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.
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 language | English |
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Pages (from-to) | 1302-1317 |
Number of pages | 13 |
Journal | Addiction |
Volume | 112 |
Issue number | 7 |
Early online date | 3 Mar 2017 |
DOIs | |
Publication status | Published - 6 Jun 2017 |