Imperial College London
Alternate

ProfessorMarie-ClaudeBoily

Faculty of Medicine, School of Public Health

Professor of Mathematical Epidemiology
 
 
 
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Contact

 

+44 (0)20 7594 3263mc.boily

 
 
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Location

 

LG26Norfolk PlaceSt Mary's Campus

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Summary

 

Publications

Citation

BibTex format

@article{Borquez:2018,
author = {Borquez, A and Beletsky, L and Nosyk, B and Strathdee, S and Madrazo, A and Abramovitz, D and RAfful, C and Morales, M and Cepeda, J and Panagiotoglou, D and Krebs, E and Vickerman, P and Boily, MC and Thomson, N and Martin, N},
journal = {Lancet},
title = {Evaluating the impact of public health oriented drug law reform on HIV incidence among people who inject drugs in Tijuana, Mexico: an epidemic modelling analysis},
url = {http://hdl.handle.net/10044/1/61561},
year = {2018}
}
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RIS format (EndNote, RefMan)

TY  - JOUR
AB  - Background: As  countries  embark on public health-­oriented drug law    reform,    health    impact    evaluations  are  needed.    In    2012,    Mexico  mandated the ‘Narcomenudeo reform’,  depenalising    possession    of    small    amounts  of  drugs    and    instituting drug treatment    instead    of    incarceration.    We  investigated its    impact    on    HIV incidence among people who iinject drugs    (PWID)  in  Tijuana, Mexico.Methods: We    developed  a  deterministic    model    of    injecting    and    sexual    HIV    transmission    among    PWID    in    Tijuana disaggregated    by    sex,    incarceration    status,    syringe    confiscation  by    the    police,    and    exposure  to  drug treatment/”rehabilitation”   (either    opioid    agonist    therapy    (OAT)    or  compulsory    drug  abstinence  programmes    (CAP)).    We    modelled    the    effect of  these exposures on HIV    risk among  PWID,    estimating the    impact  of  observed  and    potential    future reform    enforcement    levels. Findings: Modelling    estimated    the    limited    reform    implementation    averted    2%    [95% Confidence  Interval  (CI):    0.2-­15 3%]    of    new    HIV    infections    among    PWID    between    2012-­2017.    If    implementation    reduced    incarceration  among    PWID    by    80%    from    2018    onward,    9%    [95% CI: 4-­16%]    of new  HIV infections    between    2018-­2030    could    be    averted,    with    21%  [95% CI:    10­33%]    averted    if    PWID    were    referred    to    OAT  instead  of  incarcerated.    However,  referral    to    CAP    instead    of    prison    could    have    a    lower    or    potentially    negative  impact    with    -­2%    [95% CI: 23­9%]    infections    averted. Interpretation  Mexican drug  law  reform    has had    negligible    impact    on    the    HIV    epidemic  among    PWID in    Tijuana.
AU  - Borquez,A
AU  - Beletsky,L
AU  - Nosyk,B
AU  - Strathdee,S
AU  - Madrazo,A
AU  - Abramovitz,D
AU  - RAfful,C
AU  - Morales,M
AU  - Cepeda,J
AU  - Panagiotoglou,D
AU  - Krebs,E
AU  - Vickerman,P
AU  - Boily,MC
AU  - Thomson,N
AU  - Martin,N
PY  - 2018///
SN  - 0140-6736
TI  - Evaluating the impact of public health oriented drug law reform on HIV incidence among people who inject drugs in Tijuana, Mexico: an epidemic modelling analysis
T2  - Lancet
UR  - http://hdl.handle.net/10044/1/61561
ER  -
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