A survey of bloodborne viruses and associated risk behaviours in Greek prisons.
OBJECTIVE
To determine HIV and hepatitis infection prevalence and correlates with risk behaviour.


METHODS
Cross-sectional study: voluntary, anonymous HIV, hepatitis (HCV, HBV and HDV) surveillance and questionnaire on risk factors.


METHODS
Korydallos Prison, Athens and Ag. Stefanos Prison, Patra, Greece.


METHODS
Of 544 drug users imprisoned for drug related offences, all completed the questionnaire and 533 blood samples were collected.


METHODS
HIV (by anti-HIV-1), HCV (by anti-HCV), HBV (by anti-HBc, HBsAg) and HDV (by anti-HDV) prevalence. Data on demography, legal status, drug use, sharing of injecting equipment.


RESULTS
Of the 544 drug users, 375 (68.9%) had injected drugs (IDUs) at some time, 35% of whom had injected whilst in that prison. Of the 533 blood samples tested, one was positive for anti-HIV-1 (0.19%), 310 for anti-HCV (58.2%), 306/531 (57.6%) for anti-HBc, 34/527 (6.5%) for HBsAg and 12/527 (2.3%) for anti-HDV. Prevalence rates for IDUs only were 0.27% for HIV-1, 80.6% for hepatitis C, 62.7% for hepatitis B and 3.3% for hepatitis D. Ninety-two per cent of IDUs injecting in prison shared needles, indicating that IDUs inject less but share more during incarceration. Multiple logistic regression revealed needle-sharing as the most important risk factor for HCV infection in IDUs. Prior knowledge of a positive hepatitis result did not appear to inhibit IDUs from practising risky behaviours in prison.


CONCLUSIONS
The epidemic of hepatitis B and C among imprisoned IDUs identified by this study constitutes a major public health problem. Prevention programmes, such as counselling, HBV vaccination, community-based methadone maintenance treatment and syringe exchange schemes, are necessary in order to prevent a further spread.
Malliori
M
M
Department of Psychiatry, University of Athens, Greece.
Sypsa
V
V
Psichogiou
M
M
Touloumi
G
G
Skoutelis
A
A
Tassopoulos
N
N
Hatzakis
A
A
Stefanis
C
C
D000328:Adult; D003430:Cross-Sectional Studies; D005260:Female; D006115:Greece / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology*; D006525:Hepatitis, Viral, Human / Q000453:epidemiology*; D006801:Humans; D008297:Male; D015995:Prevalence; D011329:Prisoners; D012307:Risk Factors; D012309:Risk-Taking; D019966:Substance-Related Disorders / Q000453:epidemiology