New study calls for improved prison-based treatment and provision of harm reduction services to prevent HIV transmission among inmates

published on December 16, 2013

Vancouver, B.C. [December 16, 2013]-Authorities in charge of CanadaÍs prisons and penitentiaries need to urgently address barriers to HIV treatment for people held in correctional facilities, according to a new study by researchers at the BC Centre for Excellence in HIV/AIDS (BC-CfE).

The study found incarceration was a strong predictor of inadequate treatment for HIV/AIDS. Additionally, people living with HIV were more likely to share syringes when they were incarcerated.

ñThe findings demonstrates incarceration facilitates HIV transmission by compromising access to effective treatment for HIV infection and facilitating high-risk behaviour,î said Dr. M-J Milloy, principal investigator at the BC-CfE and lead author of the study. ñThere is a critical need to promote the health of prisoners and their home communities by improving HIV treatment and implementing harm reduction programs, such as needle exchanges, within correctional facilities.î

Between May 1996 and March 2012, BC-CfE researchers analyzed the incarceration and HIV clinical histories of 657 people who use injection drugs and were HIV-positive. Researchers found study participants spent approximately 15% of that time in jail.

Participants were interviewed throughout the study period. At the time of their interviews, individuals had a detectable amount of HIV in their bloodstream 83% of the time spent incarcerated, meaning they could transmit the infection to others because they were not taking their medication as prescribed. In comparison, only 62% of non-incarcerated time had unsuppressed viral loads. The study found those with unsuppressed viral loads were nearly twice as likely to share used needles if they had been incarcerated.

ñThis is the first study to demonstrate the correlation between risk behavior and HIV viral load in a prison setting,î said Dr. Julio Montaner, director of the BC-CfE and a senior author of the study. ñThis research underscores the need to expand HIV Treatment as Prevention and evidence-based harm reduction programs within prisons.î

The BC-CfE-pioneered Treatment as Prevention strategy has led to the widespread expansion of highly active antiretroviral therapy (HAART) coverage in British Columbia. Treatment can eliminate progression of HIV infection to AIDS and premature death, and significantly decrease the amount of virus in the blood and sexual fluids, thereby significantly decreasing transmission of HIV. HAART is fully funded by Pharmacare in B.C., although access to HIV healthcare practitioners who can prescribe treatment is limited in correctional facilities.

ñThere is absolutely no reason why incarcerated individuals should not receive the same level of medical care as those in the public,î said Terry Howard, Director of Community Based Research at Positive Living BC and former Prison Outreach Program Coordinator. ñGiven the individual and community harms associated with needle sharing and untreated HIV, itÍs imperative that access to treatment and safe injection practices be improved within correctional facilities.î The study was published in the peer-reviewed journal BioMedical Central Infectious Diseases (BMCID).


About the British Columbia Centre for Excellence in HIV/AIDS
The BC Centre for Excellence in HIV/AIDS (BC-CfE) is CanadaÍs largest HIV/AIDS research, treatment and education facility and is internationally recognized as an innovative world leader in combating HIV/AIDS and related diseases. BC-CfE is based at St. PaulÍs Hospital, Providence Health Care, a teaching hospital of the University of British Columbia. The BC-CfE works in close collaboration with key provincial stakeholders, including health authorities, health care providers, academics from other institutions, and the community to decrease the health burden of HIV and AIDS. By developing, monitoring and disseminating comprehensive research and treatment programs for HIV and related illnesses, the BC-CfE helps improve the health of British Columbians living with HIV.

About the University of British Columbia
The University of British Columbia (UBC) is one of North AmericaÍs largest public research and teaching institutions, and one of only two Canadian institutions consistently ranked among the worldÍs 40 best universities. Surrounded by the beauty of the Canadian West, it is a place that inspires bold, new ways of thinking that have helped make it a national leader in areas as diverse as community service learning, sustainability and research commercialization. UBC offers more than 55,000 students a range of innovative programs and attracts $550 million per year in research funding from government, non-profit organizations and industry through 7,000 grants.

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