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Saber LB, Kennedy SS, Yang Y, Moore KN, Wang Y, Hilton SP, Chang TY, Liu P, Phillips VL, Akiyama MJ, Moe CL, Spaulding AC. Correlation of SARS-CoV-2 in Wastewater and Individual Testing Results in a Jail, Atlanta, Georgia, USA. Emerg Infect Dis 2024; 30:S21-S27. [PMID: 38561638 PMCID: PMC10986836 DOI: 10.3201/eid3013.230775] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/04/2024] Open
Abstract
Institution-level wastewater-based surveillance was implemented during the COVID-19 pandemic, including in carceral facilities. We examined the relationship between COVID-19 diagnostic test results of residents in a jail in Atlanta, Georgia, USA (average population ≈2,700), and quantitative reverse transcription PCR signal for SARS-CoV-2 in weekly wastewater samples collected during October 2021‒May 2022. The jail offered residents rapid antigen testing at entry and periodic mass screenings by reverse transcription PCR of self-collected nasal swab specimens. We aggregated individual test data, calculated the Spearman correlation coefficient, and performed logistic regression to examine the relationship between strength of SARS-CoV-2 PCR signal (cycle threshold value) in wastewater and percentage of jail population that tested positive for COVID-19. Of 13,745 nasal specimens collected, 3.9% were COVID-positive (range 0%-29.5% per week). We observed a strong inverse correlation between diagnostic test positivity and cycle threshold value (r = -0.67; p<0.01). Wastewater-based surveillance represents an effective strategy for jailwide surveillance of COVID-19.
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Ogwara CA, Ronberg JW, Cox SM, Wagner BM, Stotts JW, Chowell G, Spaulding AC, Fung ICH. Impact of public health policy and mobility change on transmission potential of severe acute respiratory syndrome coronavirus 2 in Rhode Island, March 2020 - November 2021. Pathog Glob Health 2024; 118:65-79. [PMID: 37075167 PMCID: PMC10769146 DOI: 10.1080/20477724.2023.2201984] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/21/2023] Open
Abstract
To study the SARS-CoV-2 transmission potential in Rhode Island (RI) and its association with policy changes and mobility changes, the time-varying reproduction number, Rt, was estimated. The daily incident case counts (16 March 2020, through 30 November 2021) were bootstrapped within a 15-day sliding window and multiplied by Poisson-distributed multipliers (λ = 4, sensitivity analysis: 11) to generate 1000 estimated infection counts, to which EpiEstim was applied to generate Rt time series. The median Rt percentage change when policies changed was estimated. The time lag correlations were assessed between the 7-day moving average of the relative changes in Google mobility data in the first 90 days, and Rt and estimated infection count, respectively. There were three major pandemic waves in RI in 2020-2021: spring 2020, winter 2020-2021 and fall-winter 2021. The median Rt fluctuated within the range of 0.5-2 from April 2020 to November 2021. Mask mandate (18 April 2020) was associated with a decrease in Rt (-25.99%, 95% CrI: -37.42%, -14.30%). Termination of mask mandates on 6 July 2021 was associated with an increase in Rt (36.74%, 95% CrI: 27.20%, 49.13%). Positive correlations were found between changes in grocery and pharmacy, Rt retail and recreation, transit, and workplace visits, for both Rt and estimated infection count, respectively. Negative correlations were found between changes in residential area visits for both Rt and estimated infection count, respectively. Public health policies enacted in RI were associated with changes in the pandemic trajectory. This ecological study provides further evidence of how non-pharmaceutical interventions and vaccination slowed COVID-19 transmission in RI.
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Affiliation(s)
- Chigozie A. Ogwara
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jennifer W. Ronberg
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Sierra M. Cox
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Briana M. Wagner
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Jacqueline W. Stotts
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
| | - Gerardo Chowell
- Department of Population Health Sciences, School of Public Health, Georgia State University, Atlanta, GA, USA
| | - Anne C. Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Isaac Chun-Hai Fung
- Department of Biostatistics, Epidemiology and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, GA, USA
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Spaulding AC. The power of peers at prison exit. Lancet HIV 2024; 11:e2-e3. [PMID: 38071993 DOI: 10.1016/s2352-3018(23)00330-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2023] [Accepted: 12/05/2023] [Indexed: 12/25/2023]
Affiliation(s)
- Anne C Spaulding
- Departments of Epidemiology and Global Health, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Dirks LK, Bircher PM, González-Montalvo MDM, Kauffman AE, Prophete EJ, Bury MR, Spaulding AC. Video Directly Observed Therapy for Tuberculosis Treatment in Haitian Prisons: A Pattern of Group Adherence. medRxiv 2023:2023.12.29.23299977. [PMID: 38234774 PMCID: PMC10793512 DOI: 10.1101/2023.12.29.23299977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/19/2024]
Abstract
Classification Research paper. Purpose Haitian provincial prisons historically were strapped to provide directly observed therapy (DOT) for persons with TB (PwTB) due to healthcare understaffing. A non-governmental organization addressed this gap via correctional officer-administered video DOT (VDOT). Approach A 16-month, quasi-experimental trial of officer-facilitated VDOT started in March 2019 at four prisons. Officers delivered doses directly without video when VDOT was inaccessible. Healthcare staff remotely tracked VDOT adherence asynchronously. Three fully-staffed prisons were controls. Our primary objective was to measure VDOT effectiveness for PwTB who began VDOT within 2 weeks of starting treatment. Our secondary objective was to measure program reach, implementation and maintenance through July 2023. Findings Reach-55 PwTB on VDOT met study criteria. Effectiveness: median/mean VDOT adherence for 55 individuals enrolled in the pilot were 70.8% and 60.2% respectively. Median/mean total adherence, including doses delivered by officers, were 100% and 93.5%. Implementation: VDOT adherence varied by site but not demographic characteristics; similarity of adherence patterns between subjects within a facility was high. Nursing staff reported that adherence in controls was 100%. Correctional officers reported high comfort with the program technology. Maintenance: Since the pilot, 387 PwTB have received TB medications via VDOT in the Haitian prison system. Originality VDOT for PwTB in low-resource Haitian prisons enabled close monitoring and follow-up; it could expand treatment options elsewhere. Total adherence neared that in control prisons. VDOT adherence varied by treatment day predominately in a group pattern, reflecting facility-level, rather than individual-level, factors.
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Jenness SM, Wallrafen-Sam K, Schneider I, Kennedy S, Akiyama MJ, Spaulding AC. Dynamic Contact Networks of Residents of an Urban Jail in the Era of SARS-CoV-2. medRxiv 2023:2023.09.29.23296359. [PMID: 37873313 PMCID: PMC10593002 DOI: 10.1101/2023.09.29.23296359] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/25/2023]
Abstract
Background In custodial settings such as jails and prisons, infectious disease transmission is heightened by factors such as overcrowding and limited healthcare access. Specific features of social contact networks within these settings have not been sufficiently characterized, especially in the context of a large-scale respiratory infectious disease outbreak. The study aims to quantify contact network dynamics within the Fulton County Jail in Atlanta, Georgia, to improve our understanding respiratory disease spread to informs public health interventions. Methods As part of the Surveillance by Wastewater and Nasal Self-collection of Specimens (SWANSS) study, jail roster data were utilized to construct social contact networks. Rosters included resident details, cell locations, and demographic information. This analysis involved 6,702 residents over 140,901 person days. Network statistics, including degree, mixing, and turnover rates, were assessed across age groups, race/ethnicities, and jail floors. We compared outcomes for two distinct periods (January 2022 and April 2022) to understand potential responses in network structures during and after the SARS-CoV-2 Omicron variant peak. Results We found high cross-sectional network degree at both cell and block levels, indicative of substantial daily contacts. While mean degree increased with age, older residents exhibited lower degree during the Omicron peak, suggesting potential quarantine measures. Block-level networks demonstrated higher mean degrees than cell-level networks. Cumulative degree distributions for both levels increased from January to April, indicating heightened contacts after the outbreak. Assortative age mixing was strong, especially for residents aged 20-29. Dynamic network statistics illustrated increased degrees over time, emphasizing the potential for disease spread, albeit with a lower growth rate during the Omicron peak. Conclusions The contact networks within the Fulton County Jail presented ideal conditions for infectious disease transmission. Despite some reduction in network characteristics during the Omicron peak, the potential for disease spread remained high. Age-specific mixing patterns suggested unintentional age segregation, potentially limiting disease spread to older residents. The study underscores the need for ongoing monitoring of contact networks in carceral settings and provides valuable insights for epidemic modeling and intervention strategies, including quarantine, depopulation, and vaccination. This network analysis offers a foundation for understanding disease dynamics in carceral environments.
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Affiliation(s)
- Samuel M. Jenness
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Karina Wallrafen-Sam
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Isaac Schneider
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Shanika Kennedy
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Matthew J. Akiyama
- Divisions of General Internal Medicine & Infectious Diseases, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Anne C. Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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Spaulding AC, Kennedy SS, Osei J, Sidibeh E, Batina IV, Chhatwal J, Akiyama MJ, Strick LB. Estimates of Hepatitis C Seroprevalence and Viremia in State Prison Populations in the United States. J Infect Dis 2023; 228:S160-S167. [PMID: 37703336 DOI: 10.1093/infdis/jiad227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/15/2023] Open
Abstract
BACKGROUND Prior studies demonstrate that eliminating hepatitis C virus (HCV) in the United States (US) heavily depends on treating incarcerated persons. Knowing the scope of the carceral HCV epidemic by state will help guide national elimination efforts. METHODS Between 2019 and 2023, all state prison systems received surveys requesting data on hepatitis C antibody and viremic prevalence. We supplemented survey information with publicly available HCV data to corroborate responses and fill in data gaps. RESULTS Weighting HCV prevalence by state prison population size, we estimate that 15.2% of the US prison population is HCV seropositive and 8.7% is viremic; 54.9% of seropositive persons have detectable RNA. Applying prevalence estimates to the total prison population at year-end 2021, 91 090 persons with HCV infection resided in a state prison. CONCLUSIONS With updated and more complete HCV data from all 50 states, HCV prevalence in state prisons is nearly 9-fold higher than the US general population. The heterogeneity in HCV prevalence by state prison system may reflect variable exposure before arrest and/or differences in treatment availability during incarceration. Elimination of HCV in the country depends on addressing the carceral epidemic, and one of the first steps is understanding the size of the problem.
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Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Shanika S Kennedy
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jeffery Osei
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ebrima Sidibeh
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Isabella V Batina
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jagpreet Chhatwal
- Massachusetts General Hospital Institute for Technology Assessment, Harvard Medical School, Boston
| | - Matthew J Akiyama
- Department of Medicine, Albert Einstein College of Medicine
- Department of Medicine, Montefiore Medical Center, New York, New York
| | - Lara B Strick
- Department of Medicine, University of Washington, Seattle
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Kennedy S, Spaulding AC. Four Models of Wastewater-Based Surveillance for SARS-CoV-2 in Jail Settings: How Monitoring Wastewater Complements Individual Screening. medRxiv 2023:2023.08.04.23293152. [PMID: 37609187 PMCID: PMC10441506 DOI: 10.1101/2023.08.04.23293152] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/24/2023]
Abstract
Objective To describe four unique models of implementing Wastewater Based Surveillance (WBS) for SARS-CoV-2 in jails of graduated sizes and differing architectural designs. Methods This study summarizes how jails of Cook County (Illinois, average daily population [ADP] 6000), Fulton County (Georgia, ADP 3000, Washington DC (ADP 1600) and Middlesex County (Massachusetts, ADP 875) initiated WBS between 2020 and 2023. Results Positive signal for SARS-CoV-2 via WBS can herald new onset of infection in a previously uninfected housing unit of a jail. Challenges in implementing WBS included political will and realized value, funding, understanding of the building architecture, and the need for granularity in the findings. Conclusions WBS has been effective for detecting outbreaks of SARS-CoV-2 in differing sized jails, both those with dorm-based and cell-based architectural design. Policy implications Given its effectiveness in monitoring SARS-CoV-2, WBS provides a model for population-based surveillance in carceral facilities for future infectious disease outbreaks.
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Levano SR, Epting ME, Pluznik JA, Philips V, Riback LR, Zhang C, Aseffa B, Kapadia AR, Bowden CJ, Jordan B, O’Donovan E, Spaulding AC, Akiyama MJ. HIV testing in jails: Comparing strategies to maximize engagement in HIV treatment and prevention. PLoS One 2023; 18:e0286805. [PMID: 37352306 PMCID: PMC10289455 DOI: 10.1371/journal.pone.0286805] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Accepted: 05/23/2023] [Indexed: 06/25/2023] Open
Abstract
Despite 15,000 people enter US jails yearly with undiagnosed HIV infection, routine HIV testing is not standard. Maximizing the yield and speed of HIV testing in short-term detention facilities could promote rapid entry or re-entry of people living with HIV (PLWH) into care. The goal of this study was to evaluate the impact of third generation, rapid point-of-care (rPOC) vs. fourth generation, laboratory-based antigen/antibody (LBAg/Ab) testing on the HIV care cascade in a large urban jail during a planned transition. We used aggregate historical data to compare rPOC testing and LBAg/Ab testing in the D.C. Department of Corrections. We examined two time periods, January to August 2019 when rPOC testing was performed, and October 2019 to January 2020 after LBAg/Ab testing began. We calculated monthly rates of HIV tests performed, HIV test results received, HIV test results received among those tested, antiretroviral therapy (ART) initiation, and proportion of PLWH receiving discharge planning prior to release. We then conducted an interrupted time series analysis to assess the differences between testing periods. There were 14,237 entrants during the first time period and 7,569 entrants during the second. Transitioning from rPOC to LBAg/Ab testing increased the rate of test uptake by 38.5% (95% CI: 14.0, 68.3), decreased the rate of test results received among those tested by 13.1% (95% CI: -14.0, -12.1), and increased the combined rate of HIV tests performed and results received by 20.4% (95% CI: 1.5, 42.8). Although the rate of HIV testing was greater under LBAg/Ab, PLWH received results immediately through rPOC testing, which is critically important in short-stay enviroments. Increasing rPOC uptake would increase its value and combined testing may maximize the detection of HIV and receipt of results among persons passing through jails.
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Affiliation(s)
- Samantha R. Levano
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Mallory E. Epting
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Jacob A. Pluznik
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Victoria Philips
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lindsey R. Riback
- Divisions of General Internal Medicine & Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Chenshu Zhang
- Divisions of General Internal Medicine & Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States of America
| | - Binyam Aseffa
- D.C Department of Corrections, Washington, D.C., United States of America
| | - Aman R. Kapadia
- Unity Health Care, Washington, D.C., United States of America
| | - Chava J. Bowden
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Beth Jordan
- D.C Department of Corrections, Washington, D.C., United States of America
| | - Eleni O’Donovan
- Unity Health Care, Washington, D.C., United States of America
| | - Anne C. Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Matthew J. Akiyama
- Divisions of General Internal Medicine & Infectious Diseases, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, New York, United States of America
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Riback LR, Dickson P, Ralph K, Saber LB, Devine R, Pett LA, Clausen AJ, Pluznik JA, Bowden CJ, Sarrett JC, Wurcel AG, Phillips VL, Spaulding AC, Akiyama MJ. Coping with COVID in corrections: a qualitative study among the recently incarcerated on infection control and the acceptability of wastewater-based surveillance. Health Justice 2023; 11:5. [PMID: 36749465 PMCID: PMC9903258 DOI: 10.1186/s40352-023-00205-0] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/14/2022] [Accepted: 01/13/2023] [Indexed: 06/18/2023]
Abstract
BACKGROUND Correctional settings are hotspots for SARS-CoV-2 transmission. Social and biological risk factors contribute to higher rates of COVID-19 morbidity and mortality among justice-involved individuals. Rapidly identifying new cases in congregate settings is essential to promote proper isolation and quarantine. We sought perspectives of individuals incarcerated during COVID-19 on how to improve carceral infection control and their perspectives on acceptability of wastewater-based surveillance (WBS) accompanying individual testing. METHODS We conducted semi-structured interviews with 20 adults who self-reported being incarcerated throughout the United States between March 2020 and May 2021. We asked participants about facility enforcement of the Centers for Disease Control and Prevention (CDC) COVID-19 guidelines, and acceptability of integrating WBS into SARS-CoV-2 monitoring strategies at their most recent facility. We used descriptive statistics to characterize the study sample and report on acceptability of WBS. We analyzed qualitative data thematically using an iterative process. RESULTS Participants were predominantly Black or multiple races (50%) and men (75%); 46 years old on average. Most received a mask during their most recent incarceration (90%), although only 40% received counseling on proper mask wearing. A quarter of participants were tested for SARS-CoV-2 at intake. Most (70%) believed they were exposed to the virus while incarcerated. Reoccurring themes included (1) Correctional facility environment leading to a sense of insecurity, (2) Perceptions that punitive conditions in correctional settings were exacerbated by the pandemic; (3) Importance of peers as a source of information about mitigation measures; (4) Perceptions that the safety of correctional environments differed from that of the community during the pandemic; and (5) WBS as a logical strategy, with most (68%) believing WBS would work in the last correctional facility they were in, and 79% preferred monitoring SARS-CoV-2 levels through WBS rather than relying on just individual testing. CONCLUSION Participants supported routine WBS to monitor for SARS-CoV-2. Integrating WBS into existing surveillance strategies at correctional facilities may minimize the impact of future COVID-19 outbreaks while conserving already constrained resources. To enhance the perception and reality that correctional systems are maximizing mitigation, future measures might include focusing on closer adherence to CDC recommendations and clarity about disease pathogenesis with residents.
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Affiliation(s)
- Lindsey R Riback
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA.
| | - Peter Dickson
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Keyanna Ralph
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lindsay B Saber
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Rachel Devine
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lindsay A Pett
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Alyssa J Clausen
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jacob A Pluznik
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Chava J Bowden
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Jennifer C Sarrett
- Center for the Study of Human Health, Emory University, Atlanta, GA, USA
| | | | | | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Matthew J Akiyama
- Albert Einstein College of Medicine, Montefiore Medical Center, Bronx, NY, USA
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González-Montalvo MDM, Dickson PF, Saber LB, Boehm RA, Phillips VL, Akiyama MJ, Spaulding AC. Opinions of former jail residents about self-collection of SARS-CoV-2 specimens, paired with wastewater surveillance: A qualitative study rapidly examining acceptability of COVID-19 mitigation measures. PLoS One 2023; 18:e0285364. [PMID: 37155633 PMCID: PMC10166543 DOI: 10.1371/journal.pone.0285364] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/29/2022] [Accepted: 04/21/2023] [Indexed: 05/10/2023] Open
Abstract
In year one of the COVID-19 epidemic, the incidence of infection for US carceral populations was 5.5-fold higher than that in the community. Prior to the rapid roll out of a comprehensive jail surveillance program of Wastewater-Based Surveillance (WBS) and individual testing for SARS-CoV-2, we sought the perspectives of formerly incarcerated individuals regarding mitigation strategies against COVID-19 to inform acceptability of the new program. In focus groups, participants discussed barriers to their receiving COVID-19 testing and vaccination. We introduced WBS and individual nasal self-testing, then queried if wastewater testing to improve surveillance of emerging outbreaks before case numbers surged, and specimen self-collection, would be valued. The participants' input gives insight into ways to improve the delivery of COVID-19 interventions. Hearing the voices of those with lived experiences of incarceration is critical to understanding their views on infection control strategies and supports including justice-involved individuals in decision-making processes regarding jail-based interventions.
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Affiliation(s)
| | - Peter F Dickson
- Department of Behavioral Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Lindsay B Saber
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Rachel A Boehm
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Victoria L Phillips
- Department of Health Policy and Management, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Matthew J Akiyama
- Department of Medicine, Montefiore Hospital, New York City, New York, United States of America
| | - Anne C Spaulding
- Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Department of Medicine, Emory School of Medicine, Atlanta, Georgia, United States of America
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Frew PM, Schamel JT, Randall LA, King AR, Spaulding AC, Wu E, Holloway IW. Vaccine confidence among people who use drugs: A cross-sectional survey. Hum Vaccin Immunother 2022; 18:2123201. [PMID: 36170655 DOI: 10.1080/21645515.2022.2123201] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/15/2022] Open
Abstract
Adult immunization coverage remains low in the US, particularly for people who use drugs (PWUD), a population that experiences a disproportionate burden of vaccine-preventable diseases. The extent of and characteristics associated with vaccine confidence (VC) held by PWUD is poorly understood. As VC strongly correlates with vaccine uptake, this cross-sectional study identifies mutable factors associated with VC and quantifies its relationship to immunization status within a highly vulnerable, underimmunized population of PWUD. Using a community-engaged research strategy with select partner organizations hosting syringe exchange programs in Atlanta, Los Angeles, and Las Vegas, USA, we surveyed participants ages 18-69 years served by these organizations from 2019 to 2020. Survey measures included sociodemographics, health behavior including immunization receipt, and vaccine confidence in adult vaccinations using a modified Emory Vaccine Confidence Index (EVCI). The findings reflect relatively low VC among the 1,127 recruited participants, with 56% expressing low VC (EVCI 0-12), 35% medium (EVCI 13-20) and 10% high (EVCI 21-24). EVCI varied by city, with lowest confidence in Atlanta and highest in Las Vegas. VC was associated with past receipt of specific vaccines, including hepatitis A, MMR, Tdap, and influenza. VC varied by specific sociodemographic correlates such as housing insecurity (reduced confidence) and receipt of public benefits or disability (increased confidence). This study identified correlates associated with VC based on site and sociodemographic characteristics for this priority population, highlighting the need for specific interventions to raise VC among PWUD, especially among those experiencing housing insecurity and without public benefits.
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Affiliation(s)
- Paula M Frew
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Jay T Schamel
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Laura A Randall
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Adrian R King
- Schools of Public Health, Medicine, and Integrated Health Sciences, University of Nevada, Las Vegas, NV, USA.,Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, GA, USA
| | - Elizabeth Wu
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,Southern California HIV/AIDS Policy Research Center, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,UCLA Hub for Health Intervention, Policy, and Practice, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
| | - Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,Southern California HIV/AIDS Policy Research Center, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA.,UCLA Hub for Health Intervention, Policy, and Practice, UCLA Luskin School of Public Affairs, Los Angeles, CA, USA
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12
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Wurcel AG, Kraus C, Johnson O, Zaller ND, Ray B, Spaulding AC, Flynn T, Quinn C, Day R, Akiyama MJ, Del Pozo B, Meyer F, Glenn JE. Stakeholder-engaged research is necessary across the criminal-legal spectrum. J Clin Transl Sci 2022; 7:e5. [PMID: 36755540 PMCID: PMC9879908 DOI: 10.1017/cts.2022.501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2022] [Revised: 09/23/2022] [Accepted: 11/03/2022] [Indexed: 11/16/2022] Open
Abstract
People with lived experience of incarceration have higher rates of morbidity and mortality compared to people without history of incarceration. Research conducted unethically in prisons and jails led to increased scrutiny of research to ensure the needs of those studied are protected. One consequence of increased restrictions on research with criminal-legal involved populations is reluctance to engage in research evaluations of healthcare for people who are incarcerated and people who have lived experience of incarceration. Ethical research can be done in partnership with people with lived experience of incarceration and other key stakeholders and should be encouraged. In this article, we describe how stakeholder engagement can be accomplished in this setting, and further, how such engagement leads to impactful research that can be disseminated and implemented across disciplines and communities. The goal is to build trust across the spectrum of people who work, live in, or are impacted by the criminal-legal system, with the purpose of moving toward health equity.
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Affiliation(s)
- Alysse G. Wurcel
- Department of Medicine, Division of Geographic Medicine and Infectious Diseases, Tufts Medical Center, Boston, MA, USA
| | - Christina Kraus
- Tufts University Medical Student, JCOIN LEAP Scholar, Boston, MA, USA
| | - O’Dell Johnson
- University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | - Bradley Ray
- RTI International, Division for Applied Justice Research, 3040 Cornwallis Road, Research Triangle Park, NC27709, USA
| | - Anne C. Spaulding
- Associate Professor of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Tara Flynn
- Assistant Deputy Superintendent Health Services, Norfolk County Sheriff’s Office, Dedham, MA, USA
| | | | - Ronald Day
- The Fortune Society, Vice President of Programs and Research, Long Island City, New York, USA
| | - Matthew J. Akiyama
- Department of Medicine, Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY, USA
| | | | - Fred Meyer
- Deputy Chief (Retired), Las Vegas Metropolitan Police Department, Las Vegas, NV, USA
| | - Jason E. Glenn
- Department of History and Philosophy of Medicine, University of Kansas Medical Center, Kansas, USA
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13
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Affiliation(s)
- Matthew J Akiyama
- From the Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, New York (M.J.A.); the Department of Epidemiology and Global Health, Rollins School of Public Health, and the Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta (A.C.S.); and the Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.E.N.)
| | - Anne C Spaulding
- From the Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, New York (M.J.A.); the Department of Epidemiology and Global Health, Rollins School of Public Health, and the Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta (A.C.S.); and the Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.E.N.)
| | - Ank E Nijhawan
- From the Divisions of General Internal Medicine and Infectious Diseases, Department of Medicine, Montefiore Medical Center and Albert Einstein College of Medicine, New York (M.J.A.); the Department of Epidemiology and Global Health, Rollins School of Public Health, and the Division of Infectious Diseases, Department of Medicine, School of Medicine, Emory University, Atlanta (A.C.S.); and the Division of Infectious Diseases and Geographic Medicine, Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas (A.E.N.)
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14
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Spaulding AC, Zawitz C. Vaccination in Prisons and Jails: Corrections Needed in Future Plans. Clin Infect Dis 2022; 75:e846-e848. [PMID: 35083486 DOI: 10.1093/cid/ciab1031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/10/2021] [Indexed: 01/19/2023] Open
Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Chad Zawitz
- Department of Internal Medicine, Division of Infectious Diseases, Rush Medical College, Chicago, Illinois, USA.,Cermak Health Services, Cook County Jail, Chicago, Illinois, USA
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15
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DeStephano CC, Allyse MA, Abu Dabrh AMM, Ridgeway JL, Salinas M, Sherman ME, Spaulding AC. Pilot study of women's perspectives when abnormal uterine bleeding occurs during perimenopause. Climacteric 2022; 25:510-515. [PMID: 35652469 DOI: 10.1080/13697137.2022.2073810] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
OBJECTIVE We gained insights into women's experiences and knowledge about the occurrence of vaginal bleeding during perimenopause requiring evaluation. METHODS Qualitative inquiry was chosen to explore topics in greater depth to understand individuals' experiences. Interviews with individuals were chosen due to the sensitive nature of gynecologic symptoms and management. Interviews were completed following gynecologic care to explore individuals' experiences with the evaluation and management of vaginal bleeding during perimenopause. RESULTS Twelve individuals were interviewed between December 2019 and March 2020. Patient uncertainty about the medical significance of developing vaginal bleeding during perimenopause was associated with self-appraisal and gathering information from multiple sources. This experience of seeking evaluation and treatment resulted in varying degrees of trust concerning information received within or outside the clinic. Regarding new technologies that could replace the current invasive tests performed for diagnosis (i.e. ultrasound, hysteroscopy and biopsy), most women preferred the smartphone app and tampon home collection option. CONCLUSIONS The experience of irregular or heavy vaginal bleeding during perimenopause is fraught with ambiguity, feelings of uncertainty about how to make sense of symptoms and inevitably begins with a period of self-appraisal.
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Affiliation(s)
- C C DeStephano
- Department of Medical and Surgical Gynecology, Mayo Clinic, Jacksonville, FL, USA.,Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA
| | - M A Allyse
- Department of Clinical Genomics, Biomedical Ethics Research Program, Mayo Clinic, Jacksonville, FL, USA
| | - A M M Abu Dabrh
- Department of Integrative Medicine, Mayo Clinic, Jacksonville, FL, USA
| | - J L Ridgeway
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN, USA
| | - M Salinas
- Center for Health Equity and Community Engaged Research, Mayo Clinic, Jacksonville, FL, USA
| | - M E Sherman
- Department of Quantitative Health Sciences, Mayo Clinic, Jacksonville, FL, USA
| | - A C Spaulding
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Jacksonville, FL, USA
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16
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Spaulding AC, Rabeeah Z, Del Mar González-Montalvo M, Akiyama MJ, Baker BJ, Bauer HM, Gibson BR, Nijhawan AE, Parvez F, Wangu Z, Chan PA. Prevalence and Management of Sexually Transmitted Infections in Correctional Settings: A Systematic Review. Clin Infect Dis 2022; 74:S193-S217. [PMID: 35416974 PMCID: PMC9989347 DOI: 10.1093/cid/ciac122] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Admissions to jails and prisons in the United States number 10 million yearly; persons entering locked correctional facilities have high prevalence of sexually transmitted infections (STIs). These individuals come disproportionately from communities of color, with lower access to care and prevention, compared with the United States as a whole. Following PRISMA guidelines, the authors present results of a systematic review of literature published since 2012 on STIs in US jails, prisons, Immigration and Customs Enforcement detention centers, and juvenile facilities. This updates an earlier review of STIs in short-term facilities. This current review contributed to new recommendations in the Centers for Disease Control and Prevention 2021 treatment guidelines for STIs, advising screening for Trichomonas in women entering correctional facilities. The current review also synthesizes recommendations on screening: in particular, opt-out testing is superior to opt-in protocols. Carceral interventions-managing diagnosed cases and preventing new infections from occurring (eg, by initiating human immunodeficiency virus preexposure prophylaxis before release)-can counteract structural racism in healthcare.
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Affiliation(s)
- Anne C Spaulding
- Departments of Epidemiology and Global Health, Rollins School of Public Health; Emory University, Atlanta, Georgia, USA.,Department of Medicine, Division of Infectious Disease, Emory School of Medicine, Emory University, Atlanta, Georgia, USA
| | - Zainab Rabeeah
- Departments of Epidemiology and Global Health, Rollins School of Public Health; Emory University, Atlanta, Georgia, USA
| | | | - Matthew J Akiyama
- Department of Medicine, Divisions of General Internal Medicine and Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, New York, USA
| | - Brenda J Baker
- Nell Hodgson Woodruff School of Nursing, Emory University, Atlanta, Georgia, USA
| | - Heidi M Bauer
- California Correctional Health Care Services, Elk Grove, California, USA.,Department of Epidemiology, School of Public Health, University of California, Berkeley, Berkeley, California, USA
| | - Brent R Gibson
- National Commission on Correctional Healthcare, Chicago, Illinois, USA
| | - Ank E Nijhawan
- Department of Medicine, Division of Infectious Disease and Geographic Medicine, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Farah Parvez
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Field Services Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Bureau of Tuberculosis Control, Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, New York, USA
| | - Zoon Wangu
- National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of Tuberculosis Elimination, Field Services Branch, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.,Bureau of Tuberculosis Control, Division of Disease Control, New York City Department of Health and Mental Hygiene, New York City, New York, USA.,Department of Pediatrics, Division of Pediatric Infectious Diseases & Immunology, UMass Memorial Children's Medical Center & UMass Chan Medical School, Worcester, Massachusetts, USA.,Ratelle STD/HIV Prevention Training Center, Massachusetts Department of Public Health, Jamaica Plain, Massachusetts, USA
| | - Philip A Chan
- Department of Medicine, Division of Infectious Disease, Warren Alpert Medical School of Brown University, Providence, Rhode Island, USA.,Department of Behavioral and Social Sciences at the Brown University School of Public Health, Providence, Rhode Island, USA.,National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Division of STD Elimination, National Centers for Disease Control and Elimination, Atlanta, Georgia, USA
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17
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Politis MD, Hua X, Ogwara CA, Davies MR, Adebile TM, Sherman MP, Zhou X, Chowell G, Spaulding AC, Fung ICH. nSpatially refined time-varying reproduction numbers of SARS-CoV-2 in Arkansas and Kentucky and their relationship to population size and public health policy, March – November, 2020. Ann Epidemiol 2022; 68:37-44. [PMID: 35031444 PMCID: PMC8750695 DOI: 10.1016/j.annepidem.2021.12.012] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 12/17/2021] [Accepted: 12/22/2021] [Indexed: 11/25/2022]
Abstract
Purpose Methods Results Conclusions
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18
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Epting ME, Pluznik JA, Levano SR, Hua X, Fung ICH, Jordan B, O'Donovan E, Robinson KM, Chakraborty R, Yousefi B, Michel CJ, Bowden CJ, Kapadia A, Riback LR, Mangla AT, Akiyama MJ, Spaulding AC. Aiming for Zero: Reducing Transmission of Coronavirus Disease 2019 in the D.C. Department of Corrections. Open Forum Infect Dis 2021; 8:ofab547. [PMID: 34901301 PMCID: PMC8661082 DOI: 10.1093/ofid/ofab547] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Accepted: 11/05/2021] [Indexed: 12/11/2022] Open
Abstract
Background Washington, District of Columbia lowered severe acute respiratory syndrome coronavirus 2 transmission in its large jail while community incidence was still high Methods Coordinated clinical and operational interventions brought new cases to near zero. Results Aggressive infection control and underlying jail architecture can promote correctional coronavirus disease 2019 management. Conclusions More intensive monitoring could help confirm that in-house transmission is truly zero.
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Affiliation(s)
- Mallory E Epting
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Jacob A Pluznik
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Samantha R Levano
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Xinyi Hua
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Isaac C H Fung
- Department of Biostatistics, Epidemiology, and Environmental Health Sciences, Jiann-Ping Hsu College of Public Health, Georgia Southern University, Statesboro, Georgia, USA
| | - Beth Jordan
- Washington DC Department of Corrections, Washington, District of Columbia, USA
| | | | | | - Reena Chakraborty
- Washington DC Department of Corrections, Washington, District of Columbia, USA
| | - Bahram Yousefi
- Washington DC Department of Corrections, Washington, District of Columbia, USA
| | - Ciara J Michel
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Chava J Bowden
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Aman Kapadia
- Unity Healthcare, Washington, District of Columbia, USA
| | - Lindsey R Riback
- Department of Medicine, Montefiore Hospital, New York City, New York, USA
| | - Anil T Mangla
- Washington DC Department of Health, Washington, District of Columbia, USA
| | - Matthew J Akiyama
- Department of Medicine, Montefiore Hospital, New York City, New York, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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19
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Hutchinson AB, MacGowan RJ, Margolis AD, Adee MG, Wen W, Bowden CJ, Spaulding AC. Costs and Consequences of Eliminating a Routine, Point-Of-Care HIV Screening Program in a High-Prevalence Jail. Am J Prev Med 2021; 61:S32-S38. [PMID: 34686288 DOI: 10.1016/j.amepre.2021.06.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2021] [Revised: 06/21/2021] [Accepted: 06/22/2021] [Indexed: 11/25/2022]
Abstract
INTRODUCTION This study aims to assess the public health impact of eliminating a longstanding routine HIV screening program and replacing it with targeted testing. In addition, costs, outcomes, and cost effectiveness of routine screening are compared with those of targeted testing in the Fulton County Jail, Atlanta, Georgia. METHODS A published mathematical model was used to assess the cost effectiveness and public health impact of routine screening (March 2013-February 2014) compared with those of targeted testing (January 2018-December 2018) from a health system perspective. Costs, outcomes, and other model inputs were derived from the testing programs and the published literature, and the cost effectiveness analysis was conducted from 2019 to 2020. RESULTS Routine screening identified 74 more new HIV infections over 1 year than targeted testing, resulting in an estimated 10 HIV transmissions averted and 45 quality-adjusted life-years saved, and was cost saving. The missed opportunity to diagnose infections because routine screening was eliminated resulted in an estimated 8.4 additional HIV transmissions and $3.7 million in additional costs to the healthcare system. CONCLUSIONS Routine HIV screening in high-prevalence jails is cost effective and has a larger impact on public health than targeted testing. Prioritizing sustained funding for routine, jail-based HIV screening programs in high-prevalence areas may be important to realizing the national HIV prevention goals.
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Affiliation(s)
- Angela B Hutchinson
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia.
| | - Robin J MacGowan
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrew D Margolis
- Division of HIV Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention (NCHHSTP), Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Madeline G Adee
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Wendy Wen
- Georgia Department of Public Health, Atlanta, Georgia
| | - Chava J Bowden
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, Georgia
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20
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Frew PM, Randall LA, King AR, Schamel JT, Spaulding AC, Holloway IW. Health Behavior Survey Among People Who Use Opioids: Protocol for Implementing Technology-Based Rapid Response Surveillance in Community Settings. JMIR Res Protoc 2021; 10:e25575. [PMID: 34505834 PMCID: PMC8463945 DOI: 10.2196/25575] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 03/23/2021] [Accepted: 04/21/2021] [Indexed: 01/19/2023] Open
Abstract
Background In 2018, 2 million Americans met the Diagnostic and Statistical Manual of Mental Disorders, 5th Edition diagnostic criteria for an opioid use disorder, and 9.9 million Americans had misused prescription pain relievers the previous year. Despite a rapid increase in opioid misuse, opioid use disorders, and overdoses, data are limited on the behavioral and contextual risks as well as the protective factors fueling the opioid epidemic in some hard hit US cities—Atlanta, Los Angeles, and Las Vegas. Opioid use also contributes to the risk of other health problems such as HIV and hepatitis C virus infections or mental health disorders and is linked to behavioral and environmental risks (eg, homelessness, experiences of violence, involvement in the justice system). Knowledge of the relationships between these linked vulnerabilities and how they influence service utilization is critical to effective policy and interventions. Objective This survey explores the relationships between demographic and economic characteristics, behavioral and environmental risk factors, and service utilization of people who use opioids to inform public health practice, policy, and future efforts to mitigate the risks faced by this population experiencing multiple health, social, and economic vulnerabilities. The results of this survey will be used to identify needs and intervention points for people who use drugs currently served by public health organizations. Methods We implemented a community-engaged strategy that involved development and execution of a two-stage purposive sampling plan involving selection of partner organizations (syringe exchange programs in urban settings) and recruitment and enrollment of participants aged 18-69 years served by these organizations in Atlanta, Los Angeles, and Las Vegas from 2019 to 2020. The recruited participants completed a survey, including a variety of measures to assess health (physical and mental) and health behaviors such as sexual behavior, vaccine receipt, and HIV/ hepatitis C virus infection testing. Additional items assessed drug use and misuse, syringe exchange and health service utilization, sex exchange, histories of interpersonal violence, and vaccine confidence. Results This protocol was successfully implemented despite challenges such as real-time technology issues and rapidly finding and surveying a difficult-to-reach population. We sampled 1127 unique participants (248 in Atlanta, 465 in Los Angeles, and 414 in Las Vegas). Conclusions The establishment and utilization of strong community partnerships enabled the rapid collection of data from a typically difficult-to-reach population. Local efforts such as these are needed to develop policies and practices that promote harm reduction among people who use opioids. International Registered Report Identifier (IRRID) RR1-10.2196/25575
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Affiliation(s)
- Paula M Frew
- University of Nevada Las Vegas School of Public Health, Las Vegas, NV, United States.,UNLV Population Health & Health Equity Initiative, Las Vegas, NV, United States
| | - Laura A Randall
- University of Nevada Las Vegas School of Public Health, Las Vegas, NV, United States.,UNLV Population Health & Health Equity Initiative, Las Vegas, NV, United States
| | - Adrian R King
- University of Nevada Las Vegas School of Public Health, Las Vegas, NV, United States.,UNLV Population Health & Health Equity Initiative, Las Vegas, NV, United States
| | - Jay T Schamel
- University of Nevada Las Vegas School of Public Health, Las Vegas, NV, United States.,UNLV Population Health & Health Equity Initiative, Las Vegas, NV, United States
| | - Anne C Spaulding
- Department of Epidemiology, Emory University School of Public Health, Atlanta, GA, United States
| | -
- University of Nevada Las Vegas School of Public Health, Las Vegas, NV, United States.,UNLV Population Health & Health Equity Initiative, Las Vegas, NV, United States.,Department of Epidemiology, Emory University School of Public Health, Atlanta, GA, United States.,Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, United States
| | - Ian W Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA, United States
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21
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Frew PM, Schamel JT, Randall LA, King AR, Holloway IW, Burris K, Spaulding AC. Identifying Missed Opportunities for Routine Vaccination among People Who Use Drugs. Int J Environ Res Public Health 2021; 18:1447. [PMID: 33557231 PMCID: PMC7913920 DOI: 10.3390/ijerph18041447] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Subscribe] [Scholar Register] [Received: 12/28/2020] [Revised: 01/28/2021] [Accepted: 01/30/2021] [Indexed: 01/08/2023]
Abstract
In the US, adult immunization coverage remains low, especially among vulnerable populations, as recent hepatitis A outbreaks have demonstrated. We studied the vaccination history variation among the US adults who use drugs by implementing a community-engaged research survey to identify reported immunization coverage, missed opportunities (MO), and places where immunizations might be delivered. Our analysis of a sample of 1127 participants recruited at community syringe exchanges in three cities identified higher overall vaccination receipt in Los Angeles compared to Atlanta or Las Vegas (e.g., HAV receipt 52.2% LA, 42.1% LV, 41.4% Atlanta). Overall, fewer participants reported having received HAV (45.9%), HBV (47.5%), or influenza (47.6%) vaccines than MMR (57.1%) or Td/Tdap (61.1%). Across sites, HAV receipt was higher for participants incarcerated ≥ 5 years (54.2% vs. 43.6% for those incarcerated < 5 years, 49.4% no incarceration history, p = 0.02). HBV receipt was higher among participants who were not intravenous drug users (56.1% vs. 46.0%, p = 0.03). Additionally, income >$20k predicted higher rates of MMR receipt (67.0% vs. 56.5%, p = 0.009), as did stable housing (62.8% vs. 54.3%, p = 0.01). To address the need to expand vaccine coverage among vulnerable adults, delivering vaccine at sites where persons who use drugs access services, or in correctional facilities, may be warranted.
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Affiliation(s)
- Paula M. Frew
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Jay T. Schamel
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Laura A. Randall
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Adrian R. King
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Ian W. Holloway
- Department of Social Welfare, UCLA Luskin School of Public Affairs, Los Angeles, CA 90095, USA;
| | - Katherine Burris
- UNLV School of Public Health, UNLV School of Medicine, and UNLV Population Health & Health Equity Initiative, University of Nevada, Las Vegas, NV 89154, USA; (P.M.F.); (J.T.S.); (L.A.R.); (A.R.K.); (K.B.)
| | - Anne C. Spaulding
- Department of Epidemiology, Emory University, Atlanta, GA 30322, USA
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Hagan LM, Williams SP, Spaulding AC, Toblin RL, Figlenski J, Ocampo J, Ross T, Bauer H, Hutchinson J, Lucas KD, Zahn M, Chiang C, Collins T, Burakoff A, Bettridge J, Stringer G, Maul R, Waters K, Dewart C, Clayton J, de Fijter S, Sadacharan R, Garcia L, Lockett N, Short K, Sunder L, Handanagic S. Mass Testing for SARS-CoV-2 in 16 Prisons and Jails - Six Jurisdictions, United States, April-May 2020. MMWR Morb Mortal Wkly Rep 2020; 69:1139-1143. [PMID: 32817597 PMCID: PMC7439979 DOI: 10.15585/mmwr.mm6933a3] [Citation(s) in RCA: 73] [Impact Index Per Article: 18.3] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Affiliation(s)
- Tochi Ohuabunwa
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA 30322, USA.
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Holloway IW, C Spaulding A, Miyashita Ochoa A, A Randall L, R King A, Frew PM. COVID-19 vulnerability among people who use drugs: recommendations for global public health programmes and policies. J Int AIDS Soc 2020; 23:e25551. [PMID: 32640098 PMCID: PMC7300636 DOI: 10.1002/jia2.25551] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/22/2020] [Accepted: 05/29/2020] [Indexed: 12/03/2022] Open
Affiliation(s)
- Ian W Holloway
- Department of Social WelfareUCLA Luskin School of Public AffairsLos AngelesCAUSA
| | | | | | - Laura A Randall
- UNLV School of Public Health and UNLV Population Health & Health Equity InitiativeUniversity of Nevada Las VegasLas VegasNVUSA
| | - Adrian R King
- UNLV School of Public Health and UNLV Population Health & Health Equity InitiativeUniversity of Nevada Las VegasLas VegasNVUSA
| | - The HBOU Study Team
- UNLV School of Public Health and UNLV Population Health & Health Equity InitiativeUniversity of Nevada Las VegasLas VegasNVUSA
| | - Paula M Frew
- UNLV School of Public Health and UNLV Population Health & Health Equity InitiativeUniversity of Nevada Las VegasLas VegasNVUSA
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25
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Affiliation(s)
- Matthew J Akiyama
- From the Department of Medicine, Divisions of General Internal Medicine and Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY (M.J.A.); the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta (A.C.S.); and the Departments of Medicine and Epidemiology, Division of Infectious Diseases, Brown University and the Miriam Hospital, Providence, RI (J.D.R.)
| | - Anne C Spaulding
- From the Department of Medicine, Divisions of General Internal Medicine and Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY (M.J.A.); the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta (A.C.S.); and the Departments of Medicine and Epidemiology, Division of Infectious Diseases, Brown University and the Miriam Hospital, Providence, RI (J.D.R.)
| | - Josiah D Rich
- From the Department of Medicine, Divisions of General Internal Medicine and Infectious Diseases, Albert Einstein College of Medicine and Montefiore Medical Center, Bronx, NY (M.J.A.); the Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta (A.C.S.); and the Departments of Medicine and Epidemiology, Division of Infectious Diseases, Brown University and the Miriam Hospital, Providence, RI (J.D.R.)
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Martin NK, Hickman M, Spaulding AC, Vickerman P. Prisons can also improve drug user health in the community. Addiction 2020; 115:914-915. [PMID: 32026531 DOI: 10.1111/add.14971] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/27/2019] [Accepted: 01/13/2020] [Indexed: 11/27/2022]
Affiliation(s)
- Natasha K Martin
- Division of Infectious Diseases and Global Public Health, University of California San Diego, San Diego, CA, USA.,Population Health Sciences, University of Bristol, Bristol, UK
| | - Matthew Hickman
- Population Health Sciences, University of Bristol, Bristol, UK
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Peter Vickerman
- Population Health Sciences, University of Bristol, Bristol, UK
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Erben Y, Spaulding AC, Oderich GS, Da Rocha-Franco JA, Farres H, Cochuyt JJ, Sorrells WS, Oldenburg AW, Frey GT, Toskich BB, Becher R, Hakaim AG. Acute Mesenteric Ischemia Remains a Highly Morbid Diagnosis after Initial Hospitalization Survival. Int J Angiol 2020; 29:189-195. [PMID: 33100803 DOI: 10.1055/s-0039-1700984] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Abstract
Acute mesenteric ischemia (AMI) remains a vascular emergency. Our aim was to explore readmission for AMI. We identified all patients admitted for AMI from the state of California through the Healthcare and Utilization Project from 2005 to 2011. Our primary end point was the rate and etiology for readmission. Our secondary end points were the length of hospitalization and in-hospital mortality. Cox proportional hazard regression was utilized to assess risk of 30-day readmission. There were 534 (9.9%) readmissions at 30 days. The mean age was 67 ± 17 years and 209 (39.1%) were male. The five most common etiologies for readmission were AMI (7.6%), cardiac events (5.3%), severe sepsis (1.2%), dehydration (1.1%), and acute kidney failure (1.1%). Once readmitted, these patients were most likely to experience cardiac catheterizations (25.4%), red blood cell transfusions (23.6%), intubation and mechanical ventilation (17.6%), biopsy of the large intestine (13.9%), reoperation for small bowel resection (10.9%), administration of total parenteral nutrition (10.5%), and transfusion of other blood products (6.9%). This hospitalization was 8.8 ± 12.7 days long. In-hospital mortality was 36 patients (6.7%). On multivariable Cox-regression analysis, severe (hazard ratio [HR]: 2.1 [1.4-3.2], p = 0.0005) and moderate (HR: 1.5 [1.03-2.13], p = 0.04) Elixhauser Comorbidity Group, complications (HR: 1.5 [1.2-1.9], p = 0.0007), and longer index hospitalization (HR: 1.02 [1.01-1.02], p < 0.0001) were predictors of readmission. Conclusion AMI remains a vascular emergency. Readmissions have a significant rate of morbid invasive procedures and can lead to an in-hospital mortality of 6.7%. The adoption of guidelines similar to the European Society for Trauma and Emergency Surgery should be considered.
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Affiliation(s)
- Y Erben
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
| | - A C Spaulding
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | - G S Oderich
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Rochester, Minnesota
| | - J A Da Rocha-Franco
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
| | - H Farres
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
| | - J J Cochuyt
- Department of Health Sciences Research, Mayo Clinic, Jacksonville, Florida
| | - W S Sorrells
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
| | - A W Oldenburg
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
| | - G T Frey
- Division of Vascular and Interventional Radiology, Mayo Clinic, Jacksonville, Florida
| | - B B Toskich
- Division of Vascular and Interventional Radiology, Mayo Clinic, Jacksonville, Florida
| | - R Becher
- Section of General Surgery, Trauma and Surgical Critical Care, Yale School of Medicine, New Haven, Connecticut
| | - A G Hakaim
- Division of Vascular and Endovascular Surgery, Mayo Clinic, Jacksonville, Florida
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Borschmann R, Tibble H, Spittal MJ, Preen D, Pirkis J, Larney S, Rosen DL, Young JT, Love AD, Altice FL, Binswanger IA, Bukten A, Butler T, Chang Z, Chen CY, Clausen T, Christensen PB, Culbert GJ, Degenhardt L, Dirkzwager AJE, Dolan K, Fazel S, Fischbacher C, Giles M, Graham L, Harding D, Huang YF, Huber F, Karaminia A, Keen C, Kouyoumdjian FG, Lim S, Møller L, Moniruzzaman A, Morenoff J, O’Moore E, Pizzicato LN, Pratt D, Proescholdbell SK, Ranapurwala SI, Shanahan ME, Shaw J, Slaunwhite A, Somers JM, Spaulding AC, Stern MF, Viner KM, Wang N, Willoughby M, Zhao B, Kinner SA. The Mortality After Release from Incarceration Consortium (MARIC): Protocol for a multi-national, individual participant data meta-analysis. Int J Popul Data Sci 2020; 5:1145. [PMID: 32935053 PMCID: PMC7473255 DOI: 10.23889/ijpds.v5i1.1145] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
INTRODUCTION More than 30 million adults are released from incarceration globally each year. Many experience complex physical and mental health problems, and are at markedly increased risk of preventable mortality. Despite this, evidence regarding the global epidemiology of mortality following release from incarceration is insufficient to inform the development of targeted, evidence-based responses. Many previous studies have suffered from inadequate power and poor precision, and even large studies have limited capacity to disaggregate data by specific causes of death, sub-populations or time since release to answer questions of clinical and public health relevance. OBJECTIVES To comprehensively document the incidence, timing, causes and risk factors for mortality in adults released from prison. METHODS We created the Mortality After Release from Incarceration Consortium (MARIC), a multi-disciplinary collaboration representing 29 cohorts of adults who have experienced incarceration from 11 countries. Findings across cohorts will be analysed using a two-step, individual participant data meta-analysis methodology. RESULTS The combined sample includes 1,337,993 individuals (89% male), with 75,795 deaths recorded over 9,191,393 person-years of follow-up. CONCLUSIONS The consortium represents an important advancement in the field, bringing international attention to this problem. It will provide internationally relevant evidence to guide policymakers and clinicians in reducing preventable deaths in this marginalized population. KEY WORDS Mortality; incarceration; prison; release; individual participant data meta-analysis; consortium; cohort.
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Affiliation(s)
- R Borschmann
- Justice Health Unit, Centre for Health Equity, The University of Melbourne, 207 Bouverie street, Carlton 3010, Melbourne, Victoria, AUSTRALIA
| | - H Tibble
- Usher Institute of Population Health Sciences and Informatics, Centre for Medical Informatics, University of Edinburgh, Edinburgh, UK
| | - MJ Spittal
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - D Preen
- The University of Western Australia, School of Population and Global Health, Nedlands, AUSTRALIA
| | - J Pirkis
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - S Larney
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, AUSTRALIA
| | - DL Rosen
- University of North Carolina at Chapel Hill, North Carolina, USA
| | - JT Young
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - AD Love
- University of Melbourne, Melbourne School of Population Health, Melbourne, AUSTRALIA
| | - FL Altice
- Yale University School of Medicine and Public Health, New Haven, Connecticut, USA
| | - IA Binswanger
- Kaiser Permanente Colorado, Colorado Permanente Medical Group, USA
| | - A Bukten
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - T Butler
- University of New South Wales, Kirby Institute, Sydney, AUSTRALIA
| | - Z Chang
- Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, SWEDEN
| | - C-Y Chen
- National Yang-Ming University, Institute of Public Health, TAIWAN
| | - T Clausen
- Norwegian Centre for Addiction Research, Institute of Clinical Medicine, University of Oslo, Norway
| | - PB Christensen
- Department of Infectious Diseases, Odense University Hospital and Department of Clinical Research, Faculty of Health Sciences, University of Southern Denmark, DENMARK
| | - GJ Culbert
- Department of Health Systems Science, University of Illinois at Chicago, Chicago, USA
| | - L Degenhardt
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, AUSTRALIA
| | - AJE Dirkzwager
- Netherlands Institute for the Study of Crime and Law Enforcement (NSCR), Amsterdam, NETHERLANDS
| | - K Dolan
- National Drug and Alcohol Research Centre, UNSW Sydney, Sydney, AUSTRALIA
| | - S Fazel
- University of Oxford, Department of Psychiatry, Medical Sciences Division, Oxford, ENGLAND
| | - C Fischbacher
- NHS National Services, Information Services Division, Edinburgh, SCOTLAND
| | - M Giles
- Edith Cowan University, School of Arts and Humanities, Joondalup, AUSTRALIA
| | - L Graham
- NHS National Services, Information Services Division, Edinburgh, SCOTLAND
| | - D Harding
- University of California Berkeley, USA
| | - Y-F Huang
- Taiwan Centers for Disease Control, Taipei, TAIWAN
| | - F Huber
- Cayenne General Hospital, COREVIH Guyane, and Reseau Kikiwi, Cayenne, French Guiana, FRANCE
| | - A Karaminia
- University of New South Wales, Sydney, AUSTRALIA
| | - C Keen
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - FG Kouyoumdjian
- McMaster University, Department of Family Medicine, Hamilton, Ontario, CANADA
| | - S Lim
- New York City Department of Health and Mental Hygiene, Bureau of Epidemiology Services, Division of Epidemiology, New York, USA
| | - L Møller
- World Health Organization, Division of Noncommunicable Diseases and Promoting Health through the Life-course, Marmorvej, DENMARK
| | - A Moniruzzaman
- Somers Research Group, Simon Fraser University, Burnaby, British Columbia, CANADA
| | - J Morenoff
- University of Michigan, Department of Sociology, USA
| | - E O’Moore
- Public Health England, London, ENGLAND
| | - LN Pizzicato
- Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - D Pratt
- University of Manchester, Division of Psychology and Mental Health, School of Health Sciences, Manchester, ENGLAND
| | - SK Proescholdbell
- North Carolina Department of Health and Human Services, North Carolina, USA
| | - SI Ranapurwala
- Department of Epidemiology, University of North Carolina at Chapel Hill, USA
| | - ME Shanahan
- Department of Maternal and Child Health, University of North Carolina at Chapel Hill, USA
| | - J Shaw
- Centre for Mental Health and Safety, Division of Psychology and Mental Health, University of Manchester, Manchester, ENGLAND
| | - A Slaunwhite
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, British Columbia, CANADA
| | - JM Somers
- Somers Research Group, Simon Fraser University, Burnaby, British Columbia, CANADA
| | - AC Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - MF Stern
- Department of Health Services, University of Washington, Seattle, Washington, USA
| | - KM Viner
- Philadelphia Department of Public Health, Philadelphia, PA, USA
| | - N Wang
- Institute of Public Health, National Yang-Ming University, TAIWAN
| | - M Willoughby
- University of Melbourne, Melbourne School of Population and Global Health, Melbourne, AUSTRALIA
| | - B Zhao
- BC Centre for Disease Control, Provincial Health Services Authority, Vancouver, British Columbia, CANADA
| | - SA Kinner
- Murdoch Children’s Research Institute, Centre for Adolescent Health, Melbourne, Victoria, AUSTRALIA
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Dalgic OO, Samur S, Spaulding AC, Llerena S, Cobo C, Ayer T, Roberts MS, Crespo J, Chhatwal J. Improved Health Outcomes from Hepatitis C Treatment Scale-Up in Spain's Prisons: A Cost-Effectiveness Study. Sci Rep 2019; 9:16849. [PMID: 31727921 PMCID: PMC6856347 DOI: 10.1038/s41598-019-52564-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2019] [Accepted: 10/14/2019] [Indexed: 01/10/2023] Open
Abstract
Hepatitis C virus (HCV) is 15 times more prevalent among persons in Spain's prisons than in the community. Recently, Spain initiated a pilot program, JAILFREE-C, to treat HCV in prisons using direct-acting antivirals (DAAs). Our aim was to identify a cost-effective strategy to scale-up HCV treatment in all prisons. Using a validated agent-based model, we simulated the HCV landscape in Spain's prisons considering disease transmission, screening, treatment, and prison-community dynamics. Costs and disease outcomes under status quo were compared with strategies to scale-up treatment in prisons considering prioritization (HCV fibrosis stage vs. HCV prevalence of prisons), treatment capacity (2,000/year vs. unlimited) and treatment initiation based on sentence lengths (>6 months vs. any). Scaling-up treatment by treating all incarcerated persons irrespective of their sentence length provided maximum health benefits-preventing 10,200 new cases of HCV, and 8,300 HCV-related deaths between 2019-2050; 90% deaths prevented would have occurred in the community. Compared with status quo, this strategy increased quality-adjusted life year (QALYs) by 69,700 and costs by €670 million, yielding an incremental cost-effectiveness ratio of €9,600/QALY. Scaling-up HCV treatment with DAAs for the entire Spanish prison population, irrespective of sentence length, is cost-effective and would reduce HCV burden.
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Affiliation(s)
- Ozden O Dalgic
- Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Sumeyye Samur
- Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Susana Llerena
- Department of Gastroenterology and Hepatology, Marques de Valdecilla University Hospital, Santander, Spain
| | - Carmen Cobo
- Medical Service, El Dueso Penitentiary Centre, Santoña, Spain
| | - Turgay Ayer
- H. Milton Stewart School of Industrial and Systems Engineering, Georgia Institute of Technology, Atlanta, Georgia, USA
| | - Mark S Roberts
- Department of Health Policy and Management, University of Pittsburgh, Pittsburgh, Pennsylvania, USA
| | - Javier Crespo
- Department of Gastroenterology and Hepatology, Marques de Valdecilla University Hospital, Santander, Spain
| | - Jagpreet Chhatwal
- Institute for Technology Assessment, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts, USA.
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Spaulding AC, Chen J, Mackey CA, Adee MG, Bowden CJ, Selvage WD, Thornton KA. Assessment and Comparison of Hepatitis C Viremia in the Prison Systems of New Mexico and Georgia. JAMA Netw Open 2019; 2:e1910900. [PMID: 31490534 PMCID: PMC6735408 DOI: 10.1001/jamanetworkopen.2019.10900] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/09/2022] Open
Abstract
This cross-sectional study assesses and compares the prevalence of hepatitis C virus among criminal justice populations in New Mexico, a state with high hepatitis C virus prevalence, and Georgia, a state with low hepatitis C virus prevalence.
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Affiliation(s)
| | - Junyu Chen
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Madeline G. Adee
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Chava J. Bowden
- Rollins School of Public Health, Emory University, Atlanta, Georgia
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Gardner SK, Elkington KS, Knight DK, Huang S, DiClemente RJ, Spaulding AC, Oser CB, Robertson AA, Baird-Thomas C. Juvenile justice staff endorsement of HIV/STI prevention, testing, and treatment linkage. Health Justice 2019; 7:15. [PMID: 31485779 PMCID: PMC6724232 DOI: 10.1186/s40352-019-0096-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 08/22/2019] [Indexed: 05/11/2023]
Abstract
BACKGROUND While involvement in the legal system offers an opportunity to educate, screen, and treat high-risk youth, research shows that staff attitudes toward these practices can serve as barriers to implementation. The current study investigates the degree to which JJ staff endorse HIV prevention, testing, and treatment linkage practices with youth under community supervision and examines differences between individuals who supervise youth (e.g., juvenile probation officer) and those working in non-supervisory roles (e.g., case manager, assessment specialist). METHODS Juvenile justice staff consenting to participation in JJ-TRIALS completed an initial staff survey (N = 501). Survey items measured perceived importance of HIV/STI prevention (4 items); perceived importance of HIV/STI testing (7 items); and perceived importance of HIV/STI treatment linkage (8 items). RESULTS Confirmatory Factor Analysis (CFA) was computed (SAS CALIS procedure) for each of the three domains. Findings suggest that while staff recognize that youth are at risk for HIV/STIs and require provision of HIV/STI prevention and treatment linkage, attitudes concerning the importance of procuring or providing testing services for youth is substantially lower. Furthermore, analytic models comparing staff with and without supervision responsibilities (computed using SAS PROC MIXED) indicated that attitudes differed by site and staff responsible for supervision rated HIV treatment linkage practices as less important compared to non-supervising staff. CONCLUSIONS Establishing partnerships with health agencies equipped with resources and skillsets to provide HIV/STI testing and related services may be an effective model to promote greater awareness and use of best practices among JJ staff and more effectively address the unmet needs of this high-risk population of youth.
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Affiliation(s)
- Sheena K. Gardner
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Katherine S. Elkington
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Danica K. Knight
- Institute of Behavioral Research, Texas Christian University, 3034 Sandage Avenue, Fort Worth, TX 76109 USA
| | - Sofia Huang
- Department of Psychiatry, Division of Child & Adolescent Psychiatry, Columbia University, 1051 Riverside Drive, #15, New York, NY 10032 USA
| | - Ralph J. DiClemente
- College of Global Public Health, New York University, 715 #719, Broadway, New York, NY 10003 USA
| | - Anne C. Spaulding
- Rollins School of Public Health, Emory University, 1518 Clifton Road, Atlanta, GA 30322 USA
| | - Carrie B. Oser
- Department of Sociology, University of Kentucky, 1531 Patterson Office Tower, Lexington, KY 40506 USA
| | - Angela A. Robertson
- Social Science Research Center, Mississippi State University, 1 Research Blvd., Suite 103, Starkville, MS 39759 USA
| | - Connie Baird-Thomas
- Social Science Research Center, Mississippi State University, 153 Mississippi Parkway, Canton, MS 39046 USA
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32
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Spaulding AC, Lemon TL, So M. Measuring Correctional Experience to Inform Development of HIV, Sexually Transmitted Infection, and Substance Use Interventions for Incarcerated Black Men Who Have Sex with Men. Am J Public Health 2019; 108:S237-S239. [PMID: 30383418 DOI: 10.2105/ajph.2018.304810] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Anne C Spaulding
- Anne C. Spaulding is with the Department of Epidemiology and Medicine, Emory University Rollins School of Public Health and School of Medicine, and Department of Medicine, Morehouse School of Medicine, Atlanta, GA. Tiffany L. Lemon is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. Marvin So is with the Department of Epidemiology, Emory University Rollins School of Public Health
| | - Tiffany L Lemon
- Anne C. Spaulding is with the Department of Epidemiology and Medicine, Emory University Rollins School of Public Health and School of Medicine, and Department of Medicine, Morehouse School of Medicine, Atlanta, GA. Tiffany L. Lemon is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. Marvin So is with the Department of Epidemiology, Emory University Rollins School of Public Health
| | - Marvin So
- Anne C. Spaulding is with the Department of Epidemiology and Medicine, Emory University Rollins School of Public Health and School of Medicine, and Department of Medicine, Morehouse School of Medicine, Atlanta, GA. Tiffany L. Lemon is with the Department of Epidemiology, Harvard T. H. Chan School of Public Health, Boston, MA. Marvin So is with the Department of Epidemiology, Emory University Rollins School of Public Health
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33
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Spaulding AC, Graham C, Akiyama MJ, Chhatwal J, Nijhawan A, Ninburg M, Rich J, Strick L, Taylor L, Trooskin S, Westergaard R, Sabol W. Letter to the Editor: Hepatitis C Virus Prevalence Estimates Among Incarcerated Persons. Hepatology 2019; 70:758-759. [PMID: 30938455 PMCID: PMC7644139 DOI: 10.1002/hep.30636] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/07/2022]
Affiliation(s)
| | - Camilla Graham
- Beth Israel Deaconess Medical Center, Division of Infectious Disease
| | | | - Jagpreet Chhatwal
- Massachusetts General Hospital, Harvard Medical School, Institute for Technology Assessment
| | - Ank Nijhawan
- University of Texas Southwestern Medical Center at Dallas
| | | | | | | | - Lynn Taylor
- University of Rhode Island Feinstein Providence Campus
| | | | - Ryan Westergaard
- University of Wisconsin Madison School of Medicine and Public Health, Department of Medicine
| | - William Sabol
- Georgia State University, Criminology and Criminal Justice
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Chhatwal J, Chen Q, Bethea ED, Hur C, Spaulding AC, Kanwal F. The impact of direct-acting anti-virals on the hepatitis C care cascade: identifying progress and gaps towards hepatitis C elimination in the United States. Aliment Pharmacol Ther 2019; 50:66-74. [PMID: 31115920 DOI: 10.1111/apt.15291] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2019] [Revised: 04/08/2019] [Accepted: 04/18/2019] [Indexed: 12/12/2022]
Abstract
BACKGROUND The hepatitis C virus (HCV) care cascade has changed dramatically following the introduction of direct-acting anti-virals (DAAs). Up-to-date estimates of the cascade are needed to monitor progress, identify key gaps and inform policy. AIM To estimate the current and future HCV care cascade in the United States, nationally and in select subpopulations of interest. METHODS We used a previously validated mathematical model to simulate the landscape of HCV in the United States from 2011 onwards, accounting for HCV screening policy updates, newer HCV treatments and rising HCV incidence. RESULTS By the end of 2018, of 4.29 million HCV persons alive, 2.71 million (63%) were actively viremic, 2.24 million (52%) aware and 1.58 million (37%) cured. By 2030, under the status quo, of 3.65 million HCV persons alive, 1.88 million (51%) would be viremic, 2.25 million (62%) aware and 1.77 million (49%) cured. The HCV care cascade in 2018 differed substantially by subpopulation: of 1.34 million incarcerated HCV persons, 96% were viremic, 36% aware and 4% cured; of 0.87 million HCV persons in Medicare, 31% were viremic, 72% aware and 69% cured; and of 0.37 million HCV persons in Medicaid, 49% were viremic, 54% aware and 51% cured. Implementing universal screening, providing unrestricted treatment and controlling HCV incidence were factors found to have the largest effect on improving the HCV care cascade. CONCLUSIONS Since the launch of DAAs, the HCV care cascade has shifted towards higher awareness and treatment rates; however, additional interventions are needed to move towards HCV elimination.
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Affiliation(s)
- Jagpreet Chhatwal
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Qiushi Chen
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts.,Pennysylvania State University, University Park, Pennsylvania
| | - Emily D Bethea
- Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
| | - Chin Hur
- Columbia University Medical Center, New York City, New York
| | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Fasiha Kanwal
- Michael E. DeBakey Veterans Affairs Medical Center, and Baylor College of Medicine, Houston, Texas
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35
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Spaulding AC, Kehus HE, Sabol WJ. In Search of Denominators. JAMA Surg 2019; 154:469-470. [DOI: 10.1001/jamasurg.2018.5844] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Affiliation(s)
- Anne C. Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Haley E. Kehus
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - William J. Sabol
- Andrew Young School of Policy Studies, Georgia State University, Atlanta
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36
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Bedell PS, So M, Morse DS, Kinner SA, Ferguson WJ, Spaulding AC. Corrections for Academic Medicine: The Importance of Using Person-First Language for Individuals Who Have Experienced Incarceration. Acad Med 2019; 94:172-175. [PMID: 30699100 DOI: 10.1097/acm.0000000000002501] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
This Invited Commentary addresses the use of labels and their impact on people involved in the criminal justice system. There are 2.2 million adults incarcerated in the United States and close to 6.6 million under correctional supervision on any day. Many of these people experience health inequalities and inadequate health care both in and out of correctional facilities. These numbers are reason enough to raise alarm among health care providers and criminal justice researchers about the need to conceptualize better ways to administer health care for these individuals. Using terms like "convict," "prisoner," "parolee," and "offender" to describe these individuals increases the stigma that they already face. The authors propose that employing person-first language for justice-involved individuals would help to reduce the stigma they face during incarceration and after they are released. Coordinated, dignified, and multidisciplinary care is essential for this population given the high rates of morbidity and mortality they experience both in and out of custody and the many barriers that impede their successful integration with families and communities. Academic medicine can begin to address the mistrust that formerly incarcerated individuals often have toward the health care system by using the humanizing labels recommended in this Invited Commentary.
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Affiliation(s)
- Precious S Bedell
- P.S. Bedell is research coordinator II, Department of Psychiatry, University of Rochester School of Medicine and Dentistry, doctoral student, Warner School of Education and Human Development, and Diversity and Inclusive Climate Leadership Fellowship Fellow 2018-2020, University of Rochester, Rochester, New York. M. So is research assistant, Department of Epidemiology, Emory University Rollins School of Public Health, Atlanta, Georgia; ORCID: https://orcid.org/0000-0002-3639-0472. D.S. Morse is associate professor of psychiatry and medicine, University of Rochester School of Medicine and Dentistry, Rochester, New York. S.A. Kinner is National Health and Medical Research Council Research Fellow and Group Leader, Justice Health, Centre for Adolescent Health, Murdoch Children's Research Institute, and head, Justice Health Unit, Melbourne School of Population and Global Health, University of Melbourne, Parkville, Victoria, Australia; ORCID: https://orcid.org/0000-0003-3956-5343. W.J. Ferguson is professor of family medicine and community health and director of academic programs, Health and Criminal Justice Program, University of Massachusetts Medical School, Worcester, Massachusetts. A.C. Spaulding is associate professor of epidemiology, Rollins School of Public Health, and medicine (joint), Emory University School of Medicine, and adjunct associate professor of medicine, Morehouse School of Medicine, Atlanta, Georgia
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Spaulding AC, Adee MG, Lawrence RT, Chhatwal J, von Oehsen W. Five Questions Concerning Managing Hepatitis C in the Justice System: Finding Practical Solutions for Hepatitis C Virus Elimination. Infect Dis Clin North Am 2019; 32:323-345. [PMID: 29778259 DOI: 10.1016/j.idc.2018.02.014] [Citation(s) in RCA: 16] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
An estimated 30% of Americans with hepatitis C virus (HCV) pass through a jail or prison annually. One in 7 incarcerated persons is viremic. Screening and treatment is cost-effective and beneficial to society as a whole. Yet at current (2018) levels of funding for HCV management, prisons are not aggressively seeking cases; few incarcerated persons with HCV actually receive treatment. This article explores barriers to screening for and treating hepatitis C in state prisons, and ways that states may overcome these barriers, such as nominal pricing. While high prices for direct-acting antivirals discourage treatment, potential strategies exist to lower prices.
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Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road Room 3033, Atlanta, GA 30322, USA; Department of Medicine, Morehouse School of Medicine, 720 Westview Dr SW, Atlanta, GA 30310, USA.
| | - Madeline G Adee
- Department of Epidemiology, Rollins School of Public Health, Emory University, 1518 Clifton Road Room 3033, Atlanta, GA 30322, USA
| | - Robert T Lawrence
- Alaska Department of Corrections, 550 West 7th Avenue, Suite 1860, Anchorage, AK 99501, USA
| | - Jagpreet Chhatwal
- Institute for Technology Assessment, Massachusetts General Hospital, Harvard University, 101 Merrimac Street, Floor 10, Boston, MA 02114, USA
| | - William von Oehsen
- Powers Pyles Sutter & Verville PC, 1501 M Street Northwest, Seventh Floor, Washington, DC 20005-1700, USA
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Spaulding AC, Eldridge GD, Chico CE, Morisseau N, Drobeniuc A, Fils-Aime R, Day C, Hopkins R, Jin X, Chen J, Dolan KA. Smoking in Correctional Settings Worldwide: Prevalence, Bans, and Interventions. Epidemiol Rev 2018; 40:82-95. [PMID: 29746635 PMCID: PMC5982806 DOI: 10.1093/epirev/mxy005] [Citation(s) in RCA: 42] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2017] [Accepted: 02/27/2018] [Indexed: 12/12/2022] Open
Abstract
Smoking tobacco contributes to 11.5% of deaths worldwide and, in some countries, more hospitalizations than alcohol and drugs combined. Globally in 2015, 25% of men and 5% of women smoked. In the United States, a higher proportion of people in prison smoke than do community-dwelling individuals. To determine smoking prevalence in prisons worldwide, we systematically reviewed the literature using Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines; we also examined whether prisons banned smoking or treated smokers. We searched databases for articles published between 2012 and 2016 and located 85 relevant articles with data representing 73.5% of all incarcerated persons from 50 countries. In 35 of 36 nations (97%) with published prevalence data, smoking for the incarcerated exceeded community rates 1.04- to 62.6-fold. Taking a conservative estimate of a 2-fold increase, we estimated that, globally, 14.5 million male and 26,000 female smokers pass through prisons annually. Prison authorities’ responses include permitting, prohibiting, or treating tobacco use. Bans may temporarily improve health and reduce in-prison health care costs but have negligible effect after prison release. Evidence-based interventions for smoking cessation effective outside prisons are effective inside; effects persist after release. Because smoking prevalence is heightened in prisons, offering evidence-based interventions to nearly 15 million smokers passing through yearly would improve global health.
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Affiliation(s)
- Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | | | - Cynthia E Chico
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Nancy Morisseau
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Ana Drobeniuc
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Rebecca Fils-Aime
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Carolyn Day
- Discipline of Addiction Medicine, Central Clinical School, University of Sydney, New South Wales, Australia
| | - Robyn Hopkins
- Department of the Attorney-General and Justice, Northern Territory Correctional Services, Darwin, Australia
| | - Xingzhong Jin
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
| | - Junyu Chen
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Kate A Dolan
- Program of International Research and Training, National Drug and Alcohol Research Centre, University of New South Wales, Sydney, Australia
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Spaulding AC, Chhatwal J, Adee MG, Lawrence RT, Beckwith CG, von Oehsen W. Funding Hepatitis C Treatment in Correctional Facilities by Using a Nominal Pricing Mechanism. J Correct Health Care 2018; 25:15-24. [PMID: 30322323 DOI: 10.1177/1078345818805770] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
The cost of treating all incarcerated people who have hepatitis C with direct-acting antiviral agents (DAAs) greatly stresses correctional facility budgets. Complex federal laws bar pharmaceutical companies from simply discounting expensive medications to prices that facilities can afford. This article discusses means by which correctional facilities may qualify under federal law as "safety-net providers" to allow sale of DAAs at a price <10% of the average manufacturer price (AMP). No new laws would need to be enacted to implement this strategy. Using fiscal year 2018 pricing data from the Georgia Department of Corrections, we derived an estimate for the AMP and then used this estimate to calculate a nominal price. The United States would save ∼$3 billion if manufacturers sold DAAs at a nominal price to correctional facilities. Use of this strategy would help solve the conundrum of how state and county governments can pay for hepatitis C treatment and would ultimately save money for society.
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Affiliation(s)
- Anne C Spaulding
- 1 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA.,2 Morehouse School of Medicine, Atlanta, GA, USA
| | - Jagpreet Chhatwal
- 3 Harvard Medical School, Boston, MA, USA.,4 Institute for Technology Assessment, Massachusetts General Hospital, Boston, MA, USA
| | - Madeline G Adee
- 1 Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | | | - Curt G Beckwith
- 6 Alpert Medical School of Brown University, Providence, RI, USA.,7 The Miriam Hospital, Providence, RI, USA
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Bedell PS, Spaulding AC, So M, Sarrett JC. The Names Have Been Changed to Protect the . . . Humanity: Person-First Language in Correctional Health Epidemiology. Am J Epidemiol 2018; 187:1140-1142. [PMID: 29697744 DOI: 10.1093/aje/kwy073] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2018] [Accepted: 03/27/2018] [Indexed: 11/14/2022] Open
Abstract
After objections surfaced following a call for papers on "Prisoner Health," the editors of Epidemiologic Reviews decided to rename this year's volume "Incarceration and Health." In this commentary, we trace the origins of person-first language and explain why using appropriate terms in correctional health, including correctional health epidemiology, matters. We discuss the potential consequences of person-first language for justice-involved individuals and how inclusive language might affect the social, emotional, and physical well-being of individuals, families, and communities. Future directions may include measuring health outcomes when language is systematically changed. The barriers that thwart successful reentry may wane when dehumanizing language disappears.
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Affiliation(s)
- Precious S Bedell
- Department of Psychiatry, School of Medicine & Dentistry, University of Rochester, Rochester, New York
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
- Department of Medicine, Morehouse School of Medicine, Atlanta, Georgia
| | - Marvin So
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia
| | - Jennifer C Sarrett
- Center for the Study of Human Health, Emory College of Arts and Sciences, Emory University, Atlanta, Georgia
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Becan JE, Bartkowski JP, Knight DK, Wiley TRA, DiClemente R, Ducharme L, Welsh WN, Bowser D, McCollister K, Hiller M, Spaulding AC, Flynn PM, Swartzendruber A, Dickson MF, Fisher JH, Aarons GA. A model for rigorously applying the Exploration, Preparation, Implementation, Sustainment (EPIS) framework in the design and measurement of a large scale collaborative multi-site study. Health Justice 2018; 6:9. [PMID: 29654518 PMCID: PMC5899075 DOI: 10.1186/s40352-018-0068-3] [Citation(s) in RCA: 55] [Impact Index Per Article: 9.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Accepted: 04/02/2018] [Indexed: 05/30/2023]
Abstract
BACKGROUND This paper describes the means by which a United States National Institute on Drug Abuse (NIDA)-funded cooperative, Juvenile Justice-Translational Research on Interventions for Adolescents in the Legal System (JJ-TRIALS), utilized an established implementation science framework in conducting a multi-site, multi-research center implementation intervention initiative. The initiative aimed to bolster the ability of juvenile justice agencies to address unmet client needs related to substance use while enhancing inter-organizational relationships between juvenile justice and local behavioral health partners. METHODS The EPIS (Exploration, Preparation, Implementation, Sustainment) framework was selected and utilized as the guiding model from inception through project completion; including the mapping of implementation strategies to EPIS stages, articulation of research questions, and selection, content, and timing of measurement protocols. Among other key developments, the project led to a reconceptualization of its governing implementation science framework into cyclical form as the EPIS Wheel. The EPIS Wheel is more consistent with rapid-cycle testing principles and permits researchers to track both progressive and recursive movement through EPIS. Moreover, because this randomized controlled trial was predicated on a bundled strategy method, JJ-TRIALS was designed to rigorously test progress through the EPIS stages as promoted by facilitation of data-driven decision making principles. The project extended EPIS by (1) elucidating the role and nature of recursive activity in promoting change (yielding the circular EPIS Wheel), (2) by expanding the applicability of the EPIS framework beyond a single evidence-based practice (EBP) to address varying process improvement efforts (representing varying EBPs), and (3) by disentangling outcome measures of progression through EPIS stages from the a priori established study timeline. DISCUSSION The utilization of EPIS in JJ-TRIALS provides a model for practical and applied use of implementation frameworks in real-world settings that span outer service system and inner organizational contexts in improving care for vulnerable populations. TRIAL REGISTRATION NCT02672150 . Retrospectively registered on 22 January 2016.
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Affiliation(s)
- Jennifer E Becan
- Institute of Behavioral Research, Texas Christian University, Box 298740, Fort Worth, TX, 76129, USA.
| | - John P Bartkowski
- Department of Sociology, University of Texas at San Antonio, San Antonio, TX, USA
| | - Danica K Knight
- Institute of Behavioral Research, Texas Christian University, Box 298740, Fort Worth, TX, 76129, USA
| | | | - Ralph DiClemente
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lori Ducharme
- National Institute on Alcohol Abuse and Alcoholism, Bethesda, MD, USA
| | - Wayne N Welsh
- Department of Criminal Justice, Temple University, Philadelphia, PA, USA
| | - Diana Bowser
- Heller School for Social Policy and Management, Brandeis University, Waltham, MA, USA
| | | | - Matthew Hiller
- Department of Criminal Justice, Temple University, Philadelphia, PA, USA
| | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, Box 298740, Fort Worth, TX, 76129, USA
| | - Andrea Swartzendruber
- College of Public Health, Epidemiology and Biostatistics, University of Georgia, Athens, GA, USA
| | - Megan F Dickson
- Behavioral Science, University of Kentucky, Lexington, KY, USA
| | | | - Gregory A Aarons
- Department of Psychiatry, and Child and Adolescent Services Research Center, University of California, San Diego, CA, USA
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Spaulding AC, Drobeniuc A, Frew PM, Lemon TL, Anderson EJ, Cerwonka C, Bowden C, Freshley J, del Rio C. Jail, an unappreciated medical home: Assessing the feasibility of a strengths-based case management intervention to improve the care retention of HIV-infected persons once released from jail. PLoS One 2018; 13:e0191643. [PMID: 29601591 PMCID: PMC5877830 DOI: 10.1371/journal.pone.0191643] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2017] [Accepted: 12/22/2017] [Indexed: 12/23/2022] Open
Abstract
Background Linkage to and retention in care for US persons living with HIV (PLWH) after release from jail usually declines. We know of no rigorously evaluated behavioral interventions that can improve this. We hypothesized that a strengths-based case management intervention that we developed for PLWH leaving jail would increase linkage/retention in care (indicated by receipt of laboratory draws) and a suppressed HIV viral load (VL) in the year following release. Methods and findings We conducted a quasi-experimental feasibility study of our intervention for PLWH jailed in Atlanta. We recruited 113 PLWH in jail starting in 2014. “SUCCESS” (Sustained, Unbroken Connection to Care, Entry Services, and Suppression) began in jail and continued post-release. Subjects who started the intervention but subsequently began long-term incarcerations were excluded from further analysis. Persons who were retained in the intervention group were compared to contemporaneously incarcerated PLWH who did not receive the intervention. Identities were submitted to an enhanced HIV/AIDS reporting system (eHARS) at the state health department to capture all laboratories drawn. Both community engagement and care upon jail return were assessed equally. For 44 intervention participants released to Atlanta, 50% of care occurred on subsequent jail stays, as documented with EventFlow software. Forty-five receiving usual services only were recruited for comparison. By examining records of jail reentries, half of participants and 60% of controls recidivated (range: 1–8 returns). All but 6 participants in the intervention and 9 subjects in the comparison arm had ≥1 laboratory recorded in eHARS post-release. Among the intervention group, 52% were retained in care (i.e., had two laboratory studies, > = 3 months apart), versus 40% among the comparison group (OR = 1.60, 95% CI (0.71, 3.81)). Both arms showed improved viral load suppression. Conclusions There was a trend towards increased retention for PLWH released from jail after SUCCESS, compared to usual services. Measuring linkage at all venues, including jail-based clinics, fully captured engagement for this frequently recidivating population. Trial registration ClinicalTrials.gov NCT02185742
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Affiliation(s)
- Anne C. Spaulding
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- * E-mail:
| | - Ana Drobeniuc
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Paula M. Frew
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Behavioral Sciences and Health Education, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Tiffany L. Lemon
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Emeli J. Anderson
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Colin Cerwonka
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Chava Bowden
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - John Freshley
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
| | - Carlos del Rio
- Department of Medicine, Division of Infectious Diseases, Emory University School of Medicine, Atlanta, Georgia, United States of America
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
- Hubert Department of Global Health, Rollins School of Public Health, Emory University, Atlanta, Georgia, United States of America
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Christopoulos KA, Cunningham WE, Beckwith CG, Kuo I, Golin CE, Knight K, Flynn PM, Spaulding AC, Coffin LS, Kruszka B, Kurth A, Young JD, Mannheimer S, Crane HM, Kahana SY. Lessons Learned From the Implementation of Seek, Test, Treat, Retain Interventions Using Mobile Phones and Text Messaging to Improve Engagement in HIV Care for Vulnerable Populations in the United States. AIDS Behav 2017; 21:3182-3193. [PMID: 28578543 DOI: 10.1007/s10461-017-1804-8] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
In the United States, little is known about interventions that rely on mobile phones and/or text messaging to improve engagement in HIV care for vulnerable populations. Domestic studies using these technologies as part of the National Institute on Drug Abuse "Seek, Test, Treat, Retain" research initiative were queried regarding intervention components, implementation issues, participant characteristics, and descriptive statistics of mobile phone service delivery. Across five studies with 1,135 predominantly male, minority participants, implementation challenges occurred in three categories: (1) service interruptions; (2) billing/overage issues, and; (3) the participant user experience. Response rules for automated text messages frequently frustrated participants. The inability to reload minutes/texting capacity remotely was a significant barrier to intervention delivery. No study encountered confidentiality breaches. Service interruption was common, even if studies provided mobile phones and plans. Future studies should attend to the type of mobile phone and service, the participant user experience, and human subjects concerns.
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Affiliation(s)
- Katerina A Christopoulos
- Division of HIV, ID and Global Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 995 Potrero Avenue, 4th Floor, San Francisco, CA, 94110, USA.
| | - William E Cunningham
- Departments of Medicine and Health Policy and Management, UCLA Schools of Medicine and Public Health, Los Angeles, CA, USA
| | - Curt G Beckwith
- Division of Infectious Diseases, Warren Alpert School of Medicine at Brown University, Providence, RI, USA
| | - Irene Kuo
- Department of Epidemiology and Biostatistics, Milken Institute School of Public Health, George Washington University, Washington, D.C., USA
| | - Carol E Golin
- Department of Health Behavior, UNC Gillings School of Global Public Health, Chapel Hill, NC, USA
| | - Kevin Knight
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Patrick M Flynn
- Institute of Behavioral Research, Texas Christian University, Fort Worth, TX, USA
| | - Anne C Spaulding
- Department of Epidemiology, Rollins School of Public Health, Emory University, Atlanta, GA, USA
| | - Lara S Coffin
- Division of HIV, ID and Global Medicine, Zuckerberg San Francisco General Hospital, University of California San Francisco, 995 Potrero Avenue, 4th Floor, San Francisco, CA, 94110, USA
| | - Bridget Kruszka
- Collaborative Health Studies Coordinating Center, University of Washington, Seattle, WA, USA
| | - Ann Kurth
- School of Nursing, Yale University, New Haven, CT, USA
| | - Jeremy D Young
- Division of Infectious Disease, University of Illinois at Chicago, Chicago, IL, USA
| | - Sharon Mannheimer
- Departments of Medicine and Epidemiology, Columbia University, New York, NY, USA
| | - Heidi M Crane
- Division of Allergy and Infectious Diseases, University of Washington, Seattle, WA, USA
| | - Shoshana Y Kahana
- Services Research Branch, National Institute on Drug Abuse, Bethesda, MD, USA
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Spaulding AC, Anderson EJ, Khan MA, Taborda-Vidarte CA, Phillips JA. HIV and HCV in U.S. Prisons and Jails: The Correctional Facility as a Bellwether Over Time for the Community's Infections. AIDS Rev 2017; 19:134-147. [PMID: 28926560] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Screening and treating correctional populations for HIV and HCV infections is essential to successfully addressing both epidemics in the USA. The prevalence of HIV and HCV infection is high in prisons and jails due to increased rates of incarceration among disproportionately affected groups such as injection drug users. Through a search of the published and grey literature and surveying persons overseeing health programs in prisons, we collected data on efforts to determine prevalence first for HIV and then for HCV. Prevalence of both infections varies geographically and temporally, reflecting epidemics in the community as well as local law enforcement policies. We estimate that seroprevalence of HCV in 2015 for persons in U.S. prisons averaged 18%, over tenfold greater than HIV. For both, transmission and acquisition during incarceration are rare. Screening can identify previously undetected cases: the efficiency of a testing strategy depends on local conditions. Universal opt-out screening of entrants is usually best as conducting risk-based screening has challenges. With HCV, the advent of highly effective regimens makes cure feasible. Treatment within facilities has the potential to reduce HCV incidence and disease burden in the community, especially in difficult-to-reach populations. The extraordinarily high cost of HCV treatment regimens and lack of political will are the main barriers to treatment expansion. Just as community-wide HIV viral suppression has required correctional/community coordination, elimination of HCV infection in the USA will depend on a thoughtful, well-funded effort to manage this disease in populations interacting with the criminal justice system.
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Affiliation(s)
- Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta GA, USA
- Emory School of Medicine, Emory University, Atlanta GA, USA
| | - Emeli J Anderson
- Rollins School of Public Health, Emory University, Atlanta GA, USA
| | - Mohammed A Khan
- Rollins School of Public Health, Emory University, Atlanta GA, USA
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Spaulding AC, Anderson EJ, Khan MA, Taborda-Vidarte CA, Phillips JA. HIV and HCV in U.S. Prisons and Jails: The Correctional Facility as a Bellwether Over Time for the Community’s Infections. AIDS Rev 2017. [DOI: 10.24875/aidsrev.m17000006] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Schoenbachler BT, Smith BD, Seña AC, Hilton A, Bachman S, Lunda M, Spaulding AC. Hepatitis C Virus Testing and Linkage to Care in North Carolina and South Carolina Jails, 2012-2014. Public Health Rep 2017; 131 Suppl 2:98-104. [PMID: 27168668 DOI: 10.1177/00333549161310s215] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022] Open
Abstract
OBJECTIVE We evaluated a hepatitis C virus (HCV) testing and linkage-to-care post-release program among detainees of small- to medium-sized jails in North Carolina and South Carolina as part of the Hepatitis Testing and Linkage to Care initiative. METHODS An HCV testing and linkage-to-care program was implemented in selected jails in North Carolina and South Carolina from December 2012 to March 2014. Health-care workers not affiliated with the jails conducted HCV antibody (anti-HCV) and HCV ribonucleic acid (RNA) testing and linkage-to-care activities. The North Carolina jail provided universal opt-out testing for HCV; South Carolina jails initially targeted high-risk individuals before expanding to routine testing. RESULTS Of 669 detainees tested for HCV in North Carolina, 88 (13.2%) tested anti-HCV positive, of whom 81 (92.0%) received an HCV RNA test, 66 (81.5%) of whom tested HCV RNA positive (i.e., currently infected). Of the 66 detainees with current HCV infection, 18 were referred to HCV medical care post-release and 10 attended their first appointment. Of 224 detainees tested for HCV in South Carolina, 18 (8.0%) tested anti-HCV positive, of whom 13 received an HCV RNA test. Nine of 13 detainees tested HCV RNA positive, seven detainees were referred to post-release medical care, and two detainees attended their first appointment. Overall, 106 of 893 (11.9%) detainees were anti-HCV positive. CONCLUSION This study demonstrated that HCV testing, identification of infection, and linkage to care are feasible among jail populations. The rate of anti-HCV positivity was lower than that found in national studies of incarcerated populations, suggesting that HCV infection prevalence in jails may vary across U.S. states or regions.
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Affiliation(s)
| | - Bryce D Smith
- Centers for Disease Control and Prevention, Division of Viral Hepatitis, Atlanta, GA
| | - Arlene C Seña
- Durham County Department of Public Health, Durham, NC; University of North Carolina at Chapel Hill, Division of Infectious Diseases, Chapel Hill, NC
| | - Alison Hilton
- Durham County Department of Public Health, Durham, NC
| | | | | | - Anne C Spaulding
- Emory University, Rollins School of Public Health, Department of Epidemiology, Atlanta, GA; Emory University School of Medicine, Department of Medicine, Division of Infectious Diseases, Atlanta, GA
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Miller LS, Rollin F, Fluker SA, Lundberg KL, Park B, Quairoli K, Niyibizi NK, Spaulding AC. High-Yield Birth-Cohort Hepatitis C Virus Screening and Linkage to Care Among Underserved African Americans, Atlanta, Georgia, 2012-2013. Public Health Rep 2017; 131 Suppl 2:84-90. [PMID: 27168666 DOI: 10.1177/00333549161310s213] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVE Hepatitis C virus (HCV) infection disproportionately affects certain populations, including those born between 1945 and 1965 (i.e., baby boomers) and African Americans. As part of the Hepatitis Testing and Linkage to Care initiative, which promoted hepatitis B and hepatitis C screening, posttest counseling, and linkage to care at 34 U.S. sites, we conducted routine HCV screening to identify previously undiagnosed, primarily African American baby boomers with chronic hepatitis C infection and link them to care. METHODS We launched the Internal Medicine Trainees Identifying and Linking to Treatment for Hepatitis C (TILT-C) initiative at the Grady Memorial Hospital Primary Care Center and Grady Liver Clinic in Atlanta, Georgia, in October 2012, and present results from the first year. TILT-C faculty implemented an electronic medical record prompt and conducted educational sessions to boost HCV screening. A project coordinator tracked testing outcomes and linked HCV-positive patients to care. RESULTS Of 2,894 patients tested for anti-HCV, 201 (6.9%) tested positive. Men had a significantly higher (p<0.001) prevalence of HCV infection than women, with 106 of 1,091 (9.7%) men compared with 95 of 1,803 (5.3%) women testing anti-HCV positive. A total of 174 of 201 (86.6%) anti-HCV-positive patients received HCV ribonucleic acid (RNA) testing. Of 124 patients with a positive HCV RNA test, 122 were referred to care and 120 attended the first appointment. CONCLUSION The TILT-C screening program was feasible and effective in detecting previously undiagnosed HCV infection and linking patients to care. The unexpectedly high prevalence of HCV infection in this primarily African American, baby boomer population underscores the need for aggressive HCV screening efforts in similar populations.
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Affiliation(s)
- Lesley S Miller
- Emory University School of Medicine, Department of Medicine, Division of General Medicine and Geriatrics, Atlanta, GA
| | - Francois Rollin
- Emory University School of Medicine, Department of Medicine, Division of General Medicine and Geriatrics, Atlanta, GA
| | - Shelly-Ann Fluker
- Emory University School of Medicine, Department of Medicine, Division of General Medicine and Geriatrics, Atlanta, GA
| | - Kristina L Lundberg
- Emory University School of Medicine, Department of Medicine, Division of General Medicine and Geriatrics, Atlanta, GA
| | - Brandi Park
- Emory University School of Medicine, Department of Medicine, Division of General Medicine and Geriatrics, Atlanta, GA
| | - Kristi Quairoli
- Grady Health System, Department of Clinical Pharmacy, Atlanta, GA
| | | | - Anne C Spaulding
- Emory University, School of Public Health, Department of Epidemiology, Atlanta, GA
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Spaulding AC. The Missing Link: HIV, Corrections, and Public Health. Am J Public Health 2017; 107:641-642. [PMID: 28398801 DOI: 10.2105/ajph.2017.303754] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Anne C Spaulding
- Anne C. Spaulding is with the Rollins School of Public Health, Emory University, Atlanta, GA
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Kim S, Ouellet LJ, Mazza J, Spaulding AC. Rasch Analysis and Differential Item Functioning of a Social Support Measure in Jail Inmates With HIV Infection. Eval Health Prof 2016; 40:33-60. [PMID: 27150117 DOI: 10.1177/0163278716644954] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
The protective effects of social support on health have been documented in a variety of groups. For HIV-infected persons released from correctional settings, strong social support may be particularly important for obtaining effective postrelease medical treatment and supportive services. Researchers and program evaluators seeking to improve access and adherence to postrelease HIV medical care in this population need accurate measures for the level and type of social support, but current measures have not been fully validated for incarcerated individuals with HIV infection. We used the Rasch model to test the Medical Outcomes Study (MOS) social support survey. Data for the analysis were collected as part of the EnhanceLink project in the five urban jails where the MOS was administered. Findings indicate that the MOS survey items may not capture the entire variability of person abilities. Respondents showed problems in discriminating among response options, indicating potential systematic bias. In addition, while there was no significant gender difference, overall levels of social support differed by gender. Further research is warranted to develop more effective social support measurement tools that can better guide interventions for persons transitioning from jail and prison to the community.
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Affiliation(s)
- Sage Kim
- University of Illinois at Chicago, Chicago, IL, USA
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50
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Zlotorzynska M, Spaulding AC, Messina LC, Coker D, Ward K, Easley K, Baillargeon J, Mink PJ, Simard EP. Retrospective cohort study of cancer incidence and mortality by HIV status in a Georgia, USA, prisoner cohort during the HAART era. BMJ Open 2016; 6:e009778. [PMID: 27067888 PMCID: PMC4838674 DOI: 10.1136/bmjopen-2015-009778] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
OBJECTIVE Non-AIDS-defining cancers (NADCs) have emerged as significant contributors to cancer mortality and morbidity among persons living with HIV (PLWH). Because NADCs are also associated with many social and behavioural risk factors that underlie HIV, determining the extent to which each of these factors contributes to NADC risk is difficult. We examined cancer incidence and mortality among persons with a history of incarceration, because distributions of other cancer risk factors are likely similar between prisoners living with HIV and non-infected prisoners. DESIGN Registry-based retrospective cohort study. PARTICIPANTS Cohort of 22,422 persons incarcerated in Georgia, USA, prisons on 30 June 1991, and still alive in 1998. OUTCOME MEASURES Cancer incidence and mortality were assessed between 1998 and 2009, using cancer and death registry data matched to prison administrative records. Age, race and sex-adjusted standardised mortality and incidence ratios, relative to the general population, were calculated for AIDS-defining cancers, viral-associated NADCs and non-infection-associated NADCs, stratified by HIV status. RESULTS There were no significant differences in cancer mortality relative to the general population in the cohort, regardless of HIV status. In contrast, cancer incidence was elevated among the PLWH. Furthermore, incidence of viral-associated NADCs was significantly higher among PLWH versus those without HIV infection (standardised incidence ratio=6.1, 95% CI 3.0 to 11.7, p<0.001). CONCLUSIONS Among PLWH with a history of incarceration, cancer incidence was elevated relative to the general population, likely related to increased prevalence of oncogenic viral co-infections. Cancer prevention and screening programmes within prisons may help to reduce the cancer burden in this high-risk population.
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Affiliation(s)
- Maria Zlotorzynska
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Anne C Spaulding
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Lauren C Messina
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Daniella Coker
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kevin Ward
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | - Kirk Easley
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
| | | | - Pamela J Mink
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
- Division of Applied Research, Allina Health, Minneapolis, Minnesota, USA
| | - Edgar P Simard
- Rollins School of Public Health, Emory University, Atlanta, Georgia, USA
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