Pollini Robin A, Alvelais Jorge, Gallardo Manuel, Vera Alicia, Lozada Remedios, Magis-Rodriquez Carlos, Strathdee Steffanie A
Division of Global Public Health, University of California-San Diego, 9500 Gilman Drive, La Jolla, CA 92093-0628, USA.
Drug Alcohol Depend. 2009 Jul 1;103(1-2):52-8. doi: 10.1016/j.drugalcdep.2009.03.005. Epub 2009 Apr 21.
Limited access to sterile syringes and condoms in correctional facilities make these settings high risk environments for HIV transmission. Although incarceration among injection drug users (IDUs) is common, there is limited information regarding specific IDU risk behaviors inside. We examined correlates of incarceration, injection inside and syringe sharing inside among male IDUs recruited in Tijuana, Mexico, using respondent driven sampling (RDS) (n=898). An interviewer administered survey collected data on sociodemographic, behavioral and contextual characteristics. Associations with (a) history of incarceration, (b) injection inside, and (c) syringe sharing inside were identified using univariate and multiple logistic regression models with RDS adjustment. Seventy-six percent of IDUs had been incarcerated, of whom 61% injected inside. Three quarters (75%) of those who injected shared syringes. U.S. deportation [adjusted odds ratio (AOR)=1.61; 95% confidence interval (CI): 1.07, 2.43] and migration (AOR=1.81; 95% CI: 1.12, 2.95) were independently associated with incarceration. Injection inside was independently associated with recent receptive syringe sharing (AOR=2.46; 95% CI: 1.75, 3.45) and having sex with a man while incarcerated (AOR=3.59; 95% CI: 1.65, 7.83). Sharing syringes inside was independently associated with having sex with a man while incarcerated (AOR=6.18; 95% CI: 1.78, 21.49). A majority of incarcerated IDUs reported injecting and syringe sharing during incarceration, and these IDUs were more likely to engage in sex with other men. Corrections-based interventions to reduce injection and syringe sharing are urgently needed, as are risk reduction interventions for male IDUs who have sex with men while incarcerated.
惩教设施中无菌注射器和避孕套的获取受限,使得这些场所成为艾滋病毒传播的高风险环境。虽然注射吸毒者(IDU)被监禁的情况很常见,但关于其在监狱内的具体风险行为的信息有限。我们使用应答者驱动抽样(RDS)(n = 898)对在墨西哥蒂华纳招募的男性注射吸毒者中监禁、狱内注射和狱内共用注射器的相关因素进行了研究。由访员实施的调查收集了社会人口学、行为和环境特征方面的数据。使用单变量和多因素逻辑回归模型并进行RDS调整,确定了与(a)监禁史、(b)狱内注射和(c)狱内共用注射器的关联。76%的注射吸毒者曾被监禁,其中61%在狱中注射。在狱内注射的人中,四分之三(75%)共用注射器。被美国驱逐出境[调整后的优势比(AOR)= 1.61;95%置信区间(CI):1.07,2.43]和移民(AOR = 1.81;95% CI:1.12,2.95)与监禁独立相关。狱内注射与近期接受性共用注射器(AOR = 2.46;95% CI:1.75,3.45)以及在监禁期间与男性发生性行为(AOR = 3.59;95% CI:1.65,7.83)独立相关。狱内共用注射器与在监禁期间与男性发生性行为(AOR = 6.18;95% CI:1.78,21.49)独立相关。大多数被监禁的注射吸毒者报告在监禁期间注射和共用注射器,而且这些注射吸毒者更有可能与其他男性发生性行为。迫切需要基于惩教的干预措施来减少注射和共用注射器行为,对于在监禁期间与男性发生性行为的男性注射吸毒者,也迫切需要采取降低风险的干预措施。