HIV risk behavior in prison and factors related to reincarceration among injecting drug users

OBJECTIVES: The aim of this study was to estimate the frequency of risk beh avior for HIV transmission in prison and to identify the factors associated with reincarceration. PATIENTS AND METHODS: An epidemiologic study was carried out in the peniten tiary center of Marseilles between December 1995 and March 1997. Five hundr ed and seventy four prisoners answered an anonymous voluntary questionnaire managed by independent interviewers. RESULTS: Among the 574 prisoners, 133 (23%) reported they had injected drug s (intravenous drug users, IDU) including 71 (53%) who had injected drugs d uring the three months preceding incarceration. Seven percent of the IDU re ceived opiate substitutes before their imprisonment Nine prisoners of the 1 20 who have responded to the question (7.5%: 3.7 - 14.2 95%CI) stated they had injected drugs during the first three months of incarceration. Multivar iate analysis showed that reincarceration was significantly more frequent a mong men, HIV-infected and unemployed prisoners, and prisoners not receivin g opiate substitutes at the time of their imprisonment. DISCUSSION: This study show that risk behaviors of HIV and hepatitis virus transmission are frequent among intravenous drug users, including during th eir incarceration. The relationship between opiate substitution treatment a nd reincarceration deserves to be studied further on larger samples in orde r to better evaluate its impact on social rehabilitation of drug addicts. T his data also underline the need to strengthen prevention programs in priso ns and the importance of social and health policies targeted on drug users especially opiate substitution programs. (C) 2000, Masson, Paris.