Health Outcomes for Clients of Needle and Syringe Programs in Prisons

Jeffrey V Lazarus, Kelly Safreed-Harmon, Kristina L Hetherington, Daniel J Bromberg, Denise Ocampo, Niels Graf, Anna Dichtl, Heino Stöver, Hans Wolff
2018 Epidemiologic Reviews  
High levels of drug dependence have been observed in the prison population globally, and the sharing of injecting drug equipment in prisons has contributed to higher prevalence of bloodborne diseases in prisoners than in the general population. WHO, UNODC, and UNAIDS have advised governments to instituteFew prison needle and syringe programs (PNSPs), but few such programs) exist. We conducted a systematic review to assess evidence regarding health outcomes of PNSPs. We searched peer-reviewed
more » ... ed peer-reviewed databases (Medline, Embase, PsycINFO, and CINAHL) for data relating to needle and syringe programs in prisons. The search methodology was conducted in accordance with PRISMA MOOSEaccepted guidelines. Five studies met review inclusion criteria, and all presented evidence associating PNSPs with one or more health benefits, but the strength of the evidence was low. The outcomes for which the studies collectively demonstrated the strongest evidence were prevention of HIVhuman immunodeficiency virus and viral hepatitis. Few negative consequences from PNSPs were observed, consistent with previous evidence assessments. More research is needed on PNSP effectiveness, and innovative study designs are needed to overcome methodological limitations of previous research. Until stronger evidence becomes available, policy-makerspolicymakers are urged to recognize that not implementing PNSPs has the potential to cause considerable harm, in light of what is currently known about the risks and benefits of NSPsneedle and syringe programs and PNSPs and about the high prevalence of HIV, HBV and HCVhuman immunodeficiency virus and viral hepatitis in prisons.
doi:10.1093/epirev/mxx019 pmid:29659780 fatcat:5jkgcjftcvardnuwoh3srczvhi