Estimating the impact of a police education program on hepatitis C virus transmission and disease burden among people who inject drugs in Tijuana, Mexico: A dynamic modeling analysis.
Epidemic modelling
HCV
PWID
Tijuana
incarceration
police education
Journal
Addiction (Abingdon, England)
ISSN: 1360-0443
Titre abrégé: Addiction
Pays: England
ID NLM: 9304118
Informations de publication
Date de publication:
09 2023
09 2023
Historique:
received:
01
07
2022
accepted:
23
03
2023
pmc-release:
01
09
2024
medline:
8
8
2023
pubmed:
12
4
2023
entrez:
11
4
2023
Statut:
ppublish
Résumé
Criminalization of drug use and punitive policing are key structural drivers of hepatitis C virus (HCV) risk among people who inject drugs (PWID). A police education program (Proyecto Escudo) delivering training on occupational safety together with drug law content was implemented between 2015 and 2016 in Tijuana, Mexico, to underpin drug law reform implementation. We used data from a longitudinal cohort of PWID in Tijuana to inform epidemic modeling and assess the long-term impact of Escudo on HCV transmission and burden among PWID in Tijuana. We developed a dynamic, compartmental model of HCV transmission and incarceration among PWID and tracked liver disease progression among current and former PWID. The model was calibrated to data from Tijuana, Mexico, with 90% HCV seroprevalence. We used segmented regression analysis to estimate impact of Escudo on recent incarceration among an observational cohort of PWID. By simulating the observed incarceration trends, we estimated the potential impact of the implemented (2-year reduction in incarceration) and an extended (10-year reduction in incarceration) police education program over a 50-year follow-up (2016-2066) on HCV outcomes (incidence, cirrhosis, HCV-related deaths and disability adjusted life-years averted) compared with no intervention. Over the 2-year follow-up, Proyecto Escudo reduced HCV incidence among PWID from 21.5 per 100 person years (/100py) (95% uncertainty interval [UI] = 15.3-29.7/100py) in 2016 to 21.1/100py (UI = 15.0-29.1/100py) in 2018. If continued for 10 years, Escudo could reduce HCV incidence to 20.0/100py (14.0-27.8/100py) by 2026 and avert 186 (32-389) new infections, 76 (UI = 12-160) cases of cirrhosis and 32 (5-73) deaths per 10 000 PWID compared with no intervention over a 50-year time horizon. In Tijuana, Mexico, implementation of a police education program delivering training on occupational safety and drug law content appears to have reduced hepatitis C virus incidence among people who inject drugs.
Sections du résumé
BACKGROUND AND AIMS
Criminalization of drug use and punitive policing are key structural drivers of hepatitis C virus (HCV) risk among people who inject drugs (PWID). A police education program (Proyecto Escudo) delivering training on occupational safety together with drug law content was implemented between 2015 and 2016 in Tijuana, Mexico, to underpin drug law reform implementation. We used data from a longitudinal cohort of PWID in Tijuana to inform epidemic modeling and assess the long-term impact of Escudo on HCV transmission and burden among PWID in Tijuana.
METHODS
We developed a dynamic, compartmental model of HCV transmission and incarceration among PWID and tracked liver disease progression among current and former PWID. The model was calibrated to data from Tijuana, Mexico, with 90% HCV seroprevalence. We used segmented regression analysis to estimate impact of Escudo on recent incarceration among an observational cohort of PWID. By simulating the observed incarceration trends, we estimated the potential impact of the implemented (2-year reduction in incarceration) and an extended (10-year reduction in incarceration) police education program over a 50-year follow-up (2016-2066) on HCV outcomes (incidence, cirrhosis, HCV-related deaths and disability adjusted life-years averted) compared with no intervention.
RESULTS
Over the 2-year follow-up, Proyecto Escudo reduced HCV incidence among PWID from 21.5 per 100 person years (/100py) (95% uncertainty interval [UI] = 15.3-29.7/100py) in 2016 to 21.1/100py (UI = 15.0-29.1/100py) in 2018. If continued for 10 years, Escudo could reduce HCV incidence to 20.0/100py (14.0-27.8/100py) by 2026 and avert 186 (32-389) new infections, 76 (UI = 12-160) cases of cirrhosis and 32 (5-73) deaths per 10 000 PWID compared with no intervention over a 50-year time horizon.
CONCLUSIONS
In Tijuana, Mexico, implementation of a police education program delivering training on occupational safety and drug law content appears to have reduced hepatitis C virus incidence among people who inject drugs.
Identifiants
pubmed: 37039246
doi: 10.1111/add.16203
pmc: PMC10524658
mid: NIHMS1902948
doi:
Types de publication
Journal Article
Observational Study
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't
Langues
eng
Sous-ensembles de citation
IM
Pagination
1763-1774Subventions
Organisme : NIDA NIH HHS
ID : R01 DA039073
Pays : United States
Organisme : FIC NIH HHS
ID : D43 TW009343
Pays : United States
Organisme : NIDA NIH HHS
ID : DP2 DA049295
Pays : United States
Organisme : NIAID NIH HHS
ID : R01 AI147490
Pays : United States
Organisme : NIDA NIH HHS
ID : R37 DA019829
Pays : United States
Organisme : NIAID NIH HHS
ID : P30 AI036214
Pays : United States
Organisme : NIDA NIH HHS
ID : T32 DA023356
Pays : United States
Organisme : NIDA NIH HHS
ID : K01 DA043421
Pays : United States
Organisme : NIDA NIH HHS
ID : R01 DA037773
Pays : United States
Informations de copyright
© 2023 Society for the Study of Addiction.
Références
Addiction. 2021 Oct;116(10):2724-2733
pubmed: 33620749
BMC Public Health. 2020 Jul 28;20(1):1173
pubmed: 32723305
Lancet Infect Dis. 2018 Dec;18(12):1397-1409
pubmed: 30385157
Yale J Health Policy Law Ethics. 2012 Summer;12(2):371-431
pubmed: 23175919
AIDS Behav. 2020 Sep;24(9):2466-2468
pubmed: 32333209
J Psychoactive Drugs. 2005 Sep;37(3):333-9
pubmed: 16295018
J Hepatol. 2016 Jul;65(1):17-25
pubmed: 26867489
Int J Drug Policy. 2015 Feb;26 Suppl 1:S27-32
pubmed: 25265900
Lancet. 2016 Apr 2;387(10026):1427-1480
pubmed: 27021149
Lancet HIV. 2018 Feb;5(2):e96-e106
pubmed: 29191440
J Urban Health. 2013 Apr;90(2):284-98
pubmed: 22806453
Lancet Glob Health. 2017 Dec;5(12):e1192-e1207
pubmed: 29074409
Int J Drug Policy. 2021 Feb;88:102710
pubmed: 32165050
Lancet Glob Health. 2015 Nov;3(11):e712-23
pubmed: 26475018
Am J Public Health. 2022 Jun;112(6):860-864
pubmed: 35446602
Salud Publica Mex. 2007 May-Jun;49(3):165-72
pubmed: 17589770
Am J Public Health. 2022 Apr;112(S2):S199-S205
pubmed: 35349326
Lancet Gastroenterol Hepatol. 2017 Mar;2(3):161-176
pubmed: 28404132
AIDS Behav. 2016 May;20(5):1017-25
pubmed: 26354518
Int J Drug Policy. 2022 Dec;110:103878
pubmed: 36242829
Ann Phys Rehabil Med. 2021 Nov;64(6):101531
pubmed: 33933693
Lancet. 2016 Sep 10;388(10049):1089-1102
pubmed: 27427453
Harm Reduct J. 2021 May 10;18(1):52
pubmed: 33971892
Drug Alcohol Depend. 2009 Jul 1;103(1-2):52-8
pubmed: 19386448
Gastroenterology. 1997 Feb;112(2):463-72
pubmed: 9024300
Int J Prison Health. 2015;11(3):183-92
pubmed: 26277925
Lancet Public Health. 2018 Sep;3(9):e429-e437
pubmed: 30122559
JAMA. 2012 Dec 26;308(24):2584-93
pubmed: 23268517
Harm Reduct J. 2011 Apr 08;8:7
pubmed: 21477299
Antiviral Res. 2015 Jul;119:89-96
pubmed: 25615583
Harm Reduct J. 2018 May 23;15(1):28
pubmed: 29792191
Epidemiol Rev. 2020 Jan 31;42(1):27-40
pubmed: 33184637
Harm Reduct J. 2017 Nov 8;14(1):72
pubmed: 29117858
Lancet HIV. 2022 Jan;9(1):e42-e53
pubmed: 34895484
Lancet. 2016 Sep 10;388(10049):1115-1126
pubmed: 27427456
J Theor Biol. 2008 Sep 7;254(1):178-96
pubmed: 18572196
J Prev Med Public Health. 2022 Jan;55(1):10-18
pubmed: 35135044
J Viral Hepat. 2006 Jan;13(1):34-41
pubmed: 16364080
Int J Epidemiol. 2018 Apr 1;47(2):550-560
pubmed: 29309592
Ann Epidemiol. 2012 Jun;22(6):426-38
pubmed: 22626001
Lancet. 2016 Sep 10;388(10049):1081-1088
pubmed: 27394647
Antiviral Res. 2014 Apr;104:62-72
pubmed: 24468275
Int J Drug Policy. 2018 Apr;54:18-25
pubmed: 29367011
BMJ Open. 2015 Aug 10;5(8):e008958
pubmed: 26260350
J Int AIDS Soc. 2020 Jun;23 Suppl 1:e25493
pubmed: 32562375
Hepatology. 2008 Aug;48(2):418-31
pubmed: 18563841
Int J Drug Policy. 2017 Dec;50:56-63
pubmed: 29028564
Int J Drug Policy. 2020 Jan;75:102601
pubmed: 31775080
Am J Public Health. 2019 Jun;109(6):921-926
pubmed: 30998406