title: Street-outreach improves detection but not referral for drug users with latent tuberculosis, New York City.
abstract: Street outreach in two New York City communities, Harlem and the South Bronx, between May 2001 and March 2003, provided tuberculin skin test (TST) screening to illicit drug users outside the traditional health care system. Persons who used heroin, cocaine, and/or crack were offered a TST, incentives to return for TST reading, and further evaluation if TST was positive. Of 809 participants, 530 (66%) accepted a TST and 81% (429/530) returned for TST reading. Of 429 participants, 40 (9%) were TST positive. Participants found TST positive did not differ from those found TST negative in previous drug user treatment or drug use practices including snorting heroin, sniffing cocaine, smoking crack, and injecting drugs of any kind. Of the 40 participants found TST positive, the 21 who tested TST positive for the first time were more likely to be male (p = .03) and noninjectors (p = .02), than the 19 who had tested TST positive in the past. Only two newly identified persons pursued follow-up care. Street recruitment expanded testing. Better follow-up strategies are needed. The study's limitations are noted.
authors.affiliation: Center for Urban Epidemiologic Studies, New York Academy of Medicine, New York, New York, USA. stephanie.factor@mssm.edu
authors.forename: Stephanie H
authors.initials: SH
authors.lastname: Factor
authors.forename: Judy E
authors.initials: JE
authors.lastname: Sackoff
authors.forename: Shavvy
authors.initials: S
authors.lastname: Raj-Singh
authors.forename: Yingfeng
authors.initials: Y
authors.lastname: Wu
authors.forename: Joan
authors.initials: J
authors.lastname: Monserrate
authors.forename: Sonal
authors.initials: S
authors.lastname: Munsiff
authors.forename: David
authors.initials: D
authors.lastname: Vlahov
mesh_terms: D000293:Adolescent; D000328:Adult; D003159:Community-Institutional Relations; D055030:Drug Users; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D055985:Latent Tuberculosis / Q000150:complications / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D009519:New York City; D010349:Patient Compliance; D012017:Referral and Consultation; D012737:Sex Factors; D015819:Substance Abuse, Intravenous / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications*; D014374:Tuberculin Test