title: Incarceration is a major risk factor for blood-borne infection among intravenous drug users: Incarceration and blood borne infection among intravenous drug users.
abstract: BACKGROUND
  There is a strong association between hepatitis B virus (HBV), hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infection which are mainly transmitted by contamination with blood via intravenous drug abuse (IVDU) or sexual contact.
  
  
  OBJECTIVE
  To determine the prevalence of these infections and the risk factors associated with them among prisoner and non-prisoner IVDUs in Tehran, Iran.
  
  
  METHODS
  This cross-sectional study was performed in two jails and three drug rehabilitation centers between 2001 and 2002 in Tehran. HBsAg and HBcAb were checked using highly specific third generation enzyme immunoassays (DIA.PRO, Italy, specificity >99%, and Radim, Italy, specificity 99.7%, respectively). HCVAb was detected using ELISA (DIA.PRO, Italy) with both sensitivity and specificity >98%. HIVAb test (DRG Diagnostics kit, Germany) was performed for 459 of the 468 IDU subjects.
  
  
  RESULTS
  392 prisoners and 135 individual attending drug rehabilitation centers were approached. Of the 518 subjects studied, 464 (89.5%) were male, 386 (74.5%) were prisoners and 132 (25.5%) were non-prisoners. In this study, HBsAg, HCVAb and HIVAb were positive in 19 (3.7%), 359 (69.5%) and 70 (15.5%) of subjects, respectively. These tests were positive in 17 (4.5%), 311 (80.5%) and 63 (17%) among prisoners and 2 (1.5%), 48 (36.5%) and 7 (7.8%) in non-prisoners, respectively. Multiple logistic regression analysis revealed that independent factors related to co-infection of HCV and HIV infection were imprisonment (p<0.001. OR: 7.5) and using common syringe (p=0.03, OR: 4.5).
  
  
  CONCLUSIONS
  Our findings strongly suggest that drug injection inside prison carries is a risk for HIV infection and that HIV infection among IDUs is likely to be bridged to the broader population through sexual contact without using effective prevention programs.
authors.affiliation: Digestive Disease Research Center, Shariati Hospital, Tehran University of Medical Sciences, Tehran, IR Iran.
authors.forename: Mohammad Mehdi
authors.initials: MM
authors.lastname: Mir-Nasseri
authors.forename: Ashraf
authors.initials: A
authors.lastname: Mohammadkhani
authors.forename: Hamid
authors.initials: H
authors.lastname: Tavakkoli
authors.forename: Esmaeil
authors.initials: E
authors.lastname: Ansari
authors.forename: Hossein
authors.initials: H
authors.lastname: Poustchi
references.citation: AIDS. 2005 Oct;19 Suppl 3:S41-6
references.pmid: 16251827
references.citation: J Acquir Immune Defic Syndr. 2006 Jul;42(3):342-6
references.pmid: 16639351
references.citation: Am J Epidemiol. 1995 Aug 1;142(3):331-41
references.pmid: 7631637
references.citation: AIDS. 2004 Nov 19;18(17):2285-93
references.pmid: 15577541
references.citation: Epidemiol Infect. 1999 Aug;123(1):95-102
references.pmid: 10487645
references.citation: J Gastroenterol Hepatol. 2002 Oct;17(10):1092-7
references.pmid: 12201870
references.citation: J Infect Dis. 1991 Mar;163(3):454-9
references.pmid: 1825315
references.citation: World J Gastroenterol. 2005 Jul 14;11(26):4085-9
references.pmid: 15996035
references.citation: Am J Public Health. 1985 Oct;75(10):1213-4
references.pmid: 4037165
references.citation: BMJ. 2000 Jul 8;321(7253):78-82
references.pmid: 10884256
references.citation: AIDS. 2005 Apr 29;19(7):709-16
references.pmid: 15821397
references.citation: AIDS. 1991 Jul;5(7):845-51
references.pmid: 1892589
references.citation: Eur J Epidemiol. 1993 Sep;9(5):566-9
references.pmid: 8307145
references.citation: J Hepatol. 2004 Aug;41(2):312-8
references.pmid: 15288482
references.citation: J Viral Hepat. 1995;2(3):113-9
references.pmid: 7493305
references.citation: J Infect Dis. 2008 Jun 1;197(11):1558-66
references.pmid: 18419344
references.citation: Int J Drug Policy. 2007 Oct;18(5):359-63
references.pmid: 17854723
references.citation: J Acquir Immune Defic Syndr Hum Retrovirol. 1995 Apr 1;8(4):399-405
references.pmid: 7882106
references.citation: Int J Epidemiol. 1993 Feb;22(1):135-9
references.pmid: 8449633
references.citation: World J Gastroenterol. 2009 Aug 14;15(30):3713-24
references.pmid: 19673011
references.citation: AIDS. 2001 Feb 16;15(3):397-405
references.pmid: 11273220
references.citation: Arch Iran Med. 2009 Sep;12(5):483-7
references.pmid: 19722771
references.citation: BMJ. 1990 Nov 17;301(6761):1130-3
references.pmid: 2174705
references.citation: AIDS. 1995 Feb;9(2):183-90
references.pmid: 7718190