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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.

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Title: 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.
Authors: Rivera Saldana, Carlos D., Abramovitz, Daniela, Beletsky, Leo, Borquez, Annick, Kiene, Susan, Marquez, Lara K., Patton, Thomas, Strathdee, Steffanie, Zúñiga, María Luisa, Martin, Natasha K., Cepeda, Javier
Source: Addiction. Sep2023, Vol. 118 Issue 9, p1763-1774. 12p. 2 Diagrams, 2 Charts, 4 Graphs.
Subjects: Prevention of infectious disease transmission, Police education, Hepatitis C prevention, Health education, Evaluation of human services programs, Scientific observation, Industrial safety, Intravenous drug abuse, Hepatitis viruses, Comparative studies, Descriptive statistics, Research funding, Economic aspects of diseases, Drug abusers, Epidemiological research, Longitudinal method
Geographic Terms: Mexico
Abstract: 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. [ABSTRACT FROM AUTHOR]
Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)
Database: Psychology and Behavioral Sciences Collection
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  Data: 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.
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  Data: <searchLink fieldCode="AR" term="%22Rivera+Saldana%2C+Carlos+D%2E%22">Rivera Saldana, Carlos D.</searchLink><br /><searchLink fieldCode="AR" term="%22Abramovitz%2C+Daniela%22">Abramovitz, Daniela</searchLink><br /><searchLink fieldCode="AR" term="%22Beletsky%2C+Leo%22">Beletsky, Leo</searchLink><br /><searchLink fieldCode="AR" term="%22Borquez%2C+Annick%22">Borquez, Annick</searchLink><br /><searchLink fieldCode="AR" term="%22Kiene%2C+Susan%22">Kiene, Susan</searchLink><br /><searchLink fieldCode="AR" term="%22Marquez%2C+Lara+K%2E%22">Marquez, Lara K.</searchLink><br /><searchLink fieldCode="AR" term="%22Patton%2C+Thomas%22">Patton, Thomas</searchLink><br /><searchLink fieldCode="AR" term="%22Strathdee%2C+Steffanie%22">Strathdee, Steffanie</searchLink><br /><searchLink fieldCode="AR" term="%22Zúñiga%2C+María+Luisa%22">Zúñiga, María Luisa</searchLink><br /><searchLink fieldCode="AR" term="%22Martin%2C+Natasha+K%2E%22">Martin, Natasha K.</searchLink><br /><searchLink fieldCode="AR" term="%22Cepeda%2C+Javier%22">Cepeda, Javier</searchLink>
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  Data: <searchLink fieldCode="JN" term="%22Addiction%22">Addiction</searchLink>. Sep2023, Vol. 118 Issue 9, p1763-1774. 12p. 2 Diagrams, 2 Charts, 4 Graphs.
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  Data: <searchLink fieldCode="DE" term="%22Mexico%22">Mexico</searchLink>
– Name: Abstract
  Label: Abstract
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  Data: 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. [ABSTRACT FROM AUTHOR]
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  Data: <i>Copyright of Addiction is the property of Wiley-Blackwell and its content may not be copied or emailed to multiple sites without the copyright holder's express written permission. Additionally, content may not be used with any artificial intelligence tools or machine learning technologies. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract.</i> (Copyright applies to all Abstracts.)
PLink https://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=pbh&AN=169809854
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        Value: 10.1111/add.16203
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        Text: English
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        Type: general
      – SubjectFull: Police education
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      – SubjectFull: Hepatitis C prevention
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      – SubjectFull: Evaluation of human services programs
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      – SubjectFull: Industrial safety
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      – SubjectFull: Intravenous drug abuse
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      – SubjectFull: Hepatitis viruses
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      – SubjectFull: Comparative studies
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      – SubjectFull: Descriptive statistics
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