Associations between a history of incarceration and HIV and HCV prevalence among people who inject drugs across 17 countries in Europe

Original/alternative title: 
Univariable associations between a history of incarceration and HIV and HCV prevalence among people who inject drugs across 17 countries in Europe 2006 to 2020 - is the precautionary principle applicable?
Summary 

We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe.

Abstract

This abstract is provided here as a convenience only. Check the publisher's website (if available) for the definitive version.

Background

People who inject drugs (PWID) are frequently incarcerated, which is associated with multiple negative health outcomes.

Aim

We aimed to estimate the associations between a history of incarceration and prevalence of HIV and HCV infection among PWID in Europe.

Methods

Aggregate data from PWID recruited in drug services (excluding prison services) or elsewhere in the community were reported by 17 of 30 countries (16 per virus) collaborating in a European drug monitoring system (2006–2020; n = 52,368 HIV+/−; n = 47,268 HCV+/−). Country-specific odds ratios (OR) and prevalence ratios (PR) were calculated from country totals of HIV and HCV antibody status and self-reported life-time incarceration history, and pooled using meta-analyses. Country-specific and overall population attributable risk (PAR) were estimated using pooled PR.

Results

Univariable HIV OR ranged between 0.73 and 6.37 (median: 2.1; pooled OR: 1.92; 95% CI: 1.52–2.42). Pooled PR was 1.66 (95% CI 1.38–1.98), giving a PAR of 25.8% (95% CI 16.7–34.0). Univariable anti-HCV OR ranged between 1.06 and 5.04 (median: 2.70; pooled OR: 2.51; 95% CI: 2.17–2.91). Pooled PR was 1.42 (95% CI: 1.28–1.58) and PAR 16.7% (95% CI: 11.8–21.7). Subgroup analyses showed differences in the OR for HCV by geographical region, with lower estimates in southern Europe.

Conclusion

In univariable analysis, a history of incarceration was associated with positive HIV and HCV serostatus among PWID in Europe. Applying the precautionary principle would suggest finding alternatives to incarceration of PWID and strengthening health and social services in prison and after release (‘throughcare’).

Origin: 
Category: 
Scientific article
Date: 
1 December 2021  (approximate)
Location: 
Stockholm
Access: 
Open access
Publisher: 
Eurosurveillance
Geographical scope: 
EU/Europe
Journal: 
Eurosurveillance
26, 49, 2002093
Authors: 
Wiessing, L; Kalamara, E; Stone, J; et al
Publisher's DOI: 
10.2807/1560-7917.ES.2021.26.49.2002093
Document language: 
English
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