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Incarceration and injection drug use in Baltimore, Maryland
Author(s) -
Genberg Becky L.,
Astemborski Jacquie,
Vlahov David,
Kirk Gregory D.,
Mehta Shruti H.
Publication year - 2015
Publication title -
addiction
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 2.424
H-Index - 193
eISSN - 1360-0443
pISSN - 0965-2140
DOI - 10.1111/add.12938
Subject(s) - medicine , interquartile range , confidence interval , odds ratio , demography , injection drug use , confounding , prison , drug injection , prospective cohort study , cohort study , drug , psychiatry , psychology , criminology , sociology
Aims There is limited longitudinal research examining incarceration and subsequent changes in drug use among people who inject drugs (PWID) in the United States. The objective of the current study was to characterize the frequency of incarceration and estimate the association between incarceration and subsequent injection drug use among current and former PWIDs in one US city. Design ALIVE (AIDS Linked to the Intravenous Experience) is a prospective cohort study of current and former PWIDs, with semi‐annual follow‐up occurring since 1988. Setting Baltimore, Maryland, USA. Participants A total of 3245 participants with 48 738 study visits were included. Participants enrolled from 1988 to 2012 with a median of 13 follow‐up visits per participant (Interquartile range = 7–25). Measurements Incarcerations were defined as any self‐reported jail or prison stays in the previous 6 months that were ≥7 days or longer. The primary outcome was defined as any self‐reported injection drug use in the previous 6 months. Findings At baseline, 29% were female, 90% African American and 33% HIV‐positive. Fifty‐seven per cent of participants experienced at least one incarceration episode. After adjusting for confounders, there was a positive association between incarceration and subsequent injection drug use [adjusted odds ratio (AOR) = 1.48, 95% confidence interval (CI) = 1.37–1.59]; however, stratified analysis showed that the effect was restricted to those who were not injecting at the time of incarceration (AOR = 2.11, 95% CI = 1.88–2.37). Conclusions In the United States, incarceration of people who had previously stopped injecting drugs appears to be associated with an increased risk of subsequent injecting.