Providence VA Medical Center, Division of Infectious Diseases, Providence, Rhode Island.
Department of Veterans Affairs, Population Health Services, Palo Alto Health Care System, California.
Clin Infect Dis. 2017 Jul 15;65(2):252-258. doi: 10.1093/cid/cix295.
Veterans are disproportionately affected by human immunodeficiency virus (HIV), hepatitis C virus (HCV), and hepatitis B virus (HBV). Homeless veterans are at particularly high risk for HIV, HCV, and HBV due to a variety of overlapping risk factors, including high rates of mental health disorders and substance use disorders. The prevalence of HIV, HCV, and HBV among homeless veterans nationally is currently unknown. This study describes national testing rates and prevalence of HIV, HCV, and HBV among homeless veterans.
Using data from the Department of Veterans Affairs (VA) Corporate Warehouse Data from 2015, we evaluated HIV, HCV, and HBV laboratory testing and infection confirmation rates and diagnoses on the Problem List for nonhomeless veterans and for veterans utilizing homeless services in 2015.
Among 242740 homeless veterans in VA care in 2015, HIV, HCV, and HBV testing occurred in 63.8% (n = 154812), 78.1% (n = 189508), and 52.8% (n = 128262), respectively. The HIV population prevalence was 1.52% (3684/242740) among homeless veterans, compared with 0.44% (23797/5424685) among nonhomeless veterans. The HCV population prevalence among homeless veterans was 12.1% (29311/242740), compared with 2.7% (148079/5424685) among nonhomeless veterans, while the HBV population prevalence was 0.99% (2395/242740) for homeless veterans and 0.40% (21611/5424685) among nonhomeless veterans.
To our knowledge this work represents the most comprehensive tested prevalence and population prevalence estimates of HIV, HCV, and HBV among homeless veterans nationally. The data demonstrate high prevalence of HIV, HCV, and HBV among homeless veterans, and reinforce the need for integrated healthcare services along with homeless programming.
退伍军人受到人类免疫缺陷病毒（HIV）、丙型肝炎病毒（HCV）和乙型肝炎病毒（HBV）的影响不成比例。由于多种重叠的风险因素，包括心理健康障碍和物质使用障碍的高发病率，无家可归的退伍军人特别容易感染 HIV、HCV 和 HBV。目前，全国无家可归退伍军人中 HIV、HCV 和 HBV 的流行率尚不清楚。本研究描述了全国无家可归退伍军人中 HIV、HCV 和 HBV 的检测率和流行率。
利用 2015 年退伍军人事务部（VA）企业仓库数据，我们评估了 2015 年非无家可归退伍军人和使用无家可归服务的退伍军人的 HIV、HCV 和 HBV 实验室检测和感染确认率以及问题清单上的诊断。
2015 年，在 VA 护理的 242740 名无家可归退伍军人中，HIV、HCV 和 HBV 检测分别发生在 63.8%（n=154812）、78.1%（n=189508）和 52.8%（n=128262）。无家可归退伍军人中的 HIV 人群患病率为 1.52%（3684/242740），而非无家可归退伍军人中的患病率为 0.44%（23797/5424685）。无家可归退伍军人中的 HCV 人群患病率为 12.1%（29311/242740），而非无家可归退伍军人中的患病率为 2.7%（148079/5424685），而 HBV 人群患病率为 0.99%（2395/242740），而非无家可归退伍军人中的患病率为 0.40%（21611/5424685）。
据我们所知，这是目前全国范围内对无家可归退伍军人中 HIV、HCV 和 HBV 进行的最全面的检测流行率和人群流行率估计。这些数据表明，无家可归退伍军人中 HIV、HCV 和 HBV 的流行率很高，这加强了对综合医疗保健服务以及无家可归者计划的需求。
