Schulte B, Stöver H, Thane K, Schreiter C, Gansefort D, Reimer J
Centre for Interdisciplinary Addiction Research, University of Hamburg, Germany.
Int J Prison Health. 2009;5(1):39-44. doi: 10.1080/17449200802692144.
Injection drug use (IDU) and IDU-related infectious diseases such as hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are highly prevalent among prisoners worldwide. However, little is known about the prevalence of IDUs, HCV/HIV and the availability of respective treatment options in German prisons. Data provided by prison physicians of 31 prisons, representing 14,537 inmates, were included in this analysis. The proportion of IDUs among all prisoners was 21.9%. Substitution treatment was available in three out of four prisons (74.2%). Overall, 1137 substitution treatments were provided annually with a wide range of treatment aims. The prevalence rate was 14.3% for HCV and 1.2% for HIV. Around 5.5% of all HCV-infected prisoners were in antiviral treatment annually, 86.5% of all HIV-positive inmates in antiretroviral HIV-treatment. Generally, substitution treatment, and HCV and HIV testing and treatment are available. However, due to abstinence-orientated treatment aims, substitution treatment is rarely available as maintenance treatment, and HCV/HIV-treatment is mainly provided for patients with an existing treatment before imprisonment. The inconsistent data quality necessitates changes in prison-related policy to improve surveillance and to generate aggregated data in German prisons. The selection process in this analysis might lead to overestimating the provision of substitution and antiviral HCV-treatment.
注射吸毒（IDU）以及与IDU相关的传染病，如丙型肝炎病毒（HCV）和人类免疫缺陷病毒（HIV）感染，在全球囚犯中极为普遍。然而，对于德国监狱中注射吸毒者的患病率、HCV/HIV感染情况以及相应治疗方案的可及性知之甚少。本分析纳入了31所监狱的监狱医生提供的数据，这些数据代表了14537名囚犯。所有囚犯中注射吸毒者的比例为21.9%。四分之三的监狱（74.2%）提供替代治疗。总体而言，每年提供1137次替代治疗，治疗目的广泛。HCV的患病率为14.3%，HIV的患病率为1.2%。每年约5.5%的HCV感染囚犯接受抗病毒治疗，86.5%的HIV阳性囚犯接受抗逆转录病毒HIV治疗。一般来说，替代治疗以及HCV和HIV检测与治疗都是可及的。然而，由于以禁欲为导向的治疗目标，替代治疗很少作为维持治疗提供，HCV/HIV治疗主要提供给入狱前就已接受现有治疗的患者。数据质量参差不齐，有必要改变与监狱相关的政策，以改善监测并生成德国监狱的汇总数据。本分析中的选择过程可能导致高估替代治疗和抗病毒HCV治疗的提供情况。
