International Journal of Epidemiology, Vol 26, 1359-1366, Copyright © 1997 by International Epidemiological Association
K Stark, U Bienzle, R Vonk and I Guggenmoos-Holzmann
BACKGROUND: Injecting drug users (IDU) are at risk of parenterally
transmitted diseases such as hepatitis B virus (HBV), hepatitis C virus
(HCV), and human immunodeficiency virus (HIV) infection. We investigated
whether a history of syringe sharing in prison is a risk factor for these
infections. In the longitudinal part of the study, HBV, HCV, and HIV
seroincidence rates were determined. METHODS: The participants were
recruited by multisite-sampling at different agencies for IDU. Data on risk
behaviour were obtained by a standardized questionnaire. Serological
markers for HBV, HCV, and HIV were determined. Logistic regression analysis
was performed to adjust for confounding effects. RESULTS: A history of
syringe sharing in prison was significantly associated with HBV (adjusted
prevalence odds ratio [POR] = 3.9, 95% confidence interval [CI]: 2-10), HCV
(POR = 9.7, 95% CI: 3-33), and HIV infection (POR = 10.4, 95% CI: 4-29).
The HIV seroincidence rate was 5.9 per 100 person-years. None of the IDU
receiving methadone maintenance treatment (MMT) seroconverted whereas the
HIV incidence was 8.5 among IDU not in MMT (P = 0.01). CONCLUSIONS: The
increased risk of HBV, HCV, and HIV infection among IDU who had shared
syringes in prison warrants specific preventive action. The longitudinal
data suggest that IDU in MMT have a lower risk of HIV infection.
ARTICLES
History of syringe sharing in prison and risk of hepatitis B virus, hepatitis C virus, and human immunodeficiency virus infection among injecting drug users in Berlin
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