Evidence map›Paper›PMID 30122559›Full record

ArticleThe Lancet. Public health2018

The effect of public health-oriented drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico: an epidemic modelling study.

Annick Borquez, Leo Beletsky, Bohdan Nosyk, Steffanie A Strathdee, Alejandro Madrazo, Daniela Abramovitz, Claudia Rafful, Mario Morales, Javier Cepeda, Dimitra Panagiotoglou and 5 more

Open access · goldAbstract read
PubMed Full text at PMC Publisher
In one paragraph

Article in The Lancet. Public health, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
27citing papers in PubMed, 2 pooled it
4.4field-weighted citation impact, top 5% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

27 citing papers in PubMed, 2 syntheses or guidelines pooled it, 49 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors at 10 institutions in 5 countries.

Annick BorquezDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA. Electronic address: aborquez@ucsd.edu.
Leo BeletskyDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; School of Law and Bouvé College of Health Sciences, Northeastern University, Boston, MA, USA.
Bohdan NosykBC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada; Faculty of Health Sciences, Simon Fraser University, Burnaby, BC, Canada.
Steffanie A StrathdeeDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA.
Alejandro MadrazoDrug Policy Program, Centro de Investigación y Docencia Económicas, Sede Región Centro, Aguascalientes, Mexico.
Daniela AbramovitzDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA.
Claudia RaffulDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Centre for Urban Health Solutions, St Michael's Hospital, Toronto, ON, Canada.
Mario MoralesDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; School of Social Work, San Diego State University, CA, USA.
Javier CepedaDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA.
Dimitra PanagiotoglouBC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
Emanuel KrebsBC Centre for Excellence in HIV/AIDS, Vancouver, BC, Canada.
Peter VickermanPopulation Health Sciences, University of Bristol, Bristol, UK.
Marie Claude BoilyDepartment of Infectious Disease Epidemiology, Imperial College London, London, UK.
Nicholas ThomsonJohns Hopkins Bloomberg School of Public Health, Baltimore, MA, USA; Melbourne School of Population and Global Health, University of Melbourne, Melbourne, VIC, Australia.
Natasha K MartinDivision of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA; Population Health Sciences, University of Bristol, Bristol, UK.
University of California System · USAIDS Vancouver · CACentro de Investigación y Docencia Económicas · MXImperial College London · GBJohns Hopkins University · USNortheastern University · USSan Diego State University · USSimon Fraser University · CASt. Michael's Hospital · CAUniversity of Bristol · GB

Funding

VirologyP30AI036214 · NIAID · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI SUSAN JANET LITTLE · 1994 to 2026
$78.4M
University of California Launching Future Leaders in Global Health Research Training ProgramD43TW009343 · FIC · UNIVERSITY OF CALIFORNIA, SAN FRANCISCO · PI CRAIG R COHEN, Sung-Jae Lee · 2017 to 2026
$14.7M
Training Program in Substance Use, HIV and Related InfectionsT32DA023356 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI Natasha Martin, Steffanie A Strathdee · 2007 to 2026
$7.8M
Impact of Drug Policy Reform on the HIV Risk Environment among IDUs in TijuanaR37DA019829 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI STRATHDEE, STEFFANIE A. · 2010 to 2019
$6.7M
Localized economic modeling to support implementation of the Ending the HIV Epidemic initiativeR01DA041747 · NIDA · SIMON FRASER UNIVERSITY · PI NOSYK, BOHDAN · 2016 to 2025
$5.5M
Police Training to Reduce Occupational Needlesticks and HIV among Substance UsersR01DA039073 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI BELETSKY, LEO, STRATHDEE, STEFFANIE A. · 2015 to 2019
$3.2M
AIDS International Training Program in the US Mexico Border RegionD43TW008633 · FIC · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI STRATHDEE, STEFFANIE A. · 2010 to 2014
$1.5M
Modeling Structural HIV Determinants in Substance Users and related populationsR01DA037773 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI MARTIN, NATASHA, STRATHDEE, STEFFANIE A. · 2015 to 2017
$1.4M
MODELING THE IMPACT OF A POLICE EDUCATION PROGRAM ON HIV INCIDENCE AMONG PEOPLE WHO INJECT DRUGSK01DA043421 · NIDA · UNIVERSITY OF CALIFORNIA, SAN DIEGO · PI CEPEDA, JAVIER · 2017 to 2021
$941k
FIC NIH HHS D43 TW008633FIC NIH HHS D43 TW009343Medical Research Council MR/R015600/1NIAID NIH HHS P30 AI036214NIDA NIH HHS K01 DA043421NIDA NIH HHS R01 DA037773NIDA NIH HHS R01 DA039073NIDA NIH HHS R01 DA041747NIDA NIH HHS R37 DA019829NIDA NIH HHS T32 DA023356
6 · The paper itself

Abstract

backgroundAs countries embark on public health-oriented drug law reform, health impact evaluations are needed. In 2012, Mexico mandated the narcomenudeo reform, which depenalised the possession of small amounts of drugs and instituted drug treatment instead of incarceration. We investigated the past and future effect of this drug law reform on HIV incidence in people who inject drugs in Tijuana, Mexico.

methodsIn this epidemic modelling study, we used data from the El Cuete IV cohort study to develop a deterministic model of injecting and sexual HIV transmission in people who inject drugs in Tijuana between 2012 and 2030. The population was stratified by sex, incarceration status, syringe confiscation by the police, HIV stage, and exposure to drug treatment or rehabilitation (either opioid agonist treatment or compulsory drug abstinence programmes). We modelled the effect of these exposures on HIV risk in people who inject drugs, estimating the effect of observed and potential future reform enforcement levels.

findingsIn 2011, prior to the narcomenudeo reform, 547 (75%) of 733 people who inject drugs in the El Cuete cohort reported having ever been incarcerated, on average five times since starting injecting. Modelling estimated the limited reform implementation averted 2% (95% CI 0·2-3·0) of new HIV infections in people who inject drugs between 2012 and 2017. If implementation reduced incarceration in people who inject drugs by 80% from 2018 onward, 9% (95% CI 4-16) of new HIV infections between 2018 and 2030 could be averted, with 21% (10-33) averted if people who inject drugs were referred to opioid agonist treatment instead of being incarcerated. Referral to compulsory drug abstinence programmes instead of prison could have a lower or potentially negative impact with -2% (95% CI -23 to 9) infections averted.

interpretationMexican drug law reform has had a negligible effect on the HIV epidemic among people who inject drugs in Tijuana. However, appropriate implementation could markedly reduce HIV incidence if linked to opioid agonist treatment. Unfortunately, compulsory drug abstinence programmes are the main type of drug rehabilitation available and their expansion could potentially increase HIV transmission.

fundingNational Institute on Drug Abuse, UC San Diego Center for AIDS Research.

Indexed as

EpidemicsLegislation, DrugCohort StudiesFemaleHIV InfectionsHumansIncidenceMaleMexicoModels, TheoreticalPublic HealthSubstance Abuse, Intravenous

Identifiers

PMID30122559
PMCPMC6211569
OpenAlexW2887969670

What OpenQuestion holds

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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.