Calzavara L M, Major C, Myers T, Schlossberg J, Millson M, Wallace E, Rankin J, Fearon M
Department of Preventive Medicine and Biostatistics, University of Toronto, Ontario, Canada.
AIDS. 1995 Jun;9(6):631-7.
To estimate the prevalence of HIV-1 infection among adult and young offenders admitted to remand facilities in the province of Ontario, Canada, by using a design that reduces volunteer bias.
A study using a modified anonymous HIV-surveillance design was conducted with urine specimens routinely collected from male and female entrants to all Ontario jails, detention and youth centres between February and August 1993. Information on sex, age, and history of injecting drug use was also collected. Urine was screened using a modified commercial HIV enzyme-linked immunosorbent assay kit and confirmed using a modified in-house Western blot assay.
Data were obtained on 10,530 adult men, 1518 adult women, 1480 young male offenders, and 92 young female offenders. Urine specimens were available for 88% of new entrants. Of the entrants, 1% (n = 163) refused to have their urine used for research. Refusals were not associated with history of injecting drug use. Overall rates of HIV-1 infection were 1% for adult men, 1.2% for adult women, and 0% for young offenders. Both the rates of infection and prevalence of injecting drug use varied across facilities and geographic regions. Overall, 13% of adult men, 20% of adult women, 3% of young male offenders, and 2% of young female offenders reported a history of injecting drug use. Rates of infection were highest among self-reported injecting drug users. Rates of HIV were 3.6% for adult men and 4.2% for adult women who injected compared with 0.6 and 0.5%, respectively, for non-injecting drug users.
The use of unlinked left-over specimens is an important tool for measuring HIV-prevalence rates and should be encouraged. The results indicate that HIV rates are much higher among those entering prisons than in the general population. The pattern of HIV in Ontario prisons is similar to that reported in Europe and the United States. We are optimistic that these data will stimulate much needed efforts towards education and health promotion, and open the door to further research in Canadian prisons.
采用一种减少志愿者偏倚的设计方法，估计加拿大安大略省被还押候审设施收押的成年及青少年罪犯中HIV-1感染的流行率。
1993年2月至8月期间，对从安大略省所有监狱、拘留所和青少年中心新收押的男性和女性常规采集尿液标本，采用改良的匿名HIV监测设计进行了一项研究。同时收集了性别、年龄和注射吸毒史等信息。尿液检测采用改良的商用HIV酶联免疫吸附测定试剂盒进行筛查，并采用改良的内部免疫印迹法进行确认。
获取了10530名成年男性、1518名成年女性、1480名青少年男性罪犯和92名青少年女性罪犯的数据。88%的新收押人员提供了尿液标本。在这些新收押人员中，1%（n = 163）拒绝将其尿液用于研究。拒绝与注射吸毒史无关。成年男性的HIV-1总体感染率为1%，成年女性为1.2%，青少年罪犯为0%。感染率和注射吸毒流行率在不同设施和地理区域有所不同。总体而言，13%的成年男性、20%的成年女性、3%的青少年男性罪犯和2%的青少年女性罪犯报告有注射吸毒史。自我报告的注射吸毒者中感染率最高。注射吸毒的成年男性HIV感染率为3.6%，成年女性为4.2%，而非注射吸毒者分别为0.6%和0.5%。
使用不关联的剩余标本是测量HIV流行率的重要工具，应予以鼓励。结果表明，入狱人员中的HIV感染率远高于普通人群。安大略省监狱中的HIV感染模式与欧洲和美国报告的相似。我们乐观地认为，这些数据将推动开展急需的教育和健康促进工作，并为加拿大监狱的进一步研究打开大门。
