Using a jail-based survey to monitor HIV and risk behaviors among Seattle area injection drug users

Abstract

Routine monitoring of human immunodeficiency virus (HIV) and risk behaviors among injection drug users (IDUs) is difficult outside drug treatment settings. We developed and implemented a survey of recently arrested IDUs to describe the prevalence of HIV, drug use, and sexual behaviors among them. A probability sampling survey was instituted in the King County Correctional Facility in Seattle, Washington, to sample recently arrested IDUs at the time of booking and in the jail health clinic between 1998 and 1999. Following HIV risk assessment and blood draw, additional information on drug use practices was gathered using a standardized questionnaire. Potential participants who were released from jail early could complete the study at a nearby research storefront office. Of the 4,344 persons intercepted at booking, 503 (12%) reported injection drug use, and 201 of the IDUs (40%) participated in the study. An additional 161 IDUs were enrolled in the study from the jail health clinic. Among the 348 unduplicated subjects, HIV prevalence was 2%; in the past 6 months, 69% reported two or more shooting partners, 72% used a cooker after someone else, 60% shared a syringe to divide up drugs, and 62% injected with used needles. Only 37% reported being hepatitis C seropositive, and 8% reported hepatitis B vaccination. It was feasible to conduct a jail-based survey of recently arrested IDUs that yielded useful information. The high prevalence of reported risky drug use practices warrants ongoing monitoring and illustrates the need for improving prevention programs for HIV and hepatitis B and C in this population, including expansion of hepatitis C screening and provision of hepatitis B vaccination at the jail health clinic.

Type and Location of Injection Drug Use-Related Soft Tissue Infections Predict Hospitalization

“…Although we were unable to know how many of the patients studied were HIV positive, only 2% of injection drug users in this city are HIV positive, so we do not expect HIV status to significantly influence our findings. 23 Our classification of the type and location of soft tissue infections was based on a retrospective review of the written assessments by ED physicians. Consequently, we were unable to validate these assessments and determine their degree of misclassification.…”

Trends in Hepatitis B Virus, Hepatitis C Virus, and Human Immunodeficiency Virus Prevalence, Risk Behaviors, and Preventive Measures among Seattle Injection Drug Users Aged 18–30 Years, 1994–2004

“…20 Analysis for the present study was restricted to those recruited from the Seattle jail. Participants were recruited by screening all persons booked into jail during randomly selected time intervals (76%) or from inmates visiting the jail health clinics seeking HIV counseling and testing (24%).…”

The 2004 Australian prison entrants' blood-borne virus and risk behaviour survey

“…To this end, a prison-based surveillance component could be valuable in providing access to the wider IDU population and assist in identifying outbreaks of blood-borne viruses in this population. 25 Surveying prison entrants also provides a useful means of accessing at-risk groups such as Aboriginal injecting drug users, given the massive over-representation of Indigenous people in the Australian correctional system. Overall, 17% of the sample (range 10% in Queensland to 38% in WA) was Indigenous compared with around 8% in the community NSP survey.…”