U.S. Immigration and Customs Enforcement (ICE) Health Service Corps (IHSC), 500 12th Street, SW, Washington, DC 20536, USA.
San Diego State University School of Public Health, 5500 Campanile Dr, San Diego, CA 92182, USA.
J Public Health (Oxf). 2021 Sep 22;43(3):611-617. doi: 10.1093/pubmed/fdaa003.
Persons in ICE detention represent a population about whom limited health-related data is available in the literature. Since ICE detention is generally brief, facilitating linkage to care (FLC) for detainees with chronic diseases, including HIV-positive detainees, is challenging, yet critical to encourage continued treatment beyond custody. Between 2015 and 2017, IHSC-staffed facilities implemented intensive training related to HIV care and FLC and increased clinical oversight and consultations. This study examined the impact of these changes in relation to FLC.
Demographic and clinical data for detainees with known HIV-positive diagnoses at IHSC-staffed facilities entering custody in 2015 and 2017 were obtained via electronic health record. Univariate analysis and multiple logistic regressions were performed to identify factors that may increase FLC.
After adjusting for year of entry into custody, detainees who received an infectious disease (ID) consultation had significantly higher odds (2.4, P < 0.001) of receiving FLC resources compared to those who did not receive an ID consultation. Between 2015 and 2017, the proportion of HIV-positive detainees receiving FLC resources increased from 29 to 62%.
ID consultations significantly improved FLC for HIV-positive detainees. Continued provider training and education is essential to continue improving the rate of FLC for HIV-positive ICE detainees.
被 ICE 拘留的人是一个相关健康数据有限的群体。由于 ICE 拘留通常时间很短，因此为患有慢性病（包括 HIV 阳性的被拘留者）的被拘留者提供便利的医疗服务（FLC）具有挑战性，但对于鼓励在拘留期间继续治疗至关重要。在 2015 年至 2017 年间，IHSC 工作人员实施了与 HIV 护理和 FLC 相关的强化培训，并增加了临床监督和咨询。本研究调查了这些变化对 FLC 的影响。
通过电子健康记录获取 2015 年和 2017 年在 IHSC 工作人员配备的设施中进入拘留的已知 HIV 阳性诊断的被拘留者的人口统计学和临床数据。进行单变量分析和多因素逻辑回归，以确定可能增加 FLC 的因素。
在调整了进入拘留的年份后，与未接受 ID 咨询的被拘留者相比，接受传染病（ID）咨询的被拘留者获得 FLC 资源的可能性显著增加（2.4，P<0.001）。在 2015 年至 2017 年间，接受 FLC 资源的 HIV 阳性被拘留者的比例从 29%增加到 62%。
ID 咨询显著改善了 HIV 阳性被拘留者的 FLC。继续为提供者提供培训和教育对于继续提高 HIV 阳性 ICE 被拘留者的 FLC 率至关重要。
