title: Factors associated with incarceration and incident human immunodeficiency virus (HIV) infection among injection drug users participating in an HIV vaccine trial in Bangkok, Thailand, 1999-2003.
abstract: OBJECTIVE
  To determine if incarceration was associated with human immunodeficiency virus (HIV) infection and identify risk factors for incarceration among injection drug users (IDUs) participating in an HIV vaccine trial in Bangkok.
  
  
  METHODS
  The AIDSVAX B/E HIV vaccine trial was a randomized, double-blind, placebo-controlled study. A proportional hazards model was used to evaluate demographic characteristics, risk behavior and incarceration as predictors of HIV infection and generalized estimation equation logistic regression analysis to investigate demographic characteristics and risk behaviors for predictors of incarceration.
  
  
  METHODS
  The trial was conducted in Bangkok Metropolitan Administration drug-treatment clinics, 1999-2003.
  
  
  METHODS
  A total of 2546 HIV-uninfected IDUs enrolled in the trial.
  
  
  METHODS
  HIV testing was performed and an interviewer-administered questionnaire was used to assess risk behavior and incarceration at baseline and every 6 months for a total of 36 months.
  
  
  RESULTS
  HIV incidence was 3.4 per 100 person-years [95% confidence interval (CI), 3.0-3.9] and did not differ among vaccine and placebo recipients. In multivariable analysis, being in jail (P < 0.04), injecting (P < 0.0001), injecting daily (P < 0.0001) and sharing needles (P = 0.02) were associated with HIV infection and methadone maintenance was protective (P = 0.0006). Predictors of incarceration in multivariable analysis included: male sex (P = 0.04), younger age (P < 0.0001), less education (P = 0.001) and being in jail (P < 0.0001) or prison (P < 0.0001) before enrollment.
  
  
  CONCLUSIONS
  Among IDUs in the AIDSVAX B/E trial, incarceration in jail was associated with incident HIV infection. IDUs in Thailand remain at high risk of HIV infection and additional prevention tools are needed urgently. HIV prevention services, including methadone, should be made available to IDUs.
authors.affiliation: Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand.
authors.forename: Pravan
authors.initials: P
authors.lastname: Suntharasamai
authors.forename: Michael
authors.initials: M
authors.lastname: Martin
authors.forename: Suphak
authors.initials: S
authors.lastname: Vanichseni
authors.forename: Frits
authors.initials: F
authors.lastname: van Griensven
authors.forename: Philip A
authors.initials: PA
authors.lastname: Mock
authors.forename: Punnee
authors.initials: P
authors.lastname: Pitisuttithum
authors.forename: Jordan W
authors.initials: JW
authors.lastname: Tappero
authors.forename: Udomsak
authors.initials: U
authors.lastname: Sangkum
authors.forename: Dwip
authors.initials: D
authors.lastname: Kitayaporn
authors.forename: Marc
authors.initials: M
authors.lastname: Gurwith
authors.forename: Kachit
authors.initials: K
authors.lastname: Choopanya
mesh_terms: D016915:AIDS Vaccines / Q000008:administration & dosage*; D000328:Adult; D019969:Amphetamine-Related Disorders / Q000453:epidemiology / Q000534:rehabilitation; D004311:Double-Blind Method; D005260:Female; D006678:HIV; D015658:HIV Infections / Q000453:epidemiology* / Q000517:prevention & control / Q000635:transmission; D006801:Humans; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D008875:Middle Aged; D009294:Narcotics; D016485:Needle Sharing; D011329:Prisoners / Q000706:statistics & numerical data*; D011330:Prisons; D012307:Risk Factors; D013785:Thailand / Q000453:epidemiology; D055815:Young Adult
chemical_list: D016915:AIDS Vaccines; C112734:AIDSVAX; D009294:Narcotics; D008691:Methadone