Does opioid substitution treatment in prisons reduce injecting-related HIV risk behaviours? A systematic review
Article first published online: 11 JAN 2010
© 2010 The Author. Journal compilation © 2010 Society for the Study of Addiction
Volume 105, Issue 2, pages 216–223, February 2010
How to Cite
Larney, S. (2010), Does opioid substitution treatment in prisons reduce injecting-related HIV risk behaviours? A systematic review. Addiction, 105: 216–223. doi: 10.1111/j.1360-0443.2009.02826.x
- Issue published online: 11 JAN 2010
- Article first published online: 11 JAN 2010
- Submitted 24 June 2009; initial review completed 20 August 2009; final version accepted 24 September 2009
- heroin dependence;
Objectives To review systematically the evidence on opioid substitution treatment (OST) in prisons in reducing injecting-related human immunodeficiency virus (HIV) risk behaviours.
Methods Systematic review in accordance with guidelines of the Cochrane Collaboration. Electronic databases were searched to identify studies of prison-based opioid substitution treatment programmes that included assessment of effects of prison OST on injecting drug use, sharing of needles and syringes and HIV incidence. Published data were used to calculate risk ratios for outcomes of interest. Risk ratios were not pooled due to the low number of studies and differences in study designs.
Results Five studies were included in the review. Poor follow-up rates were reported in two studies, and representativeness of the sample was uncertain in the remaining three studies. Compared to inmates in control conditions, for treated inmates the risk of injecting drug use was reduced by 55–75% and risk of needle and syringe sharing was reduced by 47–73%. No study reported a direct effect of prison OST on HIV incidence.
Conclusions There may be a role for OST in preventing HIV transmission in prisons, but methodologically rigorous research addressing this question specifically is required. OST should be implemented in prisons as part of comprehensive HIV prevention programmes that also provide condoms and sterile injecting and tattooing equipment.