Wiessing, L, Kalamara, E, Stone, J, Altan, P, Van Baelen, L, Fotiou, A, Garcia, D, Goulao, J, Guarita, B, Hope, V, Jauffret-Roustide, M, Jurgelaitienė, L, Kåberg, M, Kamarulzaman, A, Lemsalu, L, Kivite-Urtane, A, Kolarić, B, Montanari, L, Rosińska, M, Sava, L et al, Horváth, I, Seyler, T, Sypsa, V, Tarján, A, Yiasemi, I, Zimmermann, R, Ferri, M, Dolan, K, Uusküla, A and Vickerman, P (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 1560-7917

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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
Uncontrolled Keywords:	0605 Microbiology, 1117 Public Health and Health Services, 1199 Other Medical and Health Sciences
Subjects:	Q Science > QR Microbiology R Medicine > RA Public aspects of medicine R Medicine > RA Public aspects of medicine > RA0421 Public health. Hygiene. Preventive Medicine
Divisions:	Public Health Institute
Publisher:	European Centre for DIsease Prevention and Control
Date Deposited:	14 Dec 2021 09:37
Last Modified:	14 Dec 2021 09:45
DOI or ID number:	10.2807/1560-7917.es.2021.26.49.2002093
URI:	https://researchonline.ljmu.ac.uk/id/eprint/15919

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