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Integrating hepatitis, STD, and HIV services into a drug rehabilitation program
Robert A Gunn1, Marjorie A Lee, David B Callahan
1Division of STD Prevention, National Center for HIV, STD and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. Robert.gunn@sdcounty.ca.gov
American Journal of Preventive Medicine
|June 17, 2005
Summary
Integrating hepatitis B and C virus (HBV/HCV) screening and vaccination into drug rehabilitation programs is effective. These programs efficiently reach high-risk individuals, expanding vital public health services.
Area of Science:
- Public Health
- Infectious Disease Prevention
- Substance Abuse Treatment
Background:
- Challenges exist in providing screening and vaccination for inmates in short-stay facilities.
- An evaluation focused on integrating prevention services within an alternative sentencing drug rehabilitation program in San Diego, CA.
Purpose of the Study:
- To assess the feasibility and effectiveness of integrating hepatitis B virus (HBV) vaccination, HBV/hepatitis C virus (HCV) testing, STD screening, and HIV counseling into a drug rehabilitation program.
- To determine the uptake and outcomes of these integrated services.
Main Methods:
- Clients in an alternative to incarceration program (April 1999-December 2002) completed risk assessments.
- Offered HBV vaccination, HBV/HCV serologic testing, STD screening, and HIV counseling/testing.
Main Results:
- 83% of 1125 enrollees participated; 98% received the first dose of HBV vaccine, 42% completed the series.
- Prevalence of prior HBV infection was 11%, HCV was 14.7% (highest in injection drug users), HIV was 0.3%, and STDs were uncommon.
- Integrated services cost $122 per client annually (excluding HIV testing).
Conclusions:
- Alternative sentencing drug rehabilitation programs are efficient venues for delivering integrated hepatitis and other prevention services.
- These programs offer a significant opportunity to expand hepatitis services to high-risk populations in drug rehabilitation and release programs.