학술논문

Health Outcomes for Clients of Needle and Syringe Programs in Prisons
Document Type
Academic Journal
Source
Epidemiologic Reviews. Annual, 2018, Vol. 40 Issue 1, p96, 9 p.
Subject
HIV (Viruses)
World health
Prisoners
Hypodermic syringes
Hepatitis C virus
Prisons
Syringes
Hepatitis C
Hypodermic needles
Language
English
ISSN
0193-936X
Abstract
High levels of drug dependence have been observed in the prison population globally, and the sharing of injecting drug equipment in prisons has contributed to higher prevalence of bloodborne diseases in prisoners than in the general population. Few prison needle and syringe programs (PNSPs) exist. We conducted a systematic review to assess evidence regarding health outcomes of PNSPs. We searched peer-reviewed databases for data relating to needle and syringe programs in prisons. The search methodology was conducted in accordance with accepted guidelines. Five studies met review inclusion criteria, and all presented evidence associating PNSPs with one or more health benefits, but the strength of the evidence was low. The outcomes for which the studies collectively demonstrated the strongest evidence were prevention of human immunodeficiency virus and viral hepatitis. Few negative consequences from PNSPs were observed, consistent with previous evidence assessments. More research is needed on PNSP effectiveness, and innovative study designs are needed to overcome methodological limitations of previous research. Until stronger evidence becomes available, policymakers are urged to recognize that not implementing PNSPs has the potential to cause considerable harm, in light of what is currently known about the risks and benefits of needle and syringe programs and PNSPs and about the high prevalence of human immunodeficiency virus and viral hepatitis in prisons. bloodborne pathogens; drug use; harm reduction; hepatitis, viral, human; HIV; needle-exchange programs; prisons; review, systematic Abbreviations: HBV, hepatitis B virus; HCV, hepatitis C virus; HIV, human immunodeficiency virus; NSP, needle and syringe program; PNSP, prison needle and syringe program; PWID, people who inject drugs; WHO, World Health Organization.
INTRODUCTION There are 10 million people in prisons worldwide, and high levels of drug dependence have been observed in prison populations (1, 2). Some people who injected drugs before they [...]