Screening for Hepatitis C as a Prevention Enhancement (SHAPE) for HIV: An Integration Pilot Initiative in a Massachusetts County Correctional Facility
Screening for Hepatitis C as a Prevention Enhancement (SHAPE) for HIV: An Integration Pilot Initiative in a Massachusetts County Correctional Facility
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DOI：
10.1177/00333549141291s102
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发表时间：
2014-01-01
影响因子：
3.3
通讯作者：
DeMaria, Alfred, Jr.
中科院分区：
文献类型：
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作者：
Cocoros, Noelle;Nettle, Eduardo;DeMaria, Alfred, Jr.
目标。马萨诸塞州公共卫生局(MDPH)和马萨诸塞州巴恩斯特县警局(BCSD)于2009年7月启动了一项试点计划，在进行常规艾滋病毒检测的同时，向囚犯和在押人员提供教育和丙型肝炎病毒(HCV)抗体检测。该倡议的实施是为了评估在惩教环境中将丙型肝炎病毒筛查纳入艾滋病毒筛查计划的可行性，以及在获释后将丙型肝炎病毒抗体阳性囚犯与临床护理联系起来的有效性。通过筛查丙型肝炎作为一项加强预防的倡议，在囚犯入院后不久，并在监禁期间的任何时间应要求向囚犯和被拘留者提供丙型肝炎病毒和艾滋病毒检测。在为释放做准备的过程中，转诊至社区医疗提供者进行丙型肝炎后续护理。将BCSD的数据与MDPH收到的常规监测数据进行比较。截至2012年4月15日收到的确认的丙型肝炎病毒检测结果被认为是适当的出院后临床护理的指标。从2009年7月到2011年12月，2716名囚犯/被拘留者中分别有22%(n=596)和25%(n=667)接受了丙型肝炎病毒和艾滋病毒检测。丙型肝炎病毒抗体阳性者122例，占20.5%。HIV抗体阳性5例，阳性率为0.8%。在BCSD检测出丙型肝炎病毒阳性并已出狱的囚犯中，37.8%的人被确认接受了出院后的医疗护理。我们确定，将丙型肝炎病毒教育和筛查整合到教养机构是可行的，并揭示了丙型肝炎病毒的高感染率。虽然这种模式是以程序性基础设施为前提的，但服务设计和整合的要素可以为一系列矫正计划提供信息。有效的护理联系虽然很重要，但根据我们的分析，这并不是例行公事，考虑到其成本和复杂性，可能需要额外的资源。
Objectives. The Massachusetts Department of Public Health (MDPH) and the Barnstable County Sheriff's Department (BCSD) in Massachusetts initiated a pilot program in July 2009 offering education and hepatitis C virus (HCV) antibody testing to inmates and detainees, concurrent with routine HIV testing. The initiative was implemented to assess the feasibility of integrating HCV screening into an HIV screening program in a correctional setting and the efficacy of linking HCV antibody-positive inmates to clinical care upon release.Methods. Through the Screening for Hepatitis C as a Prevention Enhancement initiative, HCV and HIV testing were offered to inmates and detainees shortly after admission, and by request at any time during incarceration. In preparation for release, referrals were made to community-based medical providers for HCV follow-up care. Data from BCSD were compared with routine surveillance data received by MDPH. Confirmatory HCV test results received by April 15, 2012, were considered indicators of appropriate post-release clinical care.Results. From July 2009 through December 2011, 22% (n=596) and 25% (n=667) of 2,716 inmates/detainees accepted HCV and HIV testing, respectively. Of those tested for HCV antibody, 20.5% (n=122) were positive. Of those tested for HIV antibody, 0.8% (n=5) were positive. Of the inmates who tested HCV positive at BCSD and had been released, 37.8% were identified as receiving post-release medical care.Conclusions. We determined that integration of HCV education and screening into correctional facilities is feasible and reveals high rates of HCV infection. Although this model presupposes programmatic infrastructure, elements of the service design and integration could inform a range of correctional programs. Effective linkage to care, while substantial, was not routine based on our analysis, and may require additional resources given its cost and complexity.