TY - JOUR
T1 - Hepatitis C Virus Infection in the Dallas County Jail
T2 - Implications for Screening, Prevention, and Linkage to Care
AU - Abe, Caroline M.
AU - Aguwa, Merilyne
AU - Zhao, Michelle
AU - Sullivan, Jacqueline
AU - Porsa, Esmaeil
AU - Nijhawan, Ank E.
N1 - Funding Information:
The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: A.E.N. is supported by funding from the National Institute of Allergy and Infectious Diseases (K23 AI 112477). This study was funded in part through the Gilead FOCUS program, a branch of the Gilead Sciences Government Affairs division, which partners with health care organizations in implementing hepatitis C virus screening and best practice models. FOCUS supports activities up to first medical appointment and, thus, was not involved in FOCUS partners’ decisions for subsequent patient care, the design of this study, or preparation of this article.
Funding Information:
The authors thank the Parkland Health and Hospital System team members Patrick M. Jones, Tina M. Hill, Samsher Rawal, Leah Esseltine, Jeanette Hill, Ulysses Prioleau, Ken Dobbs, and Kyung Tae Kim for their contributions to this project. The authors disclosed receipt of the following financial support for the research, authorship, and/or publication of this article: A.E.N. is supported by funding from the National Institute of Allergy and Infectious Diseases (K23 AI 112477). This study was funded in part through the Gilead FOCUS program, a branch of the Gilead Sciences Government Affairs division, which partners with health care organizations in implementing hepatitis C virus screening and best practice models. FOCUS supports activities up to first medical appointment and, thus, was not involved in FOCUS partners? decisions for subsequent patient care, the design of this study, or preparation of this article.
Publisher Copyright:
© 2019, Association of Schools and Programs of Public Health.
PY - 2019/11/1
Y1 - 2019/11/1
N2 - Objectives: Screening for hepatitis C virus (HCV) infection in jail provides an opportunity to educate and offer care to a high-risk population. We aimed to (1) estimate the prevalence of HCV infection in jail; (2) describe the demographic characteristics, risk factors, and pre-incarceration health insurance status associated with HCV infection; and (3) examine the implementation of HCV screening in jail. Methods: We conducted a retrospective analysis of an opt-out HCV screening program with HCV RNA confirmation and patient education at the Dallas County Jail from April 1 through November 2, 2017. We extracted data on test results, demographic characteristics, and release destination from electronic medical records. A nurse navigator recorded data on patient self-reported risk factors and pre-incarceration health insurance status. Results: Of 4089 incarcerated persons screened, 708 (17.3%) had a positive HCV antibody result. Of these, 641 (90.5%) had an HCV RNA test ordered; 576 (89.9%) had RNA tests completed, of whom 413 (71.7%) had a positive HCV RNA result. Of these 413, 352 (85.2%) received patient education. Half of HCV RNA-positive incarcerated persons (n = 207, 50.1%) were born outside the birth cohort (1945-1965). Among those with HCV infection, commonly reported risk factors were injection drug use (168 of 352; 47.8%) and tattoos (82 of 352; 23.4%). Most incarcerated persons with HCV infection (284 of 350; 81.1%) did not have health insurance. HCV antibody prevalence was higher among incarcerated persons released to prison (232 of 961; 24.1%) than to outside agencies (38 of 403; 9.4%) or the community (178 of 1026; 17.4%). Conclusions: Screening for HCV with RNA confirmation in jail provides an opportunity for disease education, transmission prevention, and navigation to HCV treatment. Future efforts should examine post-incarceration linkage to care.
AB - Objectives: Screening for hepatitis C virus (HCV) infection in jail provides an opportunity to educate and offer care to a high-risk population. We aimed to (1) estimate the prevalence of HCV infection in jail; (2) describe the demographic characteristics, risk factors, and pre-incarceration health insurance status associated with HCV infection; and (3) examine the implementation of HCV screening in jail. Methods: We conducted a retrospective analysis of an opt-out HCV screening program with HCV RNA confirmation and patient education at the Dallas County Jail from April 1 through November 2, 2017. We extracted data on test results, demographic characteristics, and release destination from electronic medical records. A nurse navigator recorded data on patient self-reported risk factors and pre-incarceration health insurance status. Results: Of 4089 incarcerated persons screened, 708 (17.3%) had a positive HCV antibody result. Of these, 641 (90.5%) had an HCV RNA test ordered; 576 (89.9%) had RNA tests completed, of whom 413 (71.7%) had a positive HCV RNA result. Of these 413, 352 (85.2%) received patient education. Half of HCV RNA-positive incarcerated persons (n = 207, 50.1%) were born outside the birth cohort (1945-1965). Among those with HCV infection, commonly reported risk factors were injection drug use (168 of 352; 47.8%) and tattoos (82 of 352; 23.4%). Most incarcerated persons with HCV infection (284 of 350; 81.1%) did not have health insurance. HCV antibody prevalence was higher among incarcerated persons released to prison (232 of 961; 24.1%) than to outside agencies (38 of 403; 9.4%) or the community (178 of 1026; 17.4%). Conclusions: Screening for HCV with RNA confirmation in jail provides an opportunity for disease education, transmission prevention, and navigation to HCV treatment. Future efforts should examine post-incarceration linkage to care.
KW - health insurance
KW - hepatitis C
KW - incarceration
KW - prevalence
KW - risk factors
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U2 - 10.1177/0033354919874081
DO - 10.1177/0033354919874081
M3 - Article
C2 - 31530093
AN - SCOPUS:85073918394
SN - 0033-3549
VL - 134
SP - 626
EP - 633
JO - Public Health Reports
JF - Public Health Reports
IS - 6
ER -