Imprisonment, injecting drug use, and bloodborne viruses

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Abstract
Many injecting drug users have been imprisoned, and for some this will have been a repeated experience.2 In England and Wales in any year, an estimated 15 000 prisoners3—or between one in 13 and one in seven prisoners4—will have a history of injecting drug use. In Australia, more than one in three prison entrants were reported as having such a history.5 Between a quarter and two thirds of prisoners who have ever injected drugs have done so within prison, where use of injecting equipment previously used by others is the norm. The reports from Scotland and Australia in this week's journal emphasise that there is no room for complacency about the risks involved and illustrate the vulnerability of prisoners who inject drugs to infection with bloodborne viruses. At least eight HIV infections due to sharing of equipment by injecting drug users occurred within a Scottish prison during the first half of 1993,6 7 and in Australia an incidence of 41 hepatitis C infections per 100 person years in young …