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Integrating hepatitis, STD and HIV services into a drug rehabilitation
program.
American Journal of Preventive Medicine 2005;29(1):27-33.
Gunn RA, Lee MA, Callahan DB, Gonzales P, Murray PJ, Margolis HS.
Abstract
BACKGROUND: Considering the difficulties in providing screening and vaccination
services for inmates in short-stay incarceration facilities, an evaluation
was conducted of the integration of prevention services in an alternative
sentencing drug rehabilitation program (alternative to incarceration) in
San Diego CA. METHODS: During the period April 1999 to December 2002, clients
were asked to complete a brief risk-assessment questionnaire, and were offered
hepatitis B virus (HBV) vaccination, HBV and hepatitis C virus (HCV) serologic
testing, STD screening, and HIV counseling and testing. RESULTS: Of the estimated
1125 rehabilitation program enrollees, 930 (83%) participated in the integration
program services. Most clients were male (64%), were aged >30 years (64%),
and few (7%) reported previous HBV vaccination. Of the 854 clients eligible
for hepatitis B vaccination, 98% received the first dose, 69% the second
dose, and 42% completed the series. Eleven percent of clients had prior HBV
infection, and 14.7% had HCV infection, with positivity rates being highest
among those with a history of injection drug use-HBV, 19%, and HCV, 36%.
HIV infection was rare (prevalence, 0.3%), and STDs were uncommon (chlamydia
prevalence, 2%, and gonorrhea prevalence, 0.6%). Total annual cost of integration
services (excluding HIV testing) was dollar 31,994 equating to dollar 122
per client served. CONCLUSIONS: Alternative sentencing drug rehabilitation
programs provide a venue to efficiently deliver integrated hepatitis and
other prevention services. Considering the vast number of high-risk persons
in drug rehabilitation, probation, parole, and inmate release programs, an
opportunity exists to greatly expand hepatitis services.