Risk of prevalent HIV infection associated with incarceration among injecting drug users in Bangkok, Thailand: case-control study
Abstract Objectives: To identify risks for HIV infection related to incarceration among injecting drug users in Bangkok, Thailand. Design: Case-control study of sexual and parenteral exposures occurring before, during, and after the most recent incarceration. Setting: Metropolitan Bangkok. Participa...
Saved in:
| Published in: | BMJ Vol. 326; no. 7384; pp. 308 - 310 |
|---|---|
| Main Authors: | , , , , , , , , |
| Format: | Journal Article |
| Language: | English |
| Published: |
London
British Medical Journal Publishing Group
08-02-2003
British Medical Association BMJ Publishing Group LTD BMJ Publishing Group BMJ Publishing Group Ltd |
| Edition: | International edition |
| Subjects: | |
| Online Access: | Get full text |
| Tags: |
Add Tag
No Tags, Be the first to tag this record!
|
| Summary: | Abstract Objectives: To identify risks for HIV infection related to incarceration among injecting drug users in Bangkok, Thailand. Design: Case-control study of sexual and parenteral exposures occurring before, during, and after the most recent incarceration. Setting: Metropolitan Bangkok. Participants: Non-prison based injecting drug users formerly incarcerated for at least six months in the previous five years, with documented HIV serostatus since their most recent release; 175 HIV positive cases and 172 HIV negative controls from methadone clinics. Main outcome measure: Injection of heroin and methamphetamine, sharing of needles, sexual behaviour, and tattooing before, during, and after incarceration. Results: In the month before incarceration cases were more likely than controls to have injected methamphetamine and to have borrowed needles. More cases than controls reported using drugs (60% v 45%; P=0.005) and sharing needles (50% v 31%; P<0.01) in the holding cell before incarceration. Independent risk factors for prevalent HIV infection included injection of methamphetamine before detention (adjusted odds ratio 3.3, 95% confidence interval 1.01 to 10.7), sharing needles in the holding cell (1.9, 1.2 to 3.0), being tattooed while in prison (2.1, 1.3 to 3.4), and borrowing needles after release (2.5, 1.3 to 4.4). Conclusions: Injecting drug users in Bangkok are at significantly increased risk of HIV infection through sharing needles with multiple partners while in holding cells before incarceration. The time spent in holding cells is an important opportunity to provide risk reduction counselling and intervention to reduce the incidence of HIV. What is already known on this topic The incidence of HIV in Thailand is highest among injecting drug users in Bangkok Incarceration is a risk factor for incident HIV infection among Thai injecting drug users What this study adds Injecting drug users are at increased risk of HIV infection from sharing needles with multiple partners while in police holding cells before incarceration Other risk factors include injecting methamphetamine before imprisonment, being tattooed while imprisoned, and sharing needles after release |
|---|---|
| Bibliography: | ArticleID:bmj.326.7384.308 href:bmj-326-308-1.pdf Correspondence to: K Page-Shafer local:bmj;326/7384/308 ark:/67375/NVC-8M25SDMS-H istex:49FACCB4C2622F939B55863E2B94E54D18077965 PMID:12574043 ObjectType-Article-2 SourceType-Scholarly Journals-1 ObjectType-Feature-1 content type line 23 Contributors: AB proposed the idea for and designed the study, designed the questionnaire, oversaw data collection, and drafted the manuscript. KP-S proposed the idea for and designed the study, analysed and interpreted the data, and drafted and revised the manuscript. GJPvanG contributed to the idea for the study, interpretation of the data, and the writing and critical revisions of the paper. JSM contributed to administrative and material support, interpretation of data, and revisions of the manuscript. JE conducted analyses and contributed to the writing and revisions of the paper. JC and SC participated in acquisition and analysis of the data, translation of questionnaires and protocols, administrative and technical support, and revisions of the paper. RS participated in acquisition of the data and administrative and technical support. AM contributed to the idea for and design of the study, design of the questionnaire, interpretation of data, and the writing and critical revisions of the paper. All authors approved the final version of the manuscript. KPS is the guarantor. Correspondence to: K Page-Shafer shafer@psg.ucsf.edu |
| ISSN: | 0959-8138 0959-8146 1468-5833 1756-1833 |
| DOI: | 10.1136/bmj.326.7384.308 |