Injecting drug use in prison: prevalence and implications for needle exchange policy.
OBJECTIVE
The purpose of this paper is to explore prison drug injecting prevalence, identify any changes in injecting prevalence and practice during imprisonment and explore views on prison needle exchange.


METHODS
An empirical prospective cohort survey conducted between 2006 and 2008. The study involved a random sample of 267 remand and sentenced prisoners from a large male category B prison in England where no prison needle exchange operates. Questionnaires were administered with prisoners on reception and, where possible, at one, three and six months during their sentence.


RESULTS
In total, 64 per cent were injecting until admission into prison. The majority intended to stop injecting in prison (93 per cent), almost a quarter due to the lack of needle exchange (23 per cent). Yet when hypothetically asked if they would continue injecting in prison if needle exchange was freely available, a third of participants (33 per cent) believed that they would. Injecting cessation happened on prison entry and appeared to be maintained during the sentence.


CONCLUSIONS
Not providing sterile needles may increase risks associated with injecting for prisoners who continue to inject. However, providing such equipment may prolong injecting for other prisoners who currently cease injecting on account of needle exchange programmes (NEPs) not being provided in the UK prison setting. Practical implications - Not providing sterile needles may increase risks associated with injecting for prisoners who continue to inject. However, providing such equipment may prolong injecting for other prisoners who currently cease injecting on account of NEPs not being provided in the UK prison setting.


CONCLUSIONS
This survey is the first to question specifically regarding the timing of injecting cessation amongst male prisoners and explore alongside intention to inject should needle exchange facilities be provided in prison.
Leeds Community Healthcare, Leeds, UK.
Nat M J
NM
Wright
Charlotte N E
CN
Tompkins
Tracey M
TM
Farragher
D004739:England; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D016485:Needle Sharing / Q000523:psychology; D018671:Needle-Exchange Programs / Q000706:statistics & numerical data*; D057766:Policy; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D011446:Prospective Studies; D012307:Risk Factors; D012959:Socioeconomic Factors; D015819:Substance Abuse, Intravenous / Q000453:epidemiology* / Q000523:psychology*
Injection drug use; Injection drug users; Needle and syringe programmes; Prison; Prisoners; Substance related disorders