Survey Finds That Many Prisons And Jails Have Room To Improve HIV Testing And Coordination Of Postrelease Treatment
Survey Finds That Many Prisons And Jails Have Room To Improve HIV Testing And Coordination Of Postrelease Treatment
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DOI：
10.1377/hlthaff.2013.1115
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发表时间：
2014-03-01
期刊：
影响因子：
9.7
通讯作者：
Rich, Josiah D.
中科院分区：
文献类型：
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作者：
Solomon, Liza;Montague, Brian T.;Rich, Josiah D.
艾滋病毒的早期诊断和有效的抗逆转录病毒治疗是努力降低与艾滋病毒有关的发病率和死亡率的关键因素。被监禁的人口受到艾滋病毒的影响不成比例，据估计，这种疾病在囚犯中的流行率是一般人口的三至五倍。惩教机构提供重要的机会进行艾滋病毒检测，并将感染者与释放后治疗服务联系起来。为了检验艾滋病毒检测和帮助艾滋病毒阳性患者释放后在社区获得治疗的政策，我们对美国50个州监狱系统和40个最大监狱的医疗主管进行了一项调查。我们发现19%的监狱系统和35%的监狱提供选择退出艾滋病毒检测，这是疾病控制和预防中心（CDC）建议的。此外，只有不到20%的监狱和拘留所符合美国疾病控制与预防中心关于囚犯向社区过渡的出院计划服务的建议：与社区卫生保健提供者预约，协助登记权利计划，提供医疗记录副本和艾滋病毒药物供应。这些发现表明，在大多数监狱系统和监狱中，错过了艾滋病毒诊断和将艾滋病毒阳性囚犯释放后与社区护理联系起来的机会。
Early diagnosis of HIV and effective antiretroviral treatment are key elements in efforts to reduce the morbidity and mortality associated with HIV. Incarcerated populations are disproportionately affected by HIV, with the disease's prevalence among inmates estimated to be three to five times higher than among the general population. Correctional institutions offer important opportunities to test for HIV and link infected people to postrelease treatment services. To examine HIV testing and policies that help HIV-positive people obtain treatment in the community after release, we administered a survey to the medical directors of the fifty state prison systems and of forty of the largest jails in the United States. We found that 19 percent of prison systems and 35 percent of jails provide opt-out HIV testing, which is recommended by the Centers for Disease Control and Prevention (CDC). Additionally, fewer than 20 percent of prisons and jails conform to the CDC's recommendations regarding discharge planning services for inmates transitioning to the community: making an appointment with a community health care provider, assisting with enrollment in an entitlement program, and providing a copy of the medical record and a supply of HIV medications. These findings suggest that opportunities for HIV diagnosis and linking HIV-positive inmates to community care after release are being missed in the majority of prison systems and jails.