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10.1016/j.drugpo.2014.02.010

http://scihub22266oqcxt.onion/10.1016/j.drugpo.2014.02.010
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suck abstract from ncbi


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pmid24951025      Int+J+Drug+Policy 2014 ; 25 (5): 845-52
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  • Within-Prison Drug Injection among HIV-Infected Ukrainian Prisoners: Prevalence and Correlates of an Extremely High-Risk Behaviour #MMPMID24951025
  • Izenberg J; Bachireddy C; Wickersham JA; Soule M; Kiriazova T; Dvoriak S; Altice FL
  • Int J Drug Policy 2014[Sep]; 25 (5): 845-52 PMID24951025show ga
  • Background: In Ukraine, HIV-infection, injection drug use, and incarceration are syndemic; however, few services are available to incarcerated people who inject drugs (PWIDs). While data are limited internationally, within-prison drug injection (WP-DI) appears widespread and may pose significant challenges in countries like Ukraine, where PWIDs contribute heavily to HIV incidence. To date, WP-DI has not been specifically examined among HIV-infected prisoners, the only persons that can transmit HIV. Methods: A convenience sample of 97 HIV-infected adults recently released from prison within 1?12 months was recruited in two major Ukrainian cities. Post-release surveys inquired about WP-DI and injection equipment sharing, as well as current and prior drug use and injection, mental health, and access to within-prison treatment for HIV and other comorbidities. Logistic regression identified independent correlates of WP-DI. Results: Complete data for WP-DI were available for 95 (97.9%) respondents. Overall, 54 (56.8%) reported WP-DI, among whom 40 (74.1%) shared injecting equipment with a mean of 4.4 (range 0?30) other injectors per needle/syringe. Independent correlates of WP-DI were recruitment in Kyiv (AOR 7.46, p=0.003), male gender (AOR 22.07, p=0.006), and active pre-incarceration opioid use (AOR 8.66, p=0.005). Conclusions: Among these recently released HIV-infected prisoners, WP-DI and injection equipment sharing were frequent and involved many injecting partners per needle/syringe. The overwhelming majority of respondents reporting WP-DI used opioids both before and after incarceration, suggesting that implementation of evidence-based harm reduction practices, such as opioid substitution therapy and/or needle/syringe exchange programs within prison, is crucial to addressing continuing HIV transmission among PWIDs within prison settings. The positive correlation between Kyiv site and WP-DI suggests that additional structural interventions may be useful.
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