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Historical HIV prevalence in Edinburgh Prison: a database-linkage study.
S R Seaman1, S M Bird, R P Brettle
1INSERM U170, Villejuif France.
Journal of Epidemiology and Biostatistics
|October 31, 2000
Summary
HIV prevalence in Edinburgh Prison peaked at 8% in 1984 among injecting drug users (IDUs). Estimates suggest a gradual decline thereafter, with a 4.1% prevalence in 1991.
Area of Science:
- Epidemiology
- Public Health
- Infectious Disease Control
Background:
- Prisons often have higher HIV prevalence than communities due to a concentration of injecting drug users (IDUs).
- Reliable HIV prevalence estimation in UK prisons commenced in the 1990s.
- Edinburgh experienced a significant IDU-related HIV epidemic starting in 1983.
Purpose of the Study:
- To retrospectively estimate HIV prevalence within Edinburgh Prison between 1983 and 1994.
- To understand the trends of HIV infection among prisoners, particularly IDUs.
Main Methods:
- Abstracted records of 477 HIV-positive male patients from the Edinburgh City Hospital Cohort (including 332 IDUs).
- Estimated person-years spent in prison while HIV-positive for each month.
- Inferred HIV prevalence based on patient data and seroconversion intervals.
Main Results:
- HIV prevalence in Edinburgh Prison increased from January 1983, peaking at 8% in December 1984.
- Prevalence ranged from 5-6% during 1985-86 and subsequently declined.
- The 1991 estimate of 4.1% closely aligned with a survey estimate of 4.5%.
Conclusions:
- Estimated HIV prevalence figures are likely underestimates but reflect reliable trends.
- Database linkage offers valuable insights for HIV and IDU epidemiology.
- Further research could explore other uses of linked databases for public health surveillance.