Surveillance of HIV infection and related risk behaviour in European prisons - A multicentre pilot study

Background: In order to demonstrate the feasibility of human immunodeficien cy virus (HIV) infection and related risk behaviour surveillance in Europea n prisons, a multicentre pilot study was undertaken. Methods: A cross-secti onal survey was carried out in six European prisons (France, Germany, Italy , The Netherlands, Scotland and Sweden). Inmates were invited to complete a self-administered and anonymous questionnaire and to give a saliva sample in order to test for HIV antibodies. Results: Eight hundred and forty-seven out of 1,124 inmates participated in the survey (response rate 75%). Saliv a from 817 inmates (73%) was collected and processed for HIV antibodies. Tw enty-seven per cent reported that they had ever injected drugs and 49% of t hese reported they had injected whilst in prison. Eighteen per cent of inma tes reported that they had been tattooed whilst in prison, which was found to be higher among injecting drug users (IDUs). One and sixteen per cent re ported that they had ever had homosexual and heterosexual intercourse in pr ison respectively. The HIV prevalence among IDUs was 4% (versus 1% among no n-IDUs) (p=0.02). The proportions of inmates previously tested for hepatiti s C and vaccinated against hepatitis B were 24 and 16% respectively. Conclu sion: This survey demonstrates the feasibility of cross-sectional surveys i n European prison inmates and highlights the importance of surveillance of HIV prevalence and related risk behaviour among inmates. The continuing hig h HIV prevalence and potential for HIV spread in prisons should encourage d ecision makers in implementing or enhancing harm reduction and education pr ogrammes and substance abuse treatment services in prison.