To identify predictors of HIV-infection in injecting drug users upon incarceration.
We studied 639 IDU or ex-IDU prisoners admitted to a provincial prison of North-western Spain between 1 January 1991 and 31 December 1995.
Each was interviewed by health personnel and tested for HIV-infection (ELISA followed by immunoblot confirmation in positive cases).
Statistical analysis was based on logistic regression.
The prevalence of HIV-infection was 46.9% (95% CI : 43.1% - 50.8%). No decreasing tendency in annual prevalence of HIV-infection was observed (p=0.88) ; however, for those incarcerated for the first time prevalence fell from 38% in 1991 to 19% in 1995 (p=0.20).
Gypsies (OR : 0.43 ; 95% CI : 0.23-0.80) and prisoners who were older upon first incarceration (OR : 0.94 ; 95% CI : 0.90-0.99) were associated with lesser risk of HIV-infection.
Women (OR : 2.17 ; 95% CI : 1.29-3.65), older prisoners (OR : 1.06 ; 95% CI : 1.02-1.11), those with multiple incarceration histories (OR : 1.06 ; 95% CI : 1.01-1.11) and long-term prisoners (OR : 1.01 ; 95% CI : 1.00-1.02) were associated with higher risk.
The high prevalence of HIV-infection, especially in women, younger prisoners, repeat offenders and long-term prisoners, suggests that prevention measures directed toward the most marginal IDU have not been very effective.
Harm-reduction programs must be made to reach the IDU population, both in and outside prison walls.
Mots-clés Pascal : Toxicomanie, Voie intraveineuse, SIDA, Virose, Infection, Milieu carcéral, Epidémiologie, Facteur risque, Evolution, Incidence, Homme, Espagne, Europe, Prévention, Programme sanitaire, Immunopathologie, Immunodéficit
Mots-clés Pascal anglais : Drug addiction, Intravenous administration, AIDS, Viral disease, Infection, Carceral environment, Epidemiology, Risk factor, Evolution, Incidence, Human, Spain, Europe, Prevention, Sanitary program, Immunopathology, Immune deficiency
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 98-0395307
Code Inist : 002B06D01. Création : 25/01/1999.