title: Substitution treatment and HCV/HIV-infection in a sample of 31 German prisons for sentenced inmates.
abstract: Injection drug use (IDU) and IDU-related infectious diseases such as hepatitis C virus (HCV) and human immunodeficiency virus (HIV) infections are highly prevalent among prisoners worldwide. However, little is known about the prevalence of IDUs, HCV/HIV and the availability of respective treatment options in German prisons. Data provided by prison physicians of 31 prisons, representing 14,537 inmates, were included in this analysis. The proportion of IDUs among all prisoners was 21.9%. Substitution treatment was available in three out of four prisons (74.2%). Overall, 1137 substitution treatments were provided annually with a wide range of treatment aims. The prevalence rate was 14.3% for HCV and 1.2% for HIV. Around 5.5% of all HCV-infected prisoners were in antiviral treatment annually, 86.5% of all HIV-positive inmates in antiretroviral HIV-treatment. Generally, substitution treatment, and HCV and HIV testing and treatment are available. However, due to abstinence-orientated treatment aims, substitution treatment is rarely available as maintenance treatment, and HCV/HIV-treatment is mainly provided for patients with an existing treatment before imprisonment. The inconsistent data quality necessitates changes in prison-related policy to improve surveillance and to generate aggregated data in German prisons. The selection process in this analysis might lead to overestimating the provision of substitution and antiviral HCV-treatment.
authors.affiliation: Centre for Interdisciplinary Addiction Research, University of Hamburg, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Schulte
authors.forename: H
authors.initials: H
authors.lastname: Stöver
authors.forename: K
authors.initials: K
authors.lastname: Thane
authors.forename: C
authors.initials: C
authors.lastname: Schreiter
authors.forename: D
authors.initials: D
authors.lastname: Gansefort
authors.forename: J
authors.initials: J
authors.lastname: Reimer
mesh_terms: D000998:Antiviral Agents / Q000008:administration & dosage* / Q000627:therapeutic use; D003430:Cross-Sectional Studies; D005858:Germany / Q000453:epidemiology; D015658:HIV Infections / Q000188:drug therapy* / Q000453:epidemiology; D006526:Hepatitis C / Q000188:drug therapy* / Q000453:epidemiology; D006801:Humans; D058850:Opiate Substitution Treatment / Q000706:statistics & numerical data*; D015995:Prevalence; D011329:Prisoners; D011330:Prisons / Q000706:statistics & numerical data*; D012307:Risk Factors; D015819:Substance Abuse, Intravenous / Q000188:drug therapy* / Q000453:epidemiology
chemical_list: D000998:Antiviral Agents
keywords: German prisons; HCV; HIV; IDU; Substitution treatment