Insufficient Access to Harm Reduction Measures in Prisons in 5 Countries (PRIDE Europe): A Shared European Public Health Concern

Prisoners constitute a high-risk population, particularly for infectious diseases. The aim of this study was to estimate the level of infectious risk in the prisons of five different European countries by measuring to what extent the prison system adheres to WHO/UNODC recommendations.

Following the methodology used in a previous French survey, a postal/electronic questionnaire was sent to all prisons in Austria, Belgium, Denmark and Italy to collect data on the availability of several recommended HIV-HCV prevention interventions and HBV vaccination for prisoners. A score was built to compare adherence to WHO/UNODC recommendations (considered a proxy of environmental infectious risk) in those 4 countries. It ranged from 0 (no adherence) to 12 (full adherence). A second score (0 to 9) was built to include data from a previous French survey, thereby creating a 5-country comparison.

A majority of prisons answered in Austria (100 %), France (66 %) and Denmark (58 %), half in Belgium (50 %) and few in Italy (17 %), representing 100, 74, 89, 47 and 23 % coverage of the prison populations, respectively. Availability of prevention measures was low, with median adherence scores ranging from 3.5 to 4.5 at the national level. These results were confirmed when using the second score which included France in the inter-country comparison. Overall, the adherence score was inversely associated with prison overpopulation rates (p = 0.08).

Using a score of adherence to WHO/UNODC recommendations, the estimated environmental infectious risk remains extremely high in the prisons of the 5 European countries assessed. Public health strategies should be adjusted to comply with the principle of equivalence of care and prevention with the general community.

Below:  Mean, median, min and max values and interquartile range of the global score per country (E4 analysis)

Below:  Mean, median, min and max values and interquartile range of the global score used in the 2009 French survey per country (E5 analysis)

Full article at: http://goo.gl/x6S2QY

By: Laurent Michel^123*, Caroline Lions⁴⁵⁶, Sara Van Malderen⁷, Julie Schiltz⁸, Wouter Vanderplasschen⁸, Karina Holm⁹, Torsten Kolind⁹, Felice Nava¹⁰, Nadja Weltzien¹¹,Andrea Moser¹¹, Marie Jauffret-Roustide¹², Olivier Maguet¹³, Patrizia M Carrieri⁴⁵⁶, Cinzia Brentari¹⁴ and Heino Stöver¹⁴

¹Inserm U1178, Paris, France

²Univ Paris-Sud and Univ Paris Descartes, UMRS1178, Paris, France

³Centre Pierre Nicole, French Red Cross, Paris, France

⁴Inserm U912 (SESSTIM), Marseille, France

⁵Univ Aix Marseille, IRD, UMR-S912, Marseille, France

⁶ORS PACA, Observatoire Régional de la Santé Provence Alpes Côte d’Azur, Marseille, France

⁷Penitentiary administration, Brussels, Belgium

⁸Department of Special Education, Ghent University, Ghent, Belgium

⁹Centre for Alcohol and Drug Research, Aarhus University, Aarhus, Denmark

¹⁰Federserd, Padova, Italy

¹¹Penitentiary administration, Vienna, Austria

¹²Inserm U988, Paris, France

¹³Médecins du Monde, Paris, France

¹⁴University of Applied Sciences, Frankfurt, Germany

   

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