PT  - JOURNAL ARTICLE
AU  - F. A. Drobniewski
AU  - Y. M. Balabanova
AU  - M. C. Ruddy
AU  - C. Graham
AU  - S. I. Kuznetzov
AU  - G. I. Gusarova
AU  - S. M. Zakharova
AU  - A. S. Melentyev
AU  - I. M. Fedorin
TI  - Tuberculosis, HIV seroprevalence and intravenous drug abuse in prisoners
AID  - 10.1183/09031936.05.00136004
DP  - 2005 Aug 01
TA  - European Respiratory Journal
PG  - 298--304
VI  - 26
IP  - 2
4099  - http://erj.ersjournals.com/content/26/2/298.short
4100  - http://erj.ersjournals.com/content/26/2/298.full
SO  - Eur Respir J2005 Aug 01; 26
AB  - High rates of tuberculosis (TB) and HIV are believed to exist in Russian prisons. Prisoners with TB were studied in order to identify the following: 1) prevalence of HIV, and risk factors for HIV and other blood-borne virus infections; and 2) clinical and social factors that might compromise TB treatment effectiveness and/or patient adherence and, hence, encourage treatment failure. A 1-yr cross-sectional prevalence study of 1,345 prisoners with TB was conducted at an in-patient TB facility in Samara, Russian Federation. HIV and hepatitis B and/or C co-infection occurred in 12.2% and 24.1% of prisoners, respectively, and rates were significantly higher than in civilians. Overall, 48.6% of prisoners used drugs, of which 88.3% were intravenous users. Prisoners were more likely to be intravenous drug users and HIV positive compared with civilians with TB, and 40.2% of prisoners shared needles. Two-thirds of prisoners (68.6%) had received previous TB drug therapy (frequently multiple, interrupted courses) and were significantly more likely than civilians to have had previous therapy consistent with the high drug-resistance rates seen. Prisons are major drivers of the tuberculosis and HIV epidemics. Novel strategies are needed to reduce the spread of blood borne diseases, particularly in intravenous drug users.