Queensland Alcohol and Drug Research and Education Centre, School of Public Health, The University of Queensland, Brisbane, Australia.
Communicable Diseases Branch, Department of Health, Queensland Government, Brisbane, Australia.
Drug Alcohol Rev. 2018 Nov;37(7):831-836. doi: 10.1111/dar.12845. Epub 2018 Jul 15.
An understanding of the relationship between hepatitis C viral (HCV) infection and contextual factors such as imprisonment may contribute to the development of targeted treatment and prevention programs. We examine the associations of imprisonment and drug dependence with lifetime exposure to HCV, and whether these associations differ for Aboriginal and Torres Strait Islander and non-Indigenous people who inject drugs.
Respondent-driven sampling was used in major cities and 'peer recruitment' in regional towns of Queensland to obtain a community sample of people who injected drugs, which comprised 243 Indigenous and 227 non-Indigenous participants who had ever been tested for HCV. Data are cross-sectional. Two binary Poisson models were developed to examine associations for variables relating to imprisonment, Indigeneity and drug use history.
Sharing needles and syringes in prison (adjusted risk ratio 1.25, 95% confidence interval 1.02-1.53) remained significantly associated with HCV infection after adjustment for Indigeneity, injecting drug use history and drug dependence. Opioid dependence and concurrent dependence on opioids and methamphetamine was also independently associated with HCV infection.
Sharing needles and syringes in prison is linked with HCV infection, for both Aboriginal and Torres Strait Islander and non-Indigenous people who inject drugs. Further development of treatment and prevention programs in prisons is required, with consideration of the role of opioid and methamphetamine dependence in HCV exposure.
了解丙型肝炎病毒 (HCV) 感染与监禁等背景因素之间的关系，可能有助于制定有针对性的治疗和预防计划。我们研究了监禁和药物依赖与终生接触 HCV 的关系，以及这些关系是否因注射毒品的原住民和托雷斯海峡岛民与非原住民而有所不同。
昆士兰州的主要城市采用了响应驱动抽样法，而区域城镇则采用了“同伴招募”法，以获得一个社区注射毒品人群样本，其中包括 243 名原住民和 227 名非原住民参与者，他们曾接受过 HCV 检测。数据是横断面的。开发了两个二项泊松模型来检验与监禁、原住民身份和药物使用史相关的变量的关联。
调整原住民身份、注射毒品使用史和药物依赖后，在监狱中共用针具和注射器（调整后的风险比 1.25，95%置信区间 1.02-1.53）与 HCV 感染仍显著相关。阿片类药物依赖以及同时依赖阿片类药物和甲基苯丙胺也与 HCV 感染独立相关。
在监狱中共享针具和注射器与 HCV 感染有关，无论是原住民和托雷斯海峡岛民还是非原住民注射毒品者。需要进一步在监狱中开发治疗和预防计划，并考虑阿片类药物和甲基苯丙胺依赖在 HCV 暴露中的作用。
