison spread of HIV infection. Arch Intern Med 1994; 154: 793–795.
Martín V, Bayas JM, Laliga A, Pumarola T, Vidal J, Jimnez de Anta MT, Salleras L. Seroepidemiology of HIV-1 infection in a Catalonian penitentiary. AIDS 1990, 4: 1023–1026.
Estébanez P, Colomo C, Zunzunegui MV, Rua M, Pérez M, Ortiz C, et al. Carceles y SIDA. Factores de riesgo de infección por el VIH en las cárceles de Madrid. Gaceta Sanitaria 1990, 4: 100–105.
Bayas JM, Martín V, Vidal J, Pumarola T, Jiménez de Anta MT, Salleras L. Infección por el virus de la inmunodeficiencia humana tipo l en la población penitenciaria de Cataluña. Med Clin (Bare) 1994; 102: 209–212.
Caylà JA. Infección por VIII y SIDA en las prisiones españolas: ¿Un reto insuperable para la salud pública?, Editorial. Gaceta Sanitaria 1996, 10: 101–103.
Dean AD, Dean JA, Burton AH, Dicker RC. Epi Info, version 5: A word processing, database, and statistics program for epidemiology on microcomputers. Stone Mountain, Georgia: USD Incorporated, 1990.
Epidemiological Graphies, Estimation and Testing Package (EGRET). Seattle, Washington: Statistics and Epidemiology Research Corporation, 1990.
Des Jarlais DC, Friedman SR, Choopanya K, Vanichseni S, Ward TP. International epidemiology of HIV and AIDS among injecting drug users. AIDS 1992; 6: 1053–1068.
Rothon DA, Mathias RG, Schechter MT. Prevalence of HIV infection in provincial prisons in British Columbia (see comments). Can Med Assoc J 1995; 152(6): 781–787.
Guereña Burgueño F, Benenson AS, Sepulveda Amor J. HIV-1 prevalence in selected Tijuana sub-populations. Am J Public Health 1991; 81(5): 623–625.
Papaevangelou G, Roumeliotou A, Stergioy G, Nesordiou A, Trichopoulou E, Kallinikos G, et al. HIV infection in Greck intravenous drug users. Eur J Epidemiol 1991; 7(1): 88–90.
Gore SM, Bird AG, Burns SM, Goldberg DJ, Ross AJ, Macgegor J. Drug injection and HIV prevalence in inmates of glenochil prison (see comments). Br Med J 1995; 310(6975): 293–296.
Hankins CA, Gendron S, Handley MA, Richard C, Tung MT, O'Shaughnessy M. HIV infection among women in prison an assessment of risk factors using a nonnominal methodology. Am J Public Health 1994; 84(10): 1637–1640.
Weisfuse IB, Greenberg BL, Back SD, Makki HA, Thomas P, Rooney W, et al. HIV-1 infection among New York inmates. AIDS 1991; 5(9): 1133–1138.
Kall KI, Olin RG. HIV status and changes in risk behaviour among intravenous drug users in Stockholm 1987–1988. AIDS 1990; 4(2): 153–157.
Rotily M, Galinier-Pujol A, Obadia Y, Moatti JP, Toubiana P, Vernay-Vaisse C, et al. HIV testing, HIV infection and associated risk factors among inmates in southeastern French prisons. AIDS 1994; 8(9): 1341–1344.
Smith PF, Mikl J, Truman BI, Lessner L, Lehman JS, Stevens RW, et al. HIV infection among women entering the New York State correctional system. Am J Public Health 1991; 81Suppl: 35–40.
Sperner-Unterweger B, Fuchs D, Fleischhacker WW, Hausen A, Miller C, Most J, et al. Change in HIV-antibody seroprevalence rates i.v. drug dependent prisoners. Br J Addict 1991; 86(2): 225–232.
Anónimo. Situación socio-sanitaria de la población que ha ingresado en prisiones en 1993. Subdirección General de Sanidad Penitenciaria. Ministerio de Justicia, 1994. Madrid.
Caballero J, Rojas O, García A, García A. Infección por VIH y factores de riesgo asociados en la prisión de Guadalajara. Libro de Ponencias y Comunicaciones. I Congreso Nacional de Sanidad Penitenciaria. León 1993, 344.
Des Jarlais DC. The first and second decades of AIDS among injecting drug users. Br J Addictions 1992; 87: 353–374.
Estébanez P, Cifuentes I. Diferencias de riesgo por género para el VIH entre los UDVP (Parte I y II). Publicación oficial de la SEISIDA 1996; 1: 8–13, y 2: 2–67.
Gellert GA, Maxwell RM, Higgins KV, Pendergast T, Wilker N. HIV infection in the Women's Jail Orange County, California, 1985 through 1991. Am J Public Health 1993; 83(10): 1454–1456.
Scano G, Luzi G, Mezzaroma I, Aiuti F, Vellucci A, Guastini L, et al. One year follow-up of HIV seropositive jail population. Allergol-Immunopathol (Madr) 1991; 19(4): 165–166.
Eirós JM, Perlado E, Ortiz de Lejarazu R, Orduña A, Torres AR. Influencia de la antiguedad en la ADVP y la reclusión en la infección por VIH. Libro de Ponencias y Comunicaciones. I Congreso Nacional de Sanidad Penitenciaria. León, 1993: 340.
Muller R, Stark K, Guggenmoos-Holzmann I, Wirth D, Bienzle U. Imprisonment: A risk factor for HIV infection counteracting education and prevention programmes for intravenous drug users. AIDS 1995; 9(2): 183–190.
Doll DC. Tattoing in prison and HIV infection. Lancet 1988; 1: 66–67.
Friedman SR, Des Jarlais DC. HIV among drug injectors: The epidemic and the response. AIDS Care 1991; 3: 239–250.
Buning E, Van Brussel G. The efects of harm reduction in Amsterdam. Eur addict Res 1995; 1: 92–98.
Author information
Authors and Affiliations
Rights and permissions
About this article
Cite this article
Martín, V., Caylà, J., Morís, M. et al. Predictive factors of HIV-infection in injecting drug users upon incarceration. Eur J Epidemiol 14, 327–331 (1998). https://doi.org/10.1023/A:1007461608434
Issue Date:
DOI: https://doi.org/10.1023/A:1007461608434