Mortality among a cohort of drug users after their release from prison: an evaluation of the effectiveness of a harm reduction program in Taiwan

Huang, Yu-Ching; Kuo, Hsu Sung; Lew-Ting, Chin Yin; Tian, Fang; Yang, Chin-Hui; Tsai, Tzu I.; Gange, Stephen J.; Nelson, Kenrad E.

doi:10.1111/j.1360-0443.2011.03443.x

Cited by 52 publications

(56 citation statements)

References 21 publications

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“…Prior studies found that this IDU subgroup more often participated in injecting behaviors associated with HIV infection [25,26]. In addition, a cohort study in Taiwan showed that more than 40% of IDUs began using drugs again within 1.5 years after release from a correctional setting [27]. To better control the HIV epidemic among IDUs, incarcerated IDUs should receive education about HIV infection and, once released, should be strongly encouraged to refrain from drug use (eg, through harm reduction programs) [28].…”

Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with HIV infection among injection drug users at methadone clinics in Taipei, Taiwan

Yen

Lin³

et al. 2014

BMC Public Health

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BackgroundMethadone treatment was introduced in Taiwan in 2006 as a harm-reduction program for injection drug users (IDUs), among whom HIV was endemic. We examined the association of HIV serostatus with demographic characteristics, substance use, and sexual behaviors among IDUs at methadone clinics in Taipei, Taiwan.MethodsDuring 2012–2013, IDUs at methadone clinics in Taipei were recruited to complete a risk assessment interview and undergo serologic testing for HIV infection. Correlates of HIV infection were identified by multivariate logistic regression.ResultsOf the 827 eligible participants, 85.9% were male, median age was 45 years, and mean years of injecting was 18.0 (range 1–56). The prevalence of HIV infection was 17.7%. In multivariate analysis, HIV infection was significantly associated with age ≤45 years (adjusted odds ratio [AOR] = 1.62, 95% confidence interval [CI] 1.01–2.62), being divorced (AOR = 1.67, 95% CI 1.06–2.62), deriving the majority of income during the previous 6 months from temporary jobs or other noncriminal sources (AOR = 1.53, 95% CI 1.02–2.30), unstable housing during the previous 6 months (AOR = 1.47, 95% CI 1.003–2.15), higher number of incarcerations (AOR = 1.14, 95% CI 1.03–1.26), and a history of overdose (AOR = 1.51, 95% CI 1.01–2.28).ConclusionsTaiwanese IDUs at methadone clinics have a relatively high HIV prevalence, which was associated with younger age and history of overdose. It is imperative to educate IDUs’ about HIV transmission, particularly for the younger and overdosed IDUs.

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Section: Discussionmentioning

confidence: 99%

Prevalence and factors associated with HIV infection among injection drug users at methadone clinics in Taipei, Taiwan

Yen

Lin³

et al. 2014

BMC Public Health

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“…Previous studies have documented that over 40% of people who inject drugs in Russia have been previously incarcerated (Dolan et al, 2007) and despite an incarceration rate of over 500 per 100,000 (Walmsley, 2011), the Russian prison system suffers from a lack of effective linkage to care services for prisoners being released. This is especially evident regarding opioid substitution therapy, which remains illegal in Russia despite compelling international evidence that it can reduce the incidence of reincarceration (Larney et al, 2012), death (Dolan et al, 2005; Huang et al, 2011; Kinlock et al, 2009) and delay relapse (Gonzalez et al, 2004). …”

Section: Introductionmentioning

confidence: 99%

High-risk behaviors after release from incarceration among people who inject drugs in St. Petersburg, Russia

Cepeda¹,

Niccolai²,

Lyubimova³

et al. 2015

Drug and Alcohol Dependence

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Background Injection drug use, infectious disease, and incarceration are inextricably linked in Russia. We aimed to identify factors associated with time to relapse (first opioid injection after release from prison) and using a non-sterile, previously used syringe at relapse in a sample of people who inject drugs in St. Petersburg. Methods We collected data on time from release to relapse among individuals with a history of incarceration, a subsample of a larger study among people who inject drugs. Proportional hazards and logistic regression were used to identify factors associated with time to relapse and injection with a non-sterile previously used syringe at relapse, respectively. Results The median time to relapse after release was 30 days. Factors that were independently associated with relapsing sooner were being a native of St. Petersburg compared to not being native (AHR: 1.64; 95% CI 1.15 – 2.33), unemployed at relapse compared to employed (AHR: 4.49; 95% CI 2.96 – 6.82) and receiving a previous diagnosis of HBV and HCV compared to no previous diagnosis (AHR: 1.49; 95% CI 1.03 – 2.14). Unemployment at relapse was also significant in modeling injection with a non-sterile, previously used syringe at relapse compared to those who were employed (AOR: 6.80; 95% CI 1.96 – 23.59). Conclusions Unemployment was an important correlate for both resuming opioid injection after release and using a non-sterile previously used syringe at relapse. Linkage to medical, harm reduction, and employment services should be developed for incarcerated Russian people who inject drugs prior to release.

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“…The Taiwanese program includes methadone maintenance and needle exchange services throughout the country (Yang, Yang, Shen, & Kuo, 2008). The initiation of this countrywide harm reduction program has been linked to a dramatic decrease in HIV infections and mortality among drug users (Huang et al, 2011). • Although Vietnam has very low coverage, there are plans to increase methadone maintenance availability; yet with limited resources, Vietnam will need additional funds to provide a reasonable number of methadone maintenance slots as well as address police harassment of people who use drugs (Jardine, Crofts, Monaghan, & Morrow, 2012).…”

Section: Harm Reduction In Asiamentioning

confidence: 99%

Carl Latkin on Mukta Sharma and Anindya Chatterjee's “Failure of Substance Use Interventions: Perspectives from Asia”

Latkin

2012

Substance Use & Misuse

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Mortality among a cohort of drug users after their release from prison: an evaluation of the effectiveness of a harm reduction program in Taiwan

Abstract: In ex-prisoners in Taiwan with a history of opiate injecting, enrollment and continued participation in methadone maintenance treatment is associated with substantially lower mortality.

Cited by 52 publications

References 21 publications

Prevalence and factors associated with HIV infection among injection drug users at methadone clinics in Taipei, Taiwan

Prevalence and factors associated with HIV infection among injection drug users at methadone clinics in Taipei, Taiwan

High-risk behaviors after release from incarceration among people who inject drugs in St. Petersburg, Russia

Carl Latkin on Mukta Sharma and Anindya Chatterjee's “Failure of Substance Use Interventions: Perspectives from Asia”

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