A social ecological model (SEM) to exploring barriers of and facilitators to the implementation of Opioid Agonist Treatment (OAT) programmes in prisons

Abstract

First paragraph: Opioid agonist treatment (OAT), an evidence-based treatment for opioid dependence, has been associated with reductions in illicit drug use, injecting drug use, the sharing of injecting equipment and an increase in adherence to antiretroviral therapy (ART) (Springer and Bruce 2008; Wolfe et al. 2010; Hedrich et al. 2012). OAT in prisons therefore, plays a significant role in preventing human immunodeficiency virus (HIV) and Hepatitis C virus (HCV) transmission through the reduction of unsafe injecting practices (Kinner et al. 2013; Jürgens et al. 2009; Azbel et al. 2018). However, despite its proven effectiveness, the availability and coverage of prison OAT programmes remain low. By 2016, only 80 out of 158 countries, where injecting drug use was reported, had implemented OAT programmes (Harm Reduction International 2016). OAT implementation in prisons was even lower. Only 29 countries provided such programmes in 2008 (Larney 2009).