title: Screening for Hepatitis C as a Prevention Enhancement (SHAPE) for HIV: an integration pilot initiative in a Massachusetts County correctional facility.
abstract: OBJECTIVE
  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.
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Noelle
authors.initials: N
authors.lastname: Cocoros
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Eduardo
authors.initials: E
authors.lastname: Nettle
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Daniel
authors.initials: D
authors.lastname: Church
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Lori
authors.initials: L
authors.lastname: Bourassa
authors.affiliation: Barnstable County Sheriff's Department, Bourne, MA.
authors.forename: Vicki
authors.initials: V
authors.lastname: Sherwin
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Kevin
authors.initials: K
authors.lastname: Cranston
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Robert
authors.initials: R
authors.lastname: Carr
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: H Dawn
authors.initials: HD
authors.lastname: Fukuda
authors.affiliation: Massachusetts Department of Public Health, Bureau of Infectious Disease, Jamaica Plain, MA.
authors.forename: Alfred
authors.initials: A
authors.lastname: DeMaria
mesh_terms: D015492:AIDS Serodiagnosis; D000293:Adolescent; D000328:Adult; D002648:Child; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006526:Hepatitis C / Q000175:diagnosis* / Q000453:epidemiology / Q000517:prevention & control; D006801:Humans; D009111:Local Government; D008297:Male; D008404:Massachusetts / Q000453:epidemiology; D008875:Middle Aged; D010865:Pilot Projects; D011329:Prisoners / Q000706:statistics & numerical data; D011330:Prisons / Q000458:organization & administration; D055815:Young Adult