Infectious disease surveillance in U.S. jails: Findings from a national survey

Abstract

While infectious diseases (ID) are a well-documented public health issue in carceral settings, research on ID screening and treatment in jails is lacking. A survey was sent to 1,126 jails in the United States to identify the prevalence of health screenings at intake and characteristics of care for ID; 371 surveys were completed correctly and analyzed. Despite conflicting Centers for Disease Control (CDC) guidance, only seven percent of surveyed jails test individuals for HIV at admission. In 46% of jails, non-healthcare personnel perform ID screenings. Jails in less urban areas were more likely to report healthcare screenings performed by correctional officers. Survey findings indicate that HIV, HCV and TB testing during jail admissions and access to PrEP are severely lacking in less urban jails in particular. Recommendations are provided to improve ID surveillance and address the burden of ID in correctional facilities.

Treating Hepatitis C Virus Infection in Jails as an Offset to Declines in Treatment Activity in the Community, New York City, NY, 2014–2020

“…Although public health guidelines 18 now recommend routine opt-out HCV testing in jails, few carceral facilities offer routine testing. 19 Given the rapid turnover of patients in jail systems, incorporating accurate point-of-care HCV viral load testing 20 could improve the efficiency of diagnosing active infection and potentially facilitate earlier initiation of treatment during a jail stay. Although Medicaid coverage remains suspended during incarceration, DAA drug prices in the U.S. are expensive for many jail systems that rely on local funding.…”

A Prospective Study of Injection Drug Use and Jail Readmission in Two Western North Carolina Counties

“…Infectious disease screening is a clear option for identifying those who may be at risk for these conditions. The CDC recommends opt-out screening upon admission to jail [36,37]; however, surveys show only 7%-35% of facilities have adopted these practices [38]. Rapid opt-out testing is feasible in jails [39,40], and this approach has been used effectively to identify new diagnoses at the time of admission [41], but more work is needed to determine how these practices can be implemented in small rural facilities in North Carolina.…”

Evaluation of 2022 Nursing Intake Forms from Massachusetts Jails: Content Analysis and Accuracy Assessment

“…People who are detained and incarcerated in criminal-legal settings face barriers to quality healthcare and have higher rates of infectious diseases, mental illness, and cardiovascular disease (Ahalt et al, 2013; Camplain et al, 2021; Dumont, 2013; Dumont et al, 2012; Freudenberg & Heller, 2016; Johnson et al, 2013; Massoglia et al, 2014). In order to facilitate continuity of care and offer preventative care, there is a medical intake process in most carceral settings where the person who is being detained interacts with a nurse or other member of the jail staff to review medical history, active medical treatments, and screen for psychiatric illness (Anno, 2001; Maner et al, 2022; Ndeffo-Mbah et al, 2018). This information is collected using a questionnaire, or medical intake form.…”

“…This information is collected using a questionnaire, or medical intake form. Medical intake forms are completed almost universally across U.S. jails, prisons, and detention centers, although there is variability about who asks the questions and what questions are asked (Carda-Auten et al, 2022; Maner et al, 2022). Beyond asking about medical history, the CDC Infectious Diseases Corrections 2022 guidelines recommend that medical intake form should include offering services, including evaluation for HIV, hepatitis, tuberculosis, gonorrhea, chlamydia, and syphilis (CDC, 2022b).…”