Canadian Prisons Contributing to Spread of HIV, Researchers Say

About 15% of incarcerated drug users at correctional facilities in the Canadian province of British Columbia reported using injection drugs during their incarceration, causing concern that prisons are contributing to the spread of HIV in Canada, according to one of two recently released studies conducted by researchers from the B.C. Centre for Excellence in HIV/AIDS, the CNS/Vancouver Sun reports.

The first study, published online in Oxford University's Journal of Public Health, followed 1,247 injection drug users for six years. Half of the IDUs were incarcerated at some point during the study. Nearly 15% of those who had been incarcerated reported using injection drugs while in prison, mostly with used needles.

The second study, published in Drug and Alcohol Review, followed 902 IDUs at Insite -- a supervised drug-injection facility in Vancouver, Canada -- over two years. About one-third of the IDUs reported having been incarcerated at each six-month follow-up, 5% of whom reported using injection drugs during their incarcerations.

The studies found that IDUs who have been incarcerated are "more likely to report syringe sharing" and to be living with HIV or hepatitis, the researchers wrote. Evan Wood, a researcher who worked on both studies, said the findings likely underestimate the number of IDUs who reuse needles while incarcerated because many people are unlikely to admit they use injection drugs or reuse needles.

The researchers are calling for needle-exchange programs in prisons to reduce the spread of HIV and hepatitis. Wood said a "coordinated public health response" is needed to address the issue and to protect inmates and their "home communities" from the spread of bloodborne diseases. The researchers added that the findings underline the "urgent need" to expand harm-reduction programs at correctional facilities across Canada.

Officials at Correctional Service of Canada said that "continuing risk behavior by inmates during incarceration presents a public health challenge." Guy Campeau, director of media relations at CSC, said that the department is implementing a "comprehensive" infectious disease program that includes methadone maintenance and the distribution of condoms, dental dams, water-based lubricant and bleach to help reduce the spread of HIV and other diseases. The department has "no plans to implement a needle-exchange program," Campeau said (Munro, CNS/Vancouver Sun, 4/6).

An abstract of the first study is available online. An abstract of the second study also is available online.

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