Centers for Disease Control and Prevention: Public Health and Corrections Update

Article excerpt

Individuals in correctional settings often have multiple risk factors for human immunodeficiency virus (HIV), sexually transmitted diseases (STDs), viral hepatitis and tuberculosis (TB). Therefore, correctional facilities can provide an opportunity for screening, testing, treatment and prevention services, said Laurie C. Reid, public health advisor for correctional health for the Centers for Disease Control and Prevention (CDC) and moderator of a Tuesday morning CDC public health and corrections update.

The workshop began with Samantha Williams, Ph.D., a CDC research psychologist, providing an overview of the two-day Corrections and Public Health Consultation that CDC hosted in March to allow CDC staff and external stakeholders to exchange ideas, strategies and best practices on infectious disease prevention and treatment both inside and outside of correctional facilities. Williams said it opened up the discussion of how public health and corrections can better partner, even with lean resources. "It served as an opportunity for corrections subject matter experts out in the field as well as those within CDC to talk and dialog."

CDC had five goals for the consultation:

* Assist in the development of the priorities around corrections within CDC;

* Provide suggestions for continuity of care and linkages to the community;

* Create an adaptable strategy to reduce the burden of infectious diseases within correctional settings;

* Develop suggestions that can guide policies, programs and research efforts; and

* Identify models of best practice for integration in improved public health programs in corrections.

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The consultation featured several speakers who set the stage for a productive training event. There were also three breakout sessions that were organized thematically and looked at the role of public health and prevention in correctional settings, how to better integrate principles and responsibilities, and the importance of best practices and outcomes. Attendees were placed in sessions that mixed people from different areas of corrections (jails, prisons, federal corrections, etc.) so that various perspectives could be heard and captured.

Throughout the course of the consultation, participants developed several recommendations, including a suggestion from external partners that CDC should consider, acknowledge and identify expertise among correctional health staff. Other recommendations included pilot testing programs and evaluating them for effectiveness; exploring the relationship between disease risk behaviors and criminality; determining disease progression among incarcerated and released populations; increasing focus on community corrections; directing funds for correctional research and training; and establishing an office of correctional health care. Williams noted that the final meeting report will be available on the CDC Web site this fall.

Andrew Margolis, MPH, a health services research officer for the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention, Division of HIV/AIDS Prevention, spoke about HIV prevention efforts within correctional populations. Between 1998 and the present, the following efforts have been undertaken:

* HIV prevention intervention research including development of new interventions and adaptation of existing interventions;

* Jail-and prison-based HIV testing and linkage to care programs;

* Epidemiological investigation of HIV transmission within a state prison system; and

* Surveillance system to document sexual violence among prison inmates.

Margolis also gave an overview of Project START, which is an HIV, STD and hepatitis risk-reduction intervention trial. It was conducted at five sites between 1998 and 2005, and examined 522 young men being released from prison and returning to the community. …