NCJ Number
204749
Date Published
January 2004
Length
7 pages
Annotation
This paper, which was featured at the 27th Annual Conference of the National Commission on Correctional Health Care and the Academy of Correctional Health Professionals, held in Texas during October 2003, discusses the management of infectious and contagious diseases in correctional facilities.
Abstract
Several doctors came together to discuss the prevalence of infectious and contagious diseases in prison and challenges to treatment. Topics focused on sexually transmitted diseases and HIV treatment. The four most common sexually transmitted diseases in prison settings are syphilis, gonorrhea, chlamydia, and genital herpes. Treating HIV in prison settings is the main focus of the paper. Following 2003 guidelines released by the Department of Health and Human Services (DHHS), Dr. Joseph Bick pointed out that HIV infections are often overlooked in correctional settings and that any patient presenting with flu-like symptoms should be considered for HIV testing. Antiretroviral treatment for HIV infection is discussed, including the goals of therapy, the advantages of resistance testing, and treatment considerations such as adverse side effects and comorbidities. In correctional settings, one of the challenges to HIV treatment is that many patients must contend with additional health problems such as hepatitis, tuberculosis, hypertension, and diabetes. Recommended treatment regimes based on the 2003 DHHS guidelines are presented and include NNRTI-based preferred and alternative regimes, PI-based preferred and alternative regimes, and Triple-NRTI alternative regimes. A table presents antiretroviral agents that are not recommended for initial therapy. Next, the prevalence and epidemiology of Hepatitis C infection (HCV) in correctional settings is described. The prevalence of HCV in the general population and in the inmate population warrants careful screening of the disease in correctional settings. Factors that indicate HCV screening are presented and include injection drug use, HIV-positive status, occupational exposure, and unexplained abnormal liver enzyme levels. A case study of a 40-year old incarcerated man with HIV and HCV co-infection is presented. The case illustrates that patients with profound hepatic failure can be successfully treated for HCV infection. Embedded within the article is a textbox on HIV and sexually transmitted diseases in the juvenile justice system that underscores the importance of HIV screening in juvenile correctional settings. A case study from Chicago describes HIV initiatives that target incarcerated youth. Tables