title: Drug use and risk of bloodborne infections: a survey of female prisoners in British Columbia.
abstract: BACKGROUND
  Clinicians working in a women's prison in British Columbia observed hepatitis C sero-conversion among inmates, prompting this study to determine: the characteristics of women who do and do not report illicit drug use in prison; patterns of drug use inside prison; factors associated with illicit drug use that might contribute to bloodborne transmission inside prison.
  
  
  METHODS
  A cross-sectional observational data set was created using an anonymous 61-item self-administered survey.
  
  
  RESULTS
  Eighty-three percent (104/126) of eligible inmates participated. Seventy-four percent (77/104) reported their current prison sentence was related to illicit drug use and 25% (26/104) reported their ethnicity as Aboriginal. Ninety-three percent (97/104) reported a prior history of illicit drug use, of whom 70% (68/97) reported a history of injection drug use. Thirty-six percent (37/104) reported illicit drug use in prison, and 21% (22/104) reported injection drug use in prison. Fifty-two percent (54/104) reported hepatitis C sero-positivity, and 8% (8/104) reported HIV sero-positivity. Of the 22 women who reported prison injection drug use, 91% (20/22) reported hepatitis C infection and 86% (19/22) reported injecting with shared needles inside prison, with or without bleach cleaning. Women were more likely to report illicit drug use in prison if they had had illegal sources of income prior to incarceration (p=0.0081, OR 3.19), had previously injected drugs (p=0.036, OR 2.97), and had first injected drugs at a friend's house (p=0.066, OR 2.70).
  
  
  CONCLUSIONS
  The majority of women reporting prison injection drug use also reported hepatitis C sero-positivity and shared needle use. Canadian prisons are risk situations for transmission of bloodborne pathogens, and provide opportunities for harm reduction strategies.
authors.affiliation: Department of Family Practice, University of British Columbia, Vancouver. remartin@interchange.ubc.ca
authors.forename: Ruth Elwood
authors.initials: RE
authors.lastname: Martin
authors.forename: Fiona
authors.initials: F
authors.lastname: Gold
authors.forename: Wendy
authors.initials: W
authors.lastname: Murphy
authors.forename: Valencia
authors.initials: V
authors.lastname: Remple
authors.forename: Jonathan
authors.initials: J
authors.lastname: Berkowitz
authors.forename: Deborah
authors.initials: D
authors.lastname: Money
mesh_terms: D000328:Adult; D001955:British Columbia / Q000453:epidemiology; D003430:Cross-Sectional Studies; D005260:Female; D015658:HIV Infections / Q000453:epidemiology* / Q000635:transmission; D006526:Hepatitis C / Q000453:epidemiology* / Q000635:transmission; D006801:Humans; D013287:Illicit Drugs; D015995:Prevalence; D011329:Prisoners; D012307:Risk Factors; D012309:Risk-Taking; D015819:Substance Abuse, Intravenous / Q000150:complications / Q000453:epidemiology*; D011795:Surveys and Questionnaires
chemical_list: D013287:Illicit Drugs