Theme: Epidemiology and Public Health Research Year: 2021
Background: Prisons constitute important settings for harm reduction and for the prevention of infectious diseases among PWID. Aim of this analysis is to estimate the number of people in prison (PIP) with lifetime injection drug use (IDU) and with HCV infection in seven European countries. Methods: Czech Republic, Latvia, Lithuania, Poland, Portugal and Slovenia implemented surveys in prisons using the European Questionnaire on Drug Use Among People in Prison (2014-2018). Data from Spain was obtained from the Spanish survey on health and drug use among prisoners (2016). Participants provided information on lifetime IDU. For each country, the total number of PIP with lifetime IDU was obtained by multiplying the total number of PIP (from official data for 2019-2019) by the proportion of PIP with lifetime IDU. The number of HCV infections in prisons was estimated by applying existing HCV prevalence estimates among PWID to the number of PIP with lifetime IDU. Linear regression was used to model the association between the prevalence of lifetime IDU in the general population (Degenhardt et al, 2017) and in prison per country. Results: The proportion of PIP with lifetime IDU ranged between 3.5%-15.62% in Slovenia/Spain/Portugal/ Poland and 25.3%-35.2% in Lithuania/Latvia/Czech Republic, representing approximately 280-9,200 PIP with lifetime IDU and 100-6,500 with HCV per country (total: 178,000 PIP, 23,560 lifetime IDU, 13,130 anti-HCV(+)). There was a positive linear association between the prevalence of lifetime IDU in prison and in the general population (slope[95% CI]: 2.41[-0.29,5.11] per 0.1% increase, p=0.070). Conclusion: The prevalence of lifetime IDU among PIP exhibits heterogeneity per country reflecting differences in patterns of drug use and prevalence of injecting in the general population. The linear regression equation may be used to estimate the proportion of PIP with lifetime IDU in other countries with available data on lifetime IDU in the general population. Disclosure of Interest Statement: The authors do not have any conflict of interest related to the current work.
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