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Prior opiate injection and incarceration history predict injection drug use among inmates

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ABSTRACT Aims 

To describe injection drug use among inmates, and to identify correlates of drug injection while incarcerated. Design 

Cross-sectional survey. Setting 

Six provincial correctional centres in Ontario, Canada. Participants 

Face-to-face interviews were conducted with a random sample of 439 adult males and 158 females. Measurements 

Inmates were asked about drug use in their lifetime, outside the year prior to their current incarceration, and while incarcerated in the past year. Among the 32% (189 / 597) with a prior history of drug injection, independent correlates of injection while incarcerated in the past year were identified using multiple logistic regression. Findings 

Among all inmates while incarcerated in the past year, 45% (269 /597) used drugs and 19% (113 / 596) used non-cannabis drugs. Among those with a prior history of injecting, 11% (20 / 189) injected while incarcerated in the past year. Rates of injection with used needles were the same pre-incarceration as they were while incarcerated (32%). Independent correlates of drug injection while incarcerated were injection of heroin (OR = 6.4) or other opiates (OR = 7.9) and not injected with used needles (OR = 0.20) outside in the year prior to incarceration, and ever being incarcerated in a federal prison (OR = 5.3). Conclusions 

The possibility of transmission of human immunodeficiency virus (HIV), hepatitis C (HCV) or other blood-borne diseases exists in Ontario correctional centres. In this setting, drug injection while incarcerated is primarily related to opiate use prior to incarceration. The correlation between injecting and extensive incarceration history suggests missed opportunities to improve inmates’ health.
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Keywords: Adult; Canada; HIV infections; cross-sectional studies; intravenous substance abuse; needle sharing; prisoners; risk-taking; transmission

Document Type: Research Article

Affiliations: 1: HIV Social, Behavioural and Epidemiological Studies Unit, Faculty of Medicine, University of Toronto, Toronto , 2: Department of Public Health Sciences, Faculty of Medicine, University of Toronto, Toronto , 3: Ontario Ministry of Health and Long-term Care, Disease Control Services, Public Health Branch, Toronto 4: Ontario Ministry of Health and Long-term Care, HIV Laboratory, Laboratory Services Branch, Toronto 5: and Centre for Addiction and Mental Health, Toronto, Canada

Publication date: 01 September 2003

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