The Kirby Institute, UNSW Sydney, Sydney, Australia.
The Kirby Institute, UNSW Sydney, Sydney, Australia.
Int J Drug Policy. 2018 Apr;54:18-25. doi: 10.1016/j.drugpo.2017.12.013. Epub 2018 Jan 24.
HCV transmission remains high in prisons globally. Understanding injecting risk behaviours in prisons is crucial to effectively develop and implement HCV prevention programs in this setting including treatment as prevention.
HITS-p is a cohort study which enrolled people with a history of injecting drug use in prisons in NSW, Australia from 2005 to 2013. Participants completed an interview at enrolment and follow-up visits to determine injecting behaviours. Generalized estimating equation (GEE) and logistic regression methods were used to assess injecting risk behaviours prior to and following prison entry and to investigate injecting risk behaviours in prison.
Overall, 499 participants with a history of injecting drug use were included (median age, 26 years; 65% male). Participants were significantly less likely to inject drugs following incarceration. Among injectors, participants were less likely to inject ≥weekly but more likely to share a needle/syringe. At enrolment, the proportion reporting any injecting, ≥weekly injecting, and needle/syringe sharing in prison was highest among younger individuals. Younger age was associated with both re-initiation and continuation of injecting drug use following prison entry. Among those continuously imprisoned, younger age was associated with increased odds of any injecting, ≥weekly injecting, and sharing a needle/syringe.
Upon entry to prison, injecting drug use decreased but syringe sharing increased among injectors. Younger individuals are most likely to exhibit high-risk injecting behaviours in prison. These data highlight the need for improved HCV prevention strategies (including improved needle/syringe access and scale up of HCV therapy) for those at increased risk of HCV transmission in prison, including younger individuals.
全球监狱中丙型肝炎病毒（HCV）的传播率仍然很高。了解监狱内的注射风险行为对于在该环境中有效制定和实施 HCV 预防计划至关重要，包括治疗即预防。
HITS-p 是一项队列研究，于 2005 年至 2013 年在澳大利亚新南威尔士州的监狱中招募有注射吸毒史的人。参与者在入组时完成一次访谈，并在随访时确定注射行为。使用广义估计方程（GEE）和逻辑回归方法来评估入监前后的注射风险行为，并调查监狱内的注射风险行为。
总体而言，共纳入 499 名有注射吸毒史的参与者（中位年龄 26 岁，65%为男性）。参与者入狱后注射毒品的可能性显著降低。在注射者中，参与者不太可能每周注射≥1 次，但更有可能共用针头/注射器。在入组时，报告在监狱内有任何注射、每周注射≥1 次和共用针头/注射器的比例在年轻个体中最高。年龄较小与入狱后重新开始和继续使用注射毒品有关。在连续监禁的人中，年龄较小与任何注射、每周注射≥1 次和共用针头/注射器的几率增加有关。
入狱后，注射毒品的行为减少，但注射者中共享注射器的行为增加。年轻个体在监狱中最有可能表现出高风险的注射行为。这些数据强调需要为那些在监狱中传播 HCV 风险增加的人（包括年轻个体）制定更好的 HCV 预防策略（包括改善针头/注射器的获取和扩大 HCV 治疗）。
