Risk of prevalent HIV infection associated with incarceration among injecting drug users in Bangkok, Thailand: case-control study.
OBJECTIVE
To identify risks for HIV infection related to incarceration among injecting drug users in Bangkok, Thailand.


METHODS
Case-control study of sexual and parenteral exposures occurring before, during, and after the most recent incarceration.


METHODS
Metropolitan Bangkok.


METHODS
Non-prison based injecting drug users formerly incarcerated for at least six months in the previous five years, with documented HIV serostatus since their most recent release; 175 HIV positive cases and 172 HIV negative controls from methadone clinics.


METHODS
Injection of heroin and methamphetamine, sharing of needles, sexual behaviour, and tattooing before, during, and after incarceration.


RESULTS
In the month before incarceration cases were more likely than controls to have injected methamphetamine and to have borrowed needles. More cases than controls reported using drugs (60% v 45%; P=0.005) and sharing needles (50% v 31%; P<0.01) in the holding cell before incarceration. Independent risk factors for prevalent HIV infection included injection of methamphetamine before detention (adjusted odds ratio 3.3, 95% confidence interval 1.01 to 10.7), sharing needles in the holding cell (1.9, 1.2 to 3.0), being tattooed while in prison (2.1, 1.3 to 3.4), and borrowing needles after release (2.5, 1.3 to 4.4).


CONCLUSIONS
Injecting drug users in Bangkok are at significantly increased risk of HIV infection through sharing needles with multiple partners while in holding cells before incarceration. The time spent in holding cells is an important opportunity to provide risk reduction counselling and intervention to reduce the incidence of HIV.
Buavirat
Aumphornpun
A
Health Promotion Division, Health Department, Bangkok Metropolitan Administration City Hall 2 Dindaeng, 7th floor Drainage Building, Mittmaitree Road, Dindaeng, Bangkok 10400, Thailand.
Page-Shafer
Kimberly
K
van Griensven
G J P
GJ
Mandel
J S
JS
Evans
J
J
Chuaratanaphong
J
J
Chiamwongpat
S
S
Sacks
R
R
Moss
A
A
D000328:Adult; D016022:Case-Control Studies; D003688:Deinstitutionalization; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology*; D006801:Humans; D008297:Male; D016485:Needle Sharing; D015995:Prevalence; D011329:Prisoners; D012307:Risk Factors; D021841:Safe Sex; D015819:Substance Abuse, Intravenous / Q000150:complications*; D013653:Tattooing; D013785:Thailand / Q000453:epidemiology