ID: HR23-747
Presenting author: Jocelyn Chan

Presenting author biography:

Dr Chan is a public health physician and epidemiologist. She is currently undertaking specialist training in addiction medicine and has a part time research appointment at the Burnet Institute focusing on the health of people who use drugs.

Impacts of incarceration on drug use and health outcomes among a cohort of people who inject drugs in Australia

Jocelyn Chan, Lisa Maher, Matthew Hickman, Thomas Kerr, Mark Stoove, Paul Agius, Peter Higgs, Bernadette Ward, Michael Livingston, Jack Stone, Margaret Hellard, Michael Curtis, Ashleigh Stewart, Rebecca Winter, Paul Dietze
Background -
Drug law enforcement remains a key policy response to drug-related harm and people who inject drugs experience incarceration at disproportionate rates. In Australia, approximately half of people incarcerated report ever injecting drugs. There is limited research on the long-term impacts of incarceration on the health and drug use trajectories of people who inject drugs. We present a preliminary examination of the impacts of incarceration on the patterns of drug use and health outcomes among the Melbourne Injecting Drug User Cohort Study (SuperMIX) cohort of people who inject drugs in Melbourne Australia.

Methods -
SuperMIX involves baseline and annual follow-up interviews with a sample of 1328 people who inject drugs in Melbourne Australia. Data on demographics, drug use, health service use and criminal justice system interactions are collected. We provide a descriptive account of lifetime incarceration, total incarceration episodes and the relationship of lifetime incarceration to a range of health and social factors.

Results -
Overall, 872 (65.7%) participants reported a history of incarceration at recruitment, increasing to 912 (68.7%) participants over the follow-up period. Participants reported a total of 2260 episodes of incarceration lasting a median of 91 days (range <1 day-14 years). One quarter of participants reported injecting drugs while incarcerated (n=235, 25.8%). Participants with a history of incarceration at recruitment were more likely to be male, identify as Aboriginal and/or Torres Strait Islander, have lower levels of education, be unemployed, report experiencing unstable accommodation and younger age at first injection of drugs.

Conclusion –
We observed high rates of incarceration among in the SuperMIX cohort of people who inject drugs. There were key differences in the baseline characteristics of participants who had experienced incarceration, linked in part to characteristics indicating marginalisation. Future analyses will characterise causal impacts of incarceration on drug use trajectories and health outcomes.