de la Flor Carolina, Porsa Esmaeil, Nijhawan Ank E
1 Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
2 Parkland Health and Hospital System, Dallas, TX, USA.
Public Health Rep. 2017 Nov/Dec;132(6):617-621. doi: 10.1177/0033354917732755. Epub 2017 Oct 18.
Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are common in the criminal justice system. We offered opt-out HIV/HCV testing at the Dallas County Jail during intake from June 2015 to November 2016, after which testing was integrated into routine phlebotomy processes. The uptake of testing increased from 12.9% (118/915) in June 2015 to 80.5% (269/334) in January 2016. HIV was confirmed in 1.0% (30/3155) of inmates; 6 were new diagnoses and all were linked to care. HCV antibody positivity was found in 16.4% (500/4042) of inmates. Sixty percent (155/258) of HCV-positive inmates born between 1945 and 1965 (ie, baby boomers) were non-Hispanic black, whereas 56.2% (136/242) born after 1965 were non-Hispanic white. Testing only baby boomers would have missed approximately half of HCV infections, predominantly among young, non-Hispanic white people. Future efforts should expand HIV and HCV testing in jails, as it is feasible, acceptable, and increases prevention and engagement in care for a high-prevalence, hard-to-reach population.
人类免疫缺陷病毒（HIV）和丙型肝炎病毒（HCV）感染在刑事司法系统中很常见。2015年6月至2016年11月期间，我们在达拉斯县监狱收押时提供了主动式HIV/HCV检测，之后检测被纳入常规静脉采血流程。检测的接受率从2015年6月的12.9%（118/915）增至2016年1月的80.5%（269/334）。在1.0%（30/3155）的囚犯中确诊感染HIV；6例为新诊断病例，且均已接受治疗。在16.4%（500/4042）的囚犯中发现HCV抗体呈阳性。1945年至1965年出生的HCV阳性囚犯（即婴儿潮一代）中有60%（155/258）是非西班牙裔黑人，而1965年以后出生的有56.2%（136/242）是非西班牙裔白人。仅对婴儿潮一代进行检测会遗漏大约一半的HCV感染病例，主要是年轻的非西班牙裔白人。未来应在监狱中扩大HIV和HCV检测，因为这是可行的、可接受的，并且能增强对这一高流行率、难以接触人群的预防和护理参与度。
