Résumé :
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[BDSP. Notice produite par INIST 84utER0x. Diffusion soumise à autorisation]. Objective : To identify predictors of HIV-infection in injecting drug users upon incarceration. Patients and methods : We studied 639 IDU or ex-IDU prisoners admitted to a provincial prison of North-western Spain between 1 January 1991 and 31 December 1995. Each was interviewed by health personnel and tested for HIV-infection (ELISA followed by immunoblot confirmation in positive cases). Statistical analysis was based on logistic regression. Results : The prevalence of HIV-infection was 46.9% (95% CI : 43.1% - 50.8%). No decreasing tendency in annual prevalence of HIV-infection was observed (p=0.88) ; however, for those incarcerated for the first time prevalence fell from 38% in 1991 to 19% in 1995 (p=0.20). Gypsies (OR : 0.43 ; 95% CI : 0.23-0.80) and prisoners who were older upon first incarceration (OR : 0.94 ; 95% CI : 0.90-0.99) were associated with lesser risk of HIV-infection. Women (OR : 2.17 ; 95% CI : 1.29-3.65), older prisoners (OR : 1.06 ; 95% CI : 1.02-1.11), those with multiple incarceration histories (OR : 1.06 ; 95% CI : 1.01-1.11) and long-term prisoners (OR : 1.01 ; 95% CI : 1.00-1.02) were associated with higher risk. Conclusions : The high prevalence of HIV-infection, especially in women, younger prisoners, repeat offenders and long-term prisoners, suggests that prevention measures directed toward the most marginal IDU have not been very effective. Harm-reduction programs must be made to reach the IDU population, both in and outside prison walls.
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