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Digest of Research on Drug Use and Hiv/Aids in the Criminal Justice System

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Digest of Research on Drug Use and Hiv/Aids in the Criminal Justice System DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM 2008 Edition Published by The European Institute of Social Services University of Kent Keynes College Canterbury CT2 7NP DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM EISS wishes to acknowledge the contribution of Cranstoun Drug Service to the present digest, which is an expansion of the Digest of Research produced till December 2006 under the European Commission funded ENDIPP project, co-managed by Cranstoun Drug Services. The Connections project has received funding from the European Commission under the Public Health Programme 2003-2008. However, the sole responsibility for the project lies with the author and the European Commission is not responsible for any use that may be made of the information contained therein. DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM Digest of Research on Drug Use and HIV/AIDS in Prisons Revised 2008 version TABLE OF CONTENTS A. ABSTRACTS................................................................................................ 4 B. REFERENCES ......................................................................................... 335 C. KEYWORDS............................................................................................ 377 D. COUNTRY INDEX.................................................................................. 381 DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM A. ABSTRACTS 1. PSYCHOACTIVE SUBSTANCE ABUSE AMONG INMATES OF A NIGERIAN PRISON POPULATION The objectives of this study were: (1) to assess the prevalence rate of psychoactive substance abuse and dependence among inmates of a Nigerian prison population within the past month; (2) to highlight how aware these prisoners were, of the various drug abuse; (3) to compare the findings with those of reports from abroad, and general Nigerian population samples. In mid 1995 395 subjects (97.5% males, mean age 30.5 years) were interviewed, with a questionnaire that contained DSM-III-R criteria for dependence. About two-thirds were those on remand or awaiting trial, and the majority (70%) were accused of theft and armed robbery. Compared with Nigerian general population samples, the cohorts had much higher prevalence rates of awareness and lifetime use of psychoactive substances. Cannabis was the only drug regularly abused in the past month, by 26 (6.6%) subjects (all male); out of whom 11 (42.3%) satisfies DSM-III-R criteria for dependence. Use of intravenous drugs was not evident. This pattern differed markedly from the situation in industrialised countries. Cannabis abuse was significantly associated with those in prison for less than six months and on a charge of theft/armed robbery. Adesanya, A., Ohaeri, J., Ogunlesi, A., Adamson, T., & Odejide O., 1997, Drug and Alcohol Dependence, 47, 39-44. Key words: drugs, prevalence of drugs NIGERIA 2. THE REVIEW OF HIV AND AIDS IN PRISON The overall aim of the review is to provide a basis for interventions in respect of HIV in prisons for the period covered by the current and next Prison Service corporate plans (i.e. up to and including 1996-97). The report is presented in logical order: the research chapter presents what is known about HIV in prison and what needs to be learned; the staff and prisoner education chapter deals with prevention of HIV through provision of information and education; the section on risk reduction and harm minimalisation looks at the means of prevention in prison; the counselling, psychological and social care chapter considers the role of counselling in changing behaviour to reduce risk and support those with HIV infection and with AIDS. The medical chapter comes last to emphasise that much can and should be done in other areas before medical intervention becomes necessary. The detailed medical care plans describe the careful monitoring, care and support that can improve the quality of life for those living with HIV as well as prolonging life. But first there are two short chapters sketching the background to the Review and setting the historical context. HIV in prison presents a complex of legal, ethical, moral, medical, psychological, sexual, educational and management issues. These can be dealt with only by the adoption of a long-term strategy, which encompasses a multi-disciplinary approach at national and local levels. Such an approach will include prison, statutory and community agencies in order to be successful. Whilst the United Kingdom remains a low HIV prevalence country it should not be assumed that vigilance in relation to HIV can be relaxed. This country is entering a phase when more people with HIV infection are becoming ill and in need of medical care. It is imperative that the Prison Service establish structures able to manage a large number of people with HIV infection who are unwell. These should be able to provide them with health care services DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM equivalent to those in the community and a prison regime which is non discriminatory and humane. AIDS Advisory Committee, 1995, HM Prison Service: London. KEY WORDS: HIV, drugs, sexual behaviour, tattooing, education, women, juveniles, injecting behaviours, counselling, policy, prevalence of HIV UK 3. ILLICIT DRUG USE, STD’S AND ABNORMAL PAP SMEARS AMONG HIV+ AND HIV- FEMALE PRISONERS The objective was to determine the positive urine toxicology screens (tox), STDs, and abnormal pap smears among HIV+ and HIV- injection drug users (IDU) entering Connecticut’s sole correctional facility (CF) fro women. All women entering this CF receive urine tox, syphilis serology (RPR/FTA-ABS), and pelvic exam with pap smear and cervical culture for gonorrhoea (GC) and chlamydia. Using a standardised data collection instrument, we conducted a retrospective chart review of a sample of HIV+ (N=77) and HIV- (N+36) IDU inmates, demographically similar to all known HIV+’s at this CF. The minimum HIV seroprevalence is 15% at this CF (average daily census=660); overall, 95% of HIV+’s and 60% of all inmates are IDU’s. Admission urine tox for heroine or cocaine were + for >75% of both HIV+’s and HIV-’s (p=NS); 54/59 (92%) HIV+’s with CD4 < or = 500 had a + cocaine tox vs. 27/36 (75%) HIV-‘s (p<.01); GC or chlamydia were found in 14% of both groups. Abnormal pap smears were seen in 65% and 50% of HIV+’s and HIV-’s (p=NS). However, 4/14 HIV+’s with CD4<200 had CIN III, vs. 4/36 HIV-’s with CD4>200 and 1/36 HIV-’s(p<.05); 3/14 HIV+’s with CD4 < 200 vs. 1/36 HIV-’s had vaginal candidiasis (p=.06). Conclusions were: 1) The majority of HIV+ and HIV- IDU’s at this CF were actively using drugs at entry, with increased cocaine use among HIV+’s with CD4 <500;2) Though syphilis was more common among HIV+’s, other STD’s and abnormal pap smears were frequently in both groups; 3) High grade CIN and vaginal candidiasis tended to be more common in HIV+’s with CD4<200 than those with higher CD$ counts and HIV-’s. These results highlight the need for further reduction interventions for all female inmates, as well as drug abuse treatment and comprehensive gynaecologic care. Altice, F., Selwyn, P., & Tanguay, S., 1993, International Conference on AIDS, 9(2), 703 KEY WORDS: HIV, women, injecting behaviours, drugs, SDT USA 4. HIV PREVENTION: REACHING OUT-OF-TREATMENT HIGH-RISK DRUG USERS IN JAIL The objective was to measure levels of illicit drugs, pregnancy rate, and HIV seroprevalence in urine samples obtained from recent felony arrestees. Assessment of the relationship between HIV-risk behaviours, HIV seroprevalence, and drug use of the target population were also examined. Subjects were interviewed in the local county jail. Eligibility requirements were: less than 48 hours in custody, arrested for non-drug-related felony, and voluntary participation. Trained CHOWs administered interviews, obtained urine samples, and provided candy bars and HIV education in return. N=1233. Drug screens were done with EMIT and GC EMIT using NIDA cut-off levels. HIV Ab tests were preformed with CB reagents, using WB confirmation. Pregnancy tests were done with Park Davis EPT within 24 hours of obtaining samples. Pharm Chem labs conducted drug screens and HIV Ab tests. DIGEST OF RESEARCH ON DRUG USE AND HIV/AIDS IN THE CRIMINAL JUSTICE SYSTEM Participation rose 90%, of which 91% provided urine specimens. The sample was 67% male, 60% ethnic minority, 58% less than 30 years old. Over half (52%) had multiple sexual partners in the past year. Eighty-one percent had never been in drug treatment. Urine positive for any drug – 71%. Of drug positives : 51% amphetamine+, 32% cocaine+, 7% opiate+. Injection drug use (IDU) admitted by 31%. Of IDU, 83% injected amphetamines, 58% injected heroine, 58% injected cocaine. Of IDU, 42% report sharing needles at least sometimes. 256 samples tested for pregnancy (last ½ of year only)-18%+ and 60% of those were drug positive. HIV test results will be presented. Previous studies have shown amphetamine IDU to be at risk for HIV. Arrestees have a significant percentage of amphetamine IDU. Also many arrestssa report engaging in other HIV high-risk behaviours. Prevention education and testing in jail, within 2 days of arrest, is an effective means of reaching out-of-treatment IDU. Anderson, R., Flynn, N., Clancy, L., Anglin, D., & Anon, K., 1994, International conference on AIDS, 10(2), 274. KEYWORDS: HIV , women, injecting behaviours, prevalence of HIV USA 5. DRUG ADDICTION, WOMEN PRISONERS AND SEXUAL BEHAVIOUR This research was carried out with the aim of evaluating the relationship between drug addiction, prison and sexual behaviour among women. The study was carried out by self- administration of an anonymous questionnaire in order to guarantee absolute confidentiality.
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