Epidemiology and Infection



A syringe exchange programme in prison as prevention strategy against HIV infection and hepatitis B and C in Berlin, Germany


K. STARK a1c1, U. HERRMANN a2, S. EHRHARDT a2 and U. BIENZLE a2
a1 Robert Koch Institute, Department of Infectious Disease Epidemiology, Berlin, Germany
a2 Institute of Tropical Medicine, Charité, Humboldt University, Berlin, Germany

Article author query
stark k   [PubMed][Google Scholar] 
herrmann u   [PubMed][Google Scholar] 
ehrhardt s   [PubMed][Google Scholar] 
bienzle u   [PubMed][Google Scholar] 

Abstract

In two prisons in Berlin, Germany, provision of sterile injection equipment for injecting drug users (IDUs) started in 1998. To assess the programme's impact, the frequency of injecting drug use and syringe sharing, and the incidence of HIV, HBV, and HCV infection were determined in a follow-up study. Of all IDUs (n=174), 75% continued to inject. After the project start the level of syringe sharing declined from 71% during a 4-month period of previous imprisonment to 11% during the first 4 months of follow-up, and to virtually zero thereafter. Baseline seroprevalences for HIV, HBV, and HCV were 18, 53, and 82%. HIV and HCV seroprevalence at baseline was significantly associated with drug injection in prison prior to the project start. No HIV and HBV seroconversions, but four HCV seroconversions occurred. The provision of syringes for IDUs in appropriate prison settings may contribute to a substantial reduction of syringe sharing. However, the prevention of HCV infection requires additional strategies.

(Accepted September 23 2005)
(Published Online December 22 2005)


Correspondence:
c1 Robert Koch Institute, Department of Infectious Disease Epidemiology, Seestr. 10, 13353 Berlin, Germany. (Email: starkk@rki.de)


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