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Drug injection and HIV prevalence in inmates of Glenochil prison

BMJ 1995; 310 doi: https://doi.org/10.1136/bmj.310.6975.293 (Published 04 February 1995) Cite this as: BMJ 1995;310:293
  1. Sheila M Gore, senior statisticiana,
  2. A Graham Bird, consultant immunologistbn,
  3. Sheila M Burns, consultant virologistc,
  4. David J Goldberg, consultant epidemiologistd,
  5. Amanda J Ross, statisticiane,
  6. James Macgregor, prison medical officer (part time)f
  1. a MRC Biostatistics Unit, Institute of Public Health, Cambridge CB2 2SR
  2. b Immunology Department, Churchill Hospital, Oxford OX3 7LJ
  3. c Regional Virus Laboratory, City Hospital, Edinburgh EH10 5SB
  4. d Scottish Centre for Infection and Environmental Health, Ruchill Hospital, Glasgow G20 9NB
  5. e MRC Biostatistical Initiative for AIDS and HIV in Scotland, Centre for HIV Research, Edinburgh EH9 3JN
  6. f HM Prison and Young Offenders Institution Glenochil, Tullibody, Alloa, Clackmannanshire FK10 3AD
  1. Correspondence to: Dr Gore.
  • Accepted 20 October 1994

Abstract

Objective: To determine prevalence of HIV infection and drug injecting behaviour among inmates of Glenochil Prison on a specified date a year after an outbreak of hepatitis B and HIV infection.

Design: Cross sectional: voluntary, anonymous HIV salivary antibody surveillance and linked self completion questionnaire on risk factors.

Setting: Glenochil prison, Scotland, a year after an outbreak of hepatitis B and HIV transmission related to drug injection.

Subjects: 352 prisoners, of whom 295 (84%) took part; 284 questionnaires (96%) passed logical checks.

Main outcome measures: HIV prevalence; proportion of all inmates who had ever injected drugs, had ever injected inside prison, had started injecting drugs while inside prison.

Results: More than half (150/284) the current inmates were also in Glenochil Prison during the critical period of January to June 1993, when hepatitis B and HIV were transmitted. Similar proportions of current inmates and men who were also in Glenochil during the critical period were drug users (27% (75/278) v 30% (44/149)). A quarter of injecting drug users (18/72) had first injected inside prison, irrespective of whether they were in Glenochil in January to June 1993 and regardless of the calendar period when they first injected. Significantly more inmates from Glasgow (41%; 56/138) than from Edinburgh (21%; 7/34) or elsewhere (11%; 12/106) were injecting drug users. On testing for HIV, seven saliva samples out of 293 gave positive results—four were presumed to be from inmates known to be infected with HIV, and the others from injecting drug users from Glasgow, all of whom had been in Glenochil during January to June 1993, when two of the three had injected drugs and had been tested for HIV, with negative results. The ratio of overall (2.4%) to disclosed (1.4%) HIV prevalence was 1.7. For men who had injected drugs in Glenochil during January to June 1993, HIV prevalence was estimated at 29%.

Conclusion: Between a quarter and a third of prisoners who injected drugs in Glenochil in January to June 1993 were infected with HIV. There is widespread ongoing risk of bloodborne virus infection within prisons, which is probably long standing but demands urgent attention.

Key messages

  • Key messages

  • The proportion of injecting drug users differed according to residence before prison: 41% of Glasgow residents, 21% of Edinburgh residents, and 11% of those resident elsewhere

  • A quarter of injecting drug users in Glenochil prison had started injecting while in some prison

  • Between a quarter and a third of men who injected drugs in Glenochil prison in January to June 1993 became infected with HIV while in prison

  • Widespread risk of bloodborne virus infections in British prisons demands urgent attention

Footnotes

  • Accepted 20 October 1994
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