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Fulltext The Influence of Medication Attitudes on Utilization of Antiretroviral Therapy (ART) in Indonesian Prisons

Culbert GJ, Bazazi AR, Waluyo A, Murni A, Muchransyah AP, Iriyanti M, et al.

AIDS Behav, 2016 05;20(5):1026-38.
PMID: 26400080 DOI: 10.1007/s10461-015-1198-4

Negative attitudes toward HIV medications may restrict utilization of antiretroviral therapy (ART) in Indonesian prisons where many people living with HIV (PLH) are diagnosed and first offered ART. This mixed-method study examines the influence of medication attitudes on ART utilization among HIV-infected Indonesian prisoners. Randomly-selected HIV-infected male prisoners (n = 102) completed face-to-face in-depth interviews and structured surveys assessing ART attitudes. Results show that although half of participants utilized ART, a quarter of those meeting ART eligibility guidelines did not. Participants not utilizing ART endorsed greater concerns about ART efficacy, safety, and adverse effects, and more certainty that ART should be deferred in PLH who feel healthy. In multivariate analyses, ART utilization was independently associated with more positive ART attitudes (AOR = 1.09, 95 % CI 1.03-1.16, p = 0.002) and higher internalized HIV stigma (AOR = 1.03, 95 % CI 1.00-1.07, p = 0.016). Social marketing of ART is needed to counteract negative ART attitudes that limit ART utilization among Indonesian prisoners.

Matched MeSH terms: Prisoners/psychology*; Prisons*
Fulltext The factors, effects and management of stress among wardens and prisoners in Selangor

Adlina, S., Narimah, A.H.H., Ahmad Fahmi, A.Z., Iskandar, M.A., Nur Amirah, S., Nurul Farahiyah, A., et al.

Malaysian Journal of Public Health Medicine, 2007;7(2):42-48.
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A cross-sectional study was conducted in May 2007 on stress and stress self management among the prisoners and wardens of a prison in Selangor. This study was conducted as part of an elective posting for second year medical students and the topic was chosen to add on to the body of knowledge on stress among prisoners and wardens. A self administered questionnaire was distributed by random sampling and the respondents consisted of 100 prisoners and 97 wardens. Majority of the prisoners did not have stress with reference to interpersonal factors such as conflict with cellmates, conflict with wardens and conflict with inmates, For interpersonal factors, majority of the prisoners experienced stress because they felt bored (78%), thought they had no bright future (63%) and they also had no visitors (61%). Stress resulted in physical effects, whereby 67% admitted that they experienced health problems and 64% experienced sleep disturbance. Emotional effects of stress experienced by the prisoners were sadness (67%), anxiousness (63%) and confusion (56%). The major spiritual effect was regret (84%) followed by feeling closer to God (78%) and feeling high spirited (59%). The major social effects experienced by
the prisoners were low self esteem (63%) and embarrassment (58%). Methods of stress self management were prayers and conduct of religious activities (87%), sharing problems with friends (78%), doing recreational activities (77%), sleeping (72%) , doing a hobby (68) and seeking help from doctors (57%). As for the wardens, with reference to interpersonal factors, high level of stress was experience with reference ta prisoners behavior (82.5%) and problems with higher authorities (83.5 %), For intrapersonal factors, sleep disturbances (64%), career problems (76.3%), financial problems (73.2%) and feeling bored (75.3%) highly contributed to stress. Wardens physical effects were 38.1% health problems and 29.9% sleep disturbances. For emotional effects, must of them were depressed (54.6%), anxious (67%), angry (63.9%), confused (64.9%), frustrated (59.8%), threatened (53.6%) and patriotic (51.5%). The spiritual effect were feeling closer to God (86.6%), feeling responsible for duties (82.5%), regret doing the job (74.2%), feeling high spirited (58.8%). For social effects, low self esteem is the highest effect experienced (68%). Wardens managed stress by praying and conducting religious activities (91.8%), recreational activities (88.7%), doing a hobby (85.6%), sleeping (74.2%), and sharing problems (68%).

Matched MeSH terms: Prisons
Fulltext The linkage between associates and drug addiction: case study on Chow Kit road

Mohd Alif Jasni, Siti Hajar Abu Bakar Ah, Jal Zabdi Mohd Yusoff, Khairiyah Md Shahid, Noralina Omar, Zaiton Azman

Malaysian Journal of Social Sciences and Humanities, 2018;3(2):146-158.
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The return of ex-prisoners who were released from prison into an environment filled with fellow
friends could lead to negative influences such as drug addiction and crime repetition among former
prisoners. This paper has been derived from a doctorate study studying the repeatition of crimes that
occurred among former prisoners in Malaysia. The findings of the study have found that former
prisoners often return to their fellow members due to family absence. This study has been used
qualitative methods by interviewing 16 ex-prisoners identified through the technique of snowball
sampling. The finding revealed that all these former prisoners from different state were concentrated
around the Chow Kit road. Addiction, as a result of invitation process by friends. This situation are
make the study to proven relationship between the influence of friends and drug abused among the
former prisoners.

Matched MeSH terms: Prisons
Treatment and care for injecting drug users with HIV infection: a review of barriers and ways forward

Wolfe D, Carrieri MP, Shepard D

Lancet, 2010 Jul 31;376(9738):355-66.
PMID: 20650513 DOI: 10.1016/S0140-6736(10)60832-X

We review evidence for effectiveness, cost-effectiveness, and coverage of antiretroviral therapy (ART) for injecting drug users (IDUs) infected with HIV, with particular attention to low-income and middle-income countries. In these countries, nearly half (47%) of all IDUs infected with HIV are in five nations--China, Vietnam, Russia, Ukraine, and Malaysia. In all five countries, IDU access to ART is disproportionately low, and systemic and structural obstacles restrict treatment access. IDUs are 67% of cumulative HIV cases in these countries, but only 25% of those receiving ART. Integration of ART with opioid substitution and tuberculosis treatment, increased peer engagement in treatment delivery, and reform of harmful policies--including police use of drug-user registries, detention of drug users in centres offering no evidence-based treatment, and imprisonment for possession of drugs for personal use--are needed to improve ART coverage of IDUs.

Matched MeSH terms: Prisons
Fulltext Tuberculosis control in prisons: current situation and research gaps

Dara M, Acosta CD, Melchers NV, Al-Darraji HA, Chorgoliani D, Reyes H, et al.

Int J Infect Dis, 2015 Mar;32:111-7.
PMID: 25809766 DOI: 10.1016/j.ijid.2014.12.029

Tuberculosis (TB) in penitentiary services (prisons) is a major challenge to TB control. This review article describes the challenges that prison systems encounter in TB control and provides solutions for the more efficient use of limited resources based on the three pillars of the post-2015 End TB Strategy. This paper also proposes research priorities for TB control in prisons based on current challenges.

Matched MeSH terms: Prisons*
Fulltext Undiagnosed pulmonary tuberculosis among prisoners in Malaysia: an overlooked risk for tuberculosis in the community

Al-Darraji HA, Altice FL, Kamarulzaman A

Trop Med Int Health, 2016 Aug;21(8):1049-1058.
PMID: 27197601 DOI: 10.1111/tmi.12726

OBJECTIVES: To investigate the prevalence of previously undiagnosed active tuberculosis (TB) cases among prisoners in Malaysia's largest prison using an intensified TB case-finding strategy.
METHODS: From October 2012 to May 2013, prisoners housed in two distinct units (HIV-negative and HIV-positive) were approached to participate in the TB screening study. Consenting prisoners submitted two sputum samples that were examined using GeneXpert MTB/RIF, smear microscopy and liquid culture. Socio-demographic and clinical information was collected and correlates of active TB, defined as having either a positive GeneXpert MTB/RIF or culture results, were assessed using regression analyses.
RESULTS: Among the total of 559 prisoners, 442 (79.1%) had complete data; 28.7% were HIV-infected, 80.8% were men and the average age was 36.4 (SD 9.8) years. Overall, 34 (7.7%) had previously undiagnosed active TB, of whom 64.7% were unable to complete their TB treatment in prison due to insufficient time (<6 months) remaining in prison. Previously undiagnosed active TB was independently associated with older age groups (AOR 11.44 and 6.06 for age ≥ 50 and age 40-49 years, respectively) and with higher levels of immunosuppression (CD4 < 200 cells/ml) in HIV-infected prisoners (AOR 3.07, 95% CI 1.03-9.17).
CONCLUSIONS: The high prevalence of previously undiagnosed active TB in this prison highlights the inadequate performance of internationally recommended case-finding strategies and suggests that passive case-finding policies should be abandoned, especially in prison settings where HIV infection is prevalent. Moreover, partnerships between criminal justice and public health treatment systems are crucial to continue TB treatment after release.

Matched MeSH terms: Prisons
Fulltext Within-prison drug injection among HIV-infected male prisoners in Indonesia: a highly constrained choice

Culbert GJ, Waluyo A, Iriyanti M, Muchransyah AP, Kamarulzaman A, Altice FL

Drug Alcohol Depend, 2015 Apr 01;149:71-9.
PMID: 25659895 DOI: 10.1016/j.drugalcdep.2015.01.018

BACKGROUND: In Indonesia, incarceration of people who inject drugs (PWID) and access to drugs in prison potentiate within-prison drug injection (WP-DI), a preventable and extremely high-risk behavior that may contribute substantially to HIV transmission in prison and communities to which prisoners are released.
AIMS: This mixed method study examined the prevalence, correlates, and social context of WP-DI among HIV-infected male prisoners in Indonesia.
METHODS: 102 randomly selected HIV-infected male prisoners completed semi-structured voice-recorded interviews about drug use changes after arrest, drug use cues within prison, and impact of WP-DI on HIV and addiction treatment. Logistic regression identified multivariate correlates of WP-DI and thematic analysis of interview transcripts used grounded-theory.
RESULTS: Over half (56%) of participants reported previous WP-DI. Of those, 93% shared injection equipment in prison, and 78.6% estimated sharing needles with ≥ 10 other prisoners. Multivariate analyses independently correlated WP-DI with being incarcerated for drug offenses (AOR = 3.29, 95%CI = 1.30-8.31, p = 0.011) and daily drug injection before arrest (AOR = 5.23, 95%CI = 1.42-19.25, p = 0.013). Drug availability and proximity to drug users while incarcerated were associated with frequent drug craving and escalating drug use risk behaviors after arrest. Energetic heroin marketing and stigmatizing attitudes toward methadone contribute to WP-DI and impede addiction and HIV treatment.
CONCLUSIONS: Frequent WP-DI and needle sharing among these HIV-infected Indonesian prison inmates indicate the need for structural interventions that reduce overcrowding, drug supply, and needle sharing, and improve detection and treatment of substance use disorders upon incarceration to minimize WP-DI and associated harm.

Matched MeSH terms: Prisoners/psychology*; Prisons*