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

TY - JOUR

T1 - Modelling the impact of incarceration and prison-based HCV treatment on HCV transmission among people who inject drugs in Scotland

AU - Stone, Jack

AU - Martin, Natasha K.

AU - Hickman, Matthew

AU - Hutchinson, Sharon

AU - Aspinall, Esther

AU - Taylor, Avril

AU - Munro, Alison

AU - Dunleavy, Karen

AU - Peters, Erica

AU - Bramley, Peter

AU - Hayes, Peter C.

AU - Goldberg, David J.

AU - Vickerman, Peter

N1 - This work was supported through a research grant from Gilead Sciences. Gilead had no influence on the design, analysis and content of the study. J.S. acknowledges funding from a PhD scholarship from the Engineering and Physical Sciences Research Council (EPSRC). N.K.M., P.V. and M.H. acknowledge funding from National Institute for Drug Abuse R01 DA037773-01A1. NK.M. acknowledges research funding from the National Institute for Drug Abuse (R01 DA037773-01A1) and the University of California San Diego Center for AIDS Research(CFAR), an NIH-funded program (P30 AI036214), which is supported by the following NIH Institutes and Centers: NIAID, NCI, NIMH, NIDA, NICHD, NHLBI, NIA, NIGMS, and NIDDK. M.H. and P.V. acknowledge funding by the National Institute for Health Research Health Protection Research Unit (NIHR HPRU) in Evaluation of Interventions at University of Bristol. The views expressed are those of the authors and not necessarily those of the UK National Health Service (NHS), NIHR or the Department of Health.

PY - 2017/6/6

Y1 - 2017/6/6

N2 - 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.

AB - 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.

U2 - 10.1111/add.13783

DO - 10.1111/add.13783

M3 - Article

C2 - 28257600

SN - 0965-2140

VL - 112

SP - 1302

EP - 1317

JO - Addiction

JF - Addiction

IS - 7

ER -