Grussing Emily D, Sato Taisuke, Cabrera Alyssa, Wurcel Alysse G
Department of Medicine, Division of Geographic Medicine and Infectious Disease, Tufts Medical Center, 800 Washington St, Boston, MA, 02111, USA.
Tufts University School of Medicine, 145 Harrison Ave, Boston, MA, 02111, USA.
Health Justice. 2025 Mar 15;13(1):15. doi: 10.1186/s40352-024-00299-0.
Eliminating infectious diseases epidemics requires resources for testing, prevention, and treatment in jails. The 2022 Centers for Diseases Control and Prevention guidelines recommend offering hepatitis C virus (HCV), HIV, and STI testing at jail intake. Currently, the impact of offering testing at intake in jails has only been analyzed in the context of multi-modal strategies to increase testing. There is a lack of real-world data about the impact of offering testing at jail intake as a strategy to increase testing. In May 2022, Plymouth County Correctional Facility in Massachusetts added questions to their intake form offering HIV, HCV, syphilis, gonorrhea, and chlamydia testing. The goal of this project was to assess frequency of testing before and after the addition of infectious diseases testing questions to the intake form.
Data about infectious diseases testing completion per month were compared between February-April 2022 and May 2022-June 2023. The transition from rapid to venipuncture HIV testing was also compared between September 2021-June 2023. Data was assessed in monthly intervals. The median number of urine tests decreased from 39 to 28, and the median number of blood tests decreased from 21 to 15 after testing was offered during intake.
There were no significant trends in the run chart after the intervention. Although offering testing at intake is one important part of healthcare in jails, intake testing should be supported with other systems including access to phlebotomy, facilitated movement from the housing areas to the medical unit, and stigma reduction tools.
消除传染病流行需要在监狱中投入用于检测、预防和治疗的资源。美国疾病控制与预防中心2022年的指南建议在监狱收押时提供丙型肝炎病毒（HCV）、HIV和性传播感染检测。目前，仅在增加检测的多模式策略背景下分析了在监狱收押时提供检测的影响。缺乏关于在监狱收押时提供检测作为增加检测策略的实际数据。2022年5月，马萨诸塞州普利茅斯县惩教所对其收押表格增加了关于HIV、HCV、梅毒、淋病和衣原体检测的问题。本项目的目标是评估在收押表格中增加传染病检测问题前后的检测频率。
比较了2022年2月至4月和2022年5月至2023年6月每月传染病检测完成情况的数据。还比较了2021年9月至2023年6月从快速HIV检测向静脉穿刺HIV检测的转变。数据按月进行评估。收押时提供检测后，尿液检测中位数从39降至28，血液检测中位数从21降至15。
干预后运行图中无显著趋势。虽然在收押时提供检测是监狱医疗保健的一个重要部分，但收押检测应得到其他系统的支持，包括静脉穿刺服务、从住宿区到医疗单元的便利通行以及减少污名化的工具。
