A collaborative effort to enhance HIV/STI screening in five county jails.
Funding from the Centers for Disease Control and Prevention and the Health Resources and Services Administration (HRSA) supports collaborations among health departments (CA, FL, GA, IL, MA, NJ, NY), correctional facilities, and community-based organizations to improve services to HIV-infected inmates, particularly as they return to the community. Additionally, HRSA funded the Evaluation and Program Support Center to guide the implementation of a multi-site evaluation of the Corrections Demonstration Project (CDP). The authors present a model approach to the problem of health disparities that involves forging collaborations among federal funders, public health departments, corrections, community-based organizations, and the scientific research community. They show how such collaboration can promote the reduction of racial/ethnic health disparities. The authors examined disease screening activities in five county jails. Screening for HIV and other sexually transmitted infections (STIs) was offered during the medical intake process and during HIV prevention education sessions. One thousand twenty inmates were tested from July 1, 2000, through December 31, 2000, for HIV infection, and 171 (17%) positive cases were identified (largely due to confirmatory testing). Of HIV-positive inmates, 83 (49%) were started on antiretroviral treatment. Additionally, 2,160 were tested for chlamydia, 1,327 for gonorrhea (largely duplicated), and 937 (duplicated) for syphilis. Across all three STIs, 78% of those who tested positive were treated. The remaining 22% either declined treatment, were released prior to notification of results, or were released prior to starting treatment. The CDP offers a model approach for addressing the poor health status of members of racial/ethnic minority groups by developing collaborations between corrections, public health departments, community-based organizations, and academia. An outgrowth of this collaboration is the improved capacity to detect and treat disease, which is a necessary component of a comprehensive HIV risk reduction program.
Dept. of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, 1518 Clifton Road NE, Atlanta, GA 30322, USA. kjacoba@sph.emory.edu
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Arriola
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Braithwaite
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Kennedy
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Hammett
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Tinsley
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Arboleda
D015492:AIDS Serodiagnosis; D002487:Centers for Disease Control and Prevention, U.S.; D003159:Community-Institutional Relations; D003191:Comprehensive Health Care / Q000191:economics / Q000458:organization & administration; D003299:Cooperative Behavior; D005260:Female; D005380:Financing, Government; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D006297:Health Services Accessibility / Q000191:economics / Q000458:organization & administration*; D006801:Humans; D009111:Local Government; D008297:Male; D008403:Mass Screening / Q000191:economics / Q000458:organization & administration*; D017146:Models, Organizational; D010865:Pilot Projects; D011329:Prisoners; D011330:Prisons / Q000191:economics / Q000458:organization & administration*; D011635:Public Health Administration; D012749:Sexually Transmitted Diseases / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D012959:Socioeconomic Factors; D014481:United States / Q000453:epidemiology; D014488:United States Health Resources and Services Administration