Evaluating peer-supported screening as a hepatitis C case-finding model in prisoners
| Autor: | Tina McHugh, Ciara Tobin, Marie Claire Van Hout, Walter Cullen, Graham Betts-Symonds, Susan McKiernan, Mary Keevans, D. Crowley, Sarah Jayne Miggin, John S. Lambert, Deirdre O’Reilly, Ross Murtagh, Eamon Laird, Eileen O'Connor |
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| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty media_common.quotation_subject Hepatitis C virus Peer-support Medicine (miscellaneous) Prison Peer support medicine.disease_cause Risk Assessment Peer Group RA0421 Surveys and Questionnaires Internal medicine Prevalence medicine Humans Mass Screening PWID media_common Needle sharing business.industry Prisoners Research lcsh:Public aspects of medicine Medical record Public health Public Health Environmental and Occupational Health Social Support virus diseases lcsh:RA1-1270 Hepatitis C medicine.disease digestive system diseases Patient Care Management Psychiatry and Mental health Prisons HCV Cohort Screening business Ireland |
| Zdroj: | Harm Reduction Journal, Vol 16, Iss 1, Pp 1-10 (2019) Harm Reduction Journal |
| ISSN: | 1477-7517 |
| Popis: | Background Hepatitis C Virus (HCV) infection is endemic in prison populations, and HCV management in prisons is suboptimal. Incarceration is a public health opportunity to target this cohort. Community peer support increases HCV screening and treatment uptake. Prison peer workers have the potential to support the engagement of prisoners with health services and reduce stigma. This study’s primary aim is to evaluate peer-supported screening as a model of active HCV case finding with a secondary aim to describe the HCV cascade among those infected including linkage to care and treatment outcomes. Methods An observational study was conducted in a medium-security Irish male prison housing 538 inmates, using a risk-based questionnaire, medical records, peer-supported screening, laboratory-based HCV serology tests and mobile elastography. Results A prison peer-supported screening initiative engaged large numbers of prisoners in HCV screening (n = 419). The mean age of participants was 32.8 years, 92% were Irish and 33% had a history of injecting drug use. Multiple risk factors for HCV acquisition were identified including needle sharing (16%). On serological testing, 87 (21%) were HCV Ab +ve and 50 (12%) were HCV RNA +ve of whom 80% were fibroscaned (25% showing evidence of liver disease). Eighty-six percent of those with active infection were linked with HCV care, with 33% undergoing or completing treatment. There was a high concordance with HCV disclosure at committal and serological testing (96% for HCV Ab +ve and 89% for HCV Ab −ve). Conclusion Peer-supported screening is an effective active HCV case-finding model to find and link prisoners with untreated active HCV infection to HCV care. |
| Databáze: | OpenAIRE |
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