Modelling the impact of incarceration and prison-based HCV treatment on HCV transmission among people who inject drugs in Scotland

Jack Stone (Lead / Corresponding author), Natasha K. Martin, Matthew Hickman, Sharon Hutchinson, Esther Aspinall, Avril Taylor, Alison Munro, Karen Dunleavy, Erica Peters, Peter Bramley, Peter C. Hayes, David J. Goldberg, Peter Vickerman

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Abstract

Background/Aims: People who inject drugs (PWID) experience high incarceration rates, and previous incarceration is associated with elevated hepatitis C virus (HCV) transmission risk. We evaluate the contribution of incarceration to HCV transmission amongst PWID, and the impact of prison-related prevention interventions, including scaling-up direct-acting antivirals (DAAs) in prison.

Design: Dynamic mathematical modelling of incarceration and HCV transmission, using approximate Bayesian computation for model calibration.

Setting: Scotland; where national survey data indicates lower HCV incidence in prison than the community (4.3 vs 7.3 per 100py), but a 2.3-fold elevated transmission risk amongst recently released (16 weeks) could reduce incidence and prevalence by 45.6% (95%CrI 38.0-51.3%) and 45.5% (95%CrI 39.3-51.0%), respectively.

Conclusions: Incarceration and the elevated transmission risk following prison-release can contribute significantly to HCV transmission amongst PWID. Scaling-up HCV treatment in prison can provide important prevention benefits.
Original languageEnglish
Pages (from-to)1302-1317
Number of pages13
JournalAddiction
Volume112
Issue number7
Early online date3 Mar 2017
DOIs
Publication statusPublished - 6 Jun 2017

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    Stone, J., Martin, N. K., Hickman, M., Hutchinson, S., Aspinall, E., Taylor, A., Munro, A., Dunleavy, K., Peters, E., Bramley, P., Hayes, P. C., Goldberg, D. J., & Vickerman, P. (2017). Modelling the impact of incarceration and prison-based HCV treatment on HCV transmission among people who inject drugs in Scotland. Addiction, 112(7), 1302-1317. https://doi.org/10.1111/add.13783