The Herald & Review reported that the Illinois Department of Corrections (IDOC) recently approved use of the highly touted hepatitis C treatment drug Sovaldi. Officials estimate the state’s prison system houses between 2,500–3,750 infected inmates, but they have yet to determine the number to be treated. IDOC must review each infected inmate’s case individually based on the severity of the disease and the length of their sentence.
The cost of treatment, estimated to reach $61,000–$122,000, is causing controversy at a time of state budget cuts that have caused Illinois correctional officials to consider releasing up to 15,500 inmates. "Please keep in mind it is impossible to say how many inmates will be treated in a particular way or with a particular drug," said IDOC SpokespersonTom Shaer. "IDOC has decided, yes, these drugs will be used, when appropriate. We cannot determine the extent to which they will be used."
The current treatment for inmates with HIV and hepatitis C costs approximately $8 million. The estimated cost of treating only one-third of hepatitis C-infected inmates with Sovaldi is $61 million. Supporters of using Sovaldi, which in clinical studies has shown to have a 95-percent cure rate, argue that if inmates are not treated, then they can spread the disease both in prison during their stay, and out of prison upon release. "It's a looming problem for all of healthcare," said state Rep. Greg Harris (D-Chicago). "It's something we're going to have to confront."
Medical Xpress reported on a study of computerized counseling to help HIV-positive individuals achieve suppressed viral load through adherence to their antiretroviral therapy (ART) regimen and to reduce transmission risk behaviors. Researchers from New York University’s (NYU) Center for Drug Use and HIV Research at NYU College of Nursing (NYUCN), used a computerized counseling intervention called Computer Assessment & Rx Education (CARE+)—a .Net-based custom software with intervention content—to provide ART support.
Professor Ann Kurth, PhD, executive director of NYUCN Global and associate dean for research at NYU’s Global Institute of Public Health, explained that CARE+ uses evidence-based elements proven to improve ART adherence or decrease sexual risk and provides personalized printouts with feedback, health plans, and referral telephone numbers.
The study investigated the effectiveness of the program made specifically to support patients in positive behavioral change. The researchers randomly separated the 240 participants into two groups: one group received the CARE+ intervention and the other received a computer questionnaire. The program focused on the participants’ confidence, motivations, and knowledge and how behaviors affect adherence and transmission risk.
Results show that after nine months, participants in the CARE+ intervention experienced a decrease in HIV viral load, improved ART adherence, and reduction in the odds of transmission risk. Also, the majority of participants expressed increased confidence in the health behavior plan’s success, found the tool easy to use, and felt the computer session was as helpful as or more so than personal counseling with a staff member.
The full report, “Computerized Counseling Reduces HIV-1 Viral Load and Sexual Transmission Risk: Findings from a Randomized Controlled Trial,” was published in the Journal of Acquired Immune Deficiency Syndromes (2014; 65(5): 611–620).
The Desert Sun reported that as part of a large HIV testing campaign, California’s Desert Regional Medical Center will begin to offer HIV testing to inpatients who visit the emergency room (ER) for follow-up care. The campaign, Get Tested Coachella Valley, hopes to make HIV testing more routine in all medical institutions, as well as reduce the stigma of getting tested.
The stigma that thwarts people from seeking a test also prevents them from receiving treatment. Officials estimate that 67 percent of valley residents have never been tested, even though the region has an HIV prevalence of double the national average.
“When you think about the alternative, that somebody would’ve come to a hospital and let’s say they have pneumonia or have symptoms that could be a symptom of HIV and no one ever offered an HIV test, what a tremendous disservice that would be, what a tremendous oversight,” said Susan Unger, project director of Get Tested Coachella Valley. “Unfortunately, that’s been the reality up until now,” she added.
Desert Regional is the first hospital to offer HIV testing in its ER as part of the three-year campaign. The hospital pledged $1.5 million to support the campaign, which started last November and will be rolled out in stages.
Lebanon Daily News reported that April is Sexually Transmitted Infection (STI) Awareness Month and although STIs such as herpes, chlamydia, and HIV are better known, trichomoniasis is less familiar to individuals. According to CDC, 2.3 million women ages 14–49 are infected with the disease in the United States, with 85 percent of them reporting no symptoms. Trichomoniasis is a sexually transmitted protozoan parasite that often infects the vulva, vagina, and urethra. As with many other STIs, detection and treatment are important to prevent complications such as the possibility of delivering pre-term babies, which often results in low birth-weight infants. Lebanon Family Health Services in Lebanon, Penn., offers free and confidential testing for trichomoniasis and other STIs on a daily basis along with onsite treatment. Call (717) 273–6741 for an appointment or visit the walk-in clinic on Fridays from 8:00 a.m. to 3:00 p.m.
KUAM News reported that Sen. Brant McCreadie (R-Agana Heights) has written a letter of concern to Guam’s Department of Corrections (DOC) and Department of Health regarding possible TB exposure of families and individuals outside of the Mangilao Correctional Compound as a result of screening for the disease at the compound. The senator is requesting that Guam’s public health department offer free TB screening for those who may have been exposed. However, TB Program Administrator Cecilia Arciaga said that outside testing is not needed, as the program uses a “consecutive circle” testing approach where they test the inner circle of contacts and if they find significant numbers of individuals with positive skin tests, then they expand their contact investigation. DOC Spokesperson Jeff Limo said that DOC Director Jose San Agustin endorses the safety measure suggested by the senator, but the department’s current primary focus is completing the baseline screening within the DOC.
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