Gunn Robert A, Lee Marjorie A, Callahan David B, Gonzales Patricia, Murray Paula J, Margolis Harold S
Division of STD Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Am J Prev Med. 2005 Jul;29(1):27-33. doi: 10.1016/j.amepre.2005.03.010.
Considering the difficulties in providing screening and vaccination services for inmates in short-stay incarceration facilities, an evaluation was conducted of the integration of prevention services in an alternative sentencing drug rehabilitation program (alternative to incarceration) in San Diego CA.
During the period April 1999 to December 2002, clients were asked to complete a brief risk-assessment questionnaire, and were offered hepatitis B virus (HBV) vaccination, HBV and hepatitis C virus (HCV) serologic testing, STD screening, and HIV counseling and testing.
Of the estimated 1125 rehabilitation program enrollees, 930 (83%) participated in the integration program services. Most clients were male (64%), were aged >30 years (64%), and few (7%) reported previous HBV vaccination. Of the 854 clients eligible for hepatitis B vaccination, 98% received the first dose, 69% the second dose, and 42% completed the series. Eleven percent of clients had prior HBV infection, and 14.7% had HCV infection, with positivity rates being highest among those with a history of injection drug use-HBV, 19%, and HCV, 36%. HIV infection was rare (prevalence, 0.3%), and STDs were uncommon (chlamydia prevalence, 2%, and gonorrhea prevalence, 0.6%). Total annual cost of integration services (excluding HIV testing) was dollar 31,994 equating to dollar 122 per client served.
Alternative sentencing drug rehabilitation programs provide a venue to efficiently deliver integrated hepatitis and other prevention services. Considering the vast number of high-risk persons in drug rehabilitation, probation, parole, and inmate release programs, an opportunity exists to greatly expand hepatitis services.
鉴于为短期监禁设施中的囚犯提供筛查和疫苗接种服务存在困难，对加利福尼亚州圣地亚哥的一个替代性量刑戒毒康复项目（替代监禁）中的预防服务整合情况进行了评估。
在1999年4月至2002年12月期间，要求服务对象填写一份简短的风险评估问卷，并为他们提供乙肝病毒（HBV）疫苗接种、HBV和丙型肝炎病毒（HCV）血清学检测、性传播疾病筛查以及HIV咨询和检测。
在估计的1125名康复项目参与者中，930人（83%）参与了整合项目服务。大多数服务对象为男性（64%），年龄大于30岁（64%），很少有人（7%）报告曾接种过HBV疫苗。在854名符合乙肝疫苗接种条件的服务对象中，98%接种了第一剂，69%接种了第二剂，42%完成了全程接种。11%的服务对象曾感染过HBV，14.7%曾感染过HCV，在有注射吸毒史的人群中阳性率最高——HBV为19%，HCV为36%。HIV感染很少见（患病率为0.3%），性传播疾病也不常见（衣原体患病率为2%，淋病患病率为0.6%）。整合服务的年度总成本（不包括HIV检测）为31,994美元，相当于每位服务对象122美元。
替代性量刑戒毒康复项目为有效提供综合肝炎及其他预防服务提供了一个场所。鉴于戒毒康复、缓刑、假释和囚犯释放项目中有大量高危人群，存在大幅扩大肝炎服务的机会。
