Ag. Bird et al., HARM REDUCTION MEASURES AND INJECTING INSIDE PRISON VERSUS MANDATORY DRUGS TESTING - RESULTS OF A CROSS-SECTIONAL ANONYMOUS QUESTIONNAIRE SURVEY, BMJ. British medical journal, 315(7099), 1997, pp. 21-24
Objectives: (a) To determine both the frequency of injecting inside pr
ison and use of sterilising tablets to clean needles in the previous f
our weeks; (b) to assess the efficiency of random mandatory drugs test
ing at detecting prisoners who inject heroin inside prison; (c) to det
ermine the percentage of prisoners who had been offered vaccination ag
ainst hepatitis B. Design: Cross sectional willing anonymous salivary
HIV surveillance linked to a self completion risk factor questionnaire
. Setting: Lowmoss prison, Glasgow, and Aberdeen prison on 11 and 30 O
ctober 1996. Subjects: 293 (94%) of all 312 inmates at Lowmoss and 146
(93%) of all 157 at Aberdeen, resulting in 286 and 143 valid question
naires. Main outcome measures: Frequency of injecting inside prison in
the precious four weeks by injector inmates who had been in prison fo
r at least four weeks. Results: 116 (41%) Lowmoss and 53 (37%) Aberdee
n prisoners had a history of injecting drug use but only 4% of inmates
(17/395; 95% confidence interval 2% to 6%) had ever been offered vacc
ination against hepatitis B. 42 Lowmoss prisoners (estimated 207 injec
tions and 258 uses of sterilising tablets) and 31 Aberdeen prisoners (
229 injections, 221 uses) had injected inside prison in the previous f
our weeks. The prisons together held 112 injector inmates who had been
in prison for more than four weeks, of whom 57 (51%; 42% to 60%) had
injected in prison in the past four weeks; their estimated mean number
of injections was 6.0 (SD 5.7). Prisoners injecting heroin six times
in four weeks will test positive in random mandatory drugs testing on
at most 18 days out of 28. Conclusions: Sterilising tablets and hepati
tis B vaccination should be offered to all prisoners. Random mandatory
drugs testing seriously underestimates injector inmates' harm reducti
on needs.