Caroline M Abe1, Merilyne Aguwa2, Michelle Zhao2, Jacqueline Sullivan3, Esmaeil Porsa3, Ank E Nijhawan4. 1. University of Texas Southwestern Medical Center, Dallas, TX, USA. 2. Parkland Health and Hospital Systems, Dallas, TX, USA. 3. Office of Strategy and Integration, Parkland Health and Hospital System, Dallas, TX, USA. 4. Division of Infectious Diseases, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA.
Abstract
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.
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.
Entities:
Keywords:
health insurance; hepatitis C; incarceration; prevalence; risk factors
Authors: Curt G Beckwith; Ann E Kurth; Lauri Bazerman; Liza Solomon; Emily Patry; Josiah D Rich; Irene Kuo Journal: Am J Public Health Date: 2015-01 Impact factor: 9.308
Authors: Adam L Beckman; Alyssa Bilinski; Ryan Boyko; George M Camp; A T Wall; Joseph K Lim; Emily A Wang; R Douglas Bruce; Gregg S Gonsalves Journal: Health Aff (Millwood) Date: 2016-10-01 Impact factor: 6.301
Authors: Karli R Hochstatter; Lauren J Stockman; Ryan Holzmacher; James Greer; David W Seal; Quinton A Taylor; Emma K Gill; Ryan P Westergaard Journal: Health Justice Date: 2017-10-30
Authors: Alysse G Wurcel; Jessica Reyes; Julia Zubiago; Peter J Koutoujian; Deirdre Burke; Tamsin A Knox; Thomas Concannon; Stephenie C Lemon; John B Wong; Karen M Freund; Curt G Beckwith; Amy M LeClair Journal: PLoS One Date: 2021-05-26 Impact factor: 3.240
Authors: Arpan A Patel; Aileen Bui; Eian Prohl; Debika Bhattacharya; Su Wang; Andrea D Branch; Ponni V Perumalswami Journal: Hepatol Commun Date: 2020-12-07