Nijhawan Ank E
Division of Infectious Diseases, University of Texas Southwestern Medical Center, Dallas, Texas; Division of Outcomes and Health Services Research, University of Texas Southwestern Medical Center, Dallas, Texas.
Am J Med Sci. 2016 Oct;352(4):399-407. doi: 10.1016/j.amjms.2016.05.020. Epub 2016 May 27.
The United States leads the world in incarceration, which disproportionately affects disadvantaged individuals, including those who are mentally ill, poor, homeless and racial minorities. Incarceration is disruptive to families and communities and contributes to health disparities in sexually transmitted infections (STIs) and human immunodeficiency virus (HIV). The objective of this grand rounds is to review (1) the epidemiology of incarceration in the United States, (2) the social factors which contribute to high rates of STIs in incarcerated individuals and (3) the HIV care cascade in incarcerated and recently released individuals. Routine screening and treatment for STIs and HIV in the criminal justice system can identify many new infections and has the potential to both improve individual outcomes and reduce transmission to others. Increased collaboration between the department of health and department of corrections, as well as partnerships between academic institutions and the criminal justice system, have the potential to improve outcomes in this vulnerable population.
美国在监禁率方面位居世界首位，这对弱势群体的影响尤为严重，其中包括精神疾病患者、贫困人口、无家可归者和少数族裔。监禁会破坏家庭和社区，并加剧性传播感染（STIs）和人类免疫缺陷病毒（HIV）方面的健康差距。本次大查房的目的是回顾：（1）美国监禁的流行病学情况；（2）导致被监禁者性传播感染率高的社会因素；（3）被监禁者和近期获释者的HIV治疗流程。刑事司法系统中对性传播感染和HIV进行常规筛查和治疗可以发现许多新感染病例，并且有可能改善个体预后并减少向他人传播。卫生部门与惩教部门之间加强合作，以及学术机构与刑事司法系统之间建立伙伴关系，有可能改善这一弱势群体的预后。
