Accessing methadone within Moldovan prisons: Prejudice and myths amplified by peers

Other literature type, Article English OPEN
Polonsky, Maxim ; Azbel, Lyuba ; Wickersham, Jeffrey A. ; Marcus, Ruthanne ; Doltu, Svetlana ; Grishaev, Evgeny ; Dvoryak, Sergey ; Altice, Frederick L. (2015)
  • Publisher: Elsevier
  • Related identifiers: doi: 10.1016/j.drugpo.2015.12.016
  • Subject: Article
    mesheuropmc: food and beverages | fungi | otorhinolaryngologic diseases | animal structures | mental disorders

BACKGROUND: The volatile HIV epidemic in Moldova, driven primarily by people who inject drugs (PWIDs), is concentrated in prisons. Although internationally recommended opioid agonist therapy (OAT) is available in Moldovan prisons, coverage remains inadequate and expansion efforts have failed to meet national and international goals.<br/> METHODS: To better understand why eligible prisoners are reluctant to initiate OAT, we surveyed recently released prisoners who met criteria for opioid dependence and compared those who had and had not been enrolled in within-prison OAT (N=56) using standardized scales on OAT knowledge and attitudes as well as within-prison harassment experiences.<br/> RESULTS: Knowledge about OAT was similar between both groups, but this knowledge and myths about OAT had independent and opposite direct effects on OAT attitudes. Those who were enrolled in OAT in prison were significantly more likely to perceive it as an effective form of treatment and had more tolerable attitudes toward OAT but were also more likely to have been bullied and to express concerns about their personal safety. Prisoners who had not been enrolled in OAT were more likely to endorse negative myths about methadone; only one person among them intended to receive OAT in the future.<br/> CONCLUSION: In Moldovan prisons, OAT enrollment and treatment continuation are influenced by ideological biases and myths that are largely formed, amplified, and reinforced behaviorally in restricted prison settings. Future interventions that expand OAT in prisons should target individual-level ideological prejudices and myths, as well as the prison environment.<br/>
  • References (14)
    14 references, page 1 of 2

    Altice, F. L., Kamarulzaman, A., Soriano, V. V., Schechter, M., & Friedland, G. H. (2010). Treatment of medical, psychiatric, and substance-use comorbidities in people infected with HIV who use drugs. Lancet, 376(9738), 367-387. doi:10.1016/S0140-6736(10)60829-X t

    Azbel, L., Wickersham, J. A., Grishaev, Y., Dvoryak, S., & Altice, F. L. (2013). Burden of infectious diseases, substance use disorders, and mental illness among Ukrainian prisoners transitioning to pthe community. PLoS One, 8(3), e59643. doi:10.1371/journal.pone.0059643 i

    Breckler, S. J. (1984). Empirical validation of affect, behavior, and cognition as distinct comrponents of

    Broadhead, R. S., Heckathorn, D. D., Altice, F. L., van Hulst, Y., Carbone, M., Friedland, cG. H., . . . Selwyn, attitude. J Pers Soc Psychol, 47(6), 1191. s P. A. (2002). Increasing drug users' adherence to HIV treatment: results of a peer-driven intervention feasibility study. Soc Sci Med, 55(2), 235-246. Retrieved from _uids=12144138 u

    Broadhead, R. S., Heckathorn, D. D., Weakliem, D. L., Anthony, D. L., Mnadray, H., Mills, R. J., & Hughes, J. (1998). Harnessing peer networks as an instrument for AIDS prevention: results from a peerdriven intervention. Public health reports, 113(Suppl 1), 42a-57.

    Dolan, K., Kite, B., Black, E., Aceijas, C., Stimson, G. V., Reference Group on, H. I. V. A. P., . . . Transitional, C. (2007). HIV in prison in low-income and middle-income countries. Lancet Infect Dis, 7(1), 32- 41. doi:10.1016/S1473-3099(06)70685-5 M

    Dolan, K., Moazen, B., Noori, A., Rahimzadeh, S., Farzadfar, F., & Hariga, F. (2015). People who inject drugs in prison: HIV prevalence, transmission and prevention. Int J Drug Policy, 26 Suppl 1, S12- 15. doi:10.1016/j.drugpo.2014.10.012 d

    Ireland, J. L. (1999). Bullying behaviors among male and female prisoners: A study of adult and young offenders. Aggressive Behavior, 25(3), e161-178.

    Keen, J., Rowse, G., Mathers, N., Campbell, Mt., & Seivewright, N. (2000). Can methadone maintenance time spent in prison? Br J Gen Ppract, 50(450), 48-49. Retrieved from for heroin-dependent patients retained in general practice reduce criminal conviction rates and

    Kurzban, R., & Leary, M. R. (2001). eEvolutionary Origins of Stigmatization: The Functions of Social c Exclusion. Psychological Bulletin, 127(2), 187-208.

  • Metrics
    No metrics available