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?

Wiessing, Lucas and Kalamara, Eleni and Stone, Jack and Altan, Peyman and Van Baelen, Luk and Fotiou, Anastasios and Garcia, D'Jamila and Goulao, Joao and Guarita, Bruno and Hope, Vivian and Jauffret-Roustide, Marie and Jurgelaitiene, Lina and Kaberg, Martin and Kamarulzaman, Adeeba and Lemsalu, Liis and Kivite-Urtane, Anda and Kolaric, Branko and Montanari, Linda and Rosinska, Magdalena and Sava, Lavinius and Horvath, Ilonka and Seyler, Thomas and Sypsa, Vana and Tarjan, Anna and Yiasemi, Ioanna and Zimmermann, Ruth and Ferri, Marica and Dolan, Kate and Uuskula, Anneli and Vickerman, Peter (2021) 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? Eurosurveillance, 26 (49). ISSN 1025-496X, DOI https://doi.org/10.2807/1560-7917.ES.2021.26.49.2002093.

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Abstract

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').

Item Type: Article
Funders: Nordic Drugs, Gilead Sciences
Uncontrolled Keywords: Hepatitis-c virus; Public-health; High-risk; Viral-hepatitis; Prison; Users; Infection; Prevention; Transmission; Tuberculosis
Subjects: R Medicine > RC Internal medicine > RC306-320.5 Tuberculosis
Divisions: Faculty of Medicine > Medicine Department
Depositing User: Ms Zaharah Ramly
Date Deposited: 20 Oct 2023 05:14
Last Modified: 20 Oct 2023 05:14
URI: http://eprints.um.edu.my/id/eprint/35273

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