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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    63 Citations (Scopus)
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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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