Sarah Larney1. 1. National Drug and Alcohol Research Centre, University of New South Wales, Sydney, NSW 2052, Australia. s.larney@unsw.edu.au
Abstract
OBJECTIVES: To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours. METHODS: Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs. RESULTS: Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55-75% and risk of needle and syringe sharing was reduced by 47-73%. No study reported a direct effect of prison OST on HIV incidence. CONCLUSIONS: There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment.
OBJECTIVES: To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours. METHODS: Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs. RESULTS: Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55-75% and risk of needle and syringe sharing was reduced by 47-73%. No study reported a direct effect of prison OST on HIV incidence. CONCLUSIONS: There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment.
Authors: Jaimie P Meyer; Javier Cepeda; Johnny Wu; Robert L Trestman; Frederick L Altice; Sandra A Springer Journal: JAMA Intern Med Date: 2014-05 Impact factor: 21.873
Authors: Jacob M Izenberg; Chethan Bachireddy; Jeffrey A Wickersham; Michael Soule; Tetiana Kiriazova; Sergii Dvoriak; Frederick L Altice Journal: Int J Drug Policy Date: 2014-02-28
Authors: Divya K Chandra; Alexander R Bazazi; Muzammil A Nahaboo Solim; Adeeba Kamarulzaman; Frederick L Altice; Gabriel J Culbert Journal: HIV Res Clin Pract Date: 2019-05-01
Authors: Dora M Dumont; Brad Brockmann; Samuel Dickman; Nicole Alexander; Josiah D Rich Journal: Annu Rev Public Health Date: 2012-01-03 Impact factor: 21.981