MOPE722 - Poster Exhibition
HIV correctional health care in the New York State Department of Corrections and Community Supervision: a model of success
D. Fish1, S. Walker1, A. Gallucci1, G. Clifford1, C. Koenigsmann2, L. Klopf2, P. Bieganski2
1Albany Medical College, HIV Medicine, Albany, United States, 2New York State Department of Corrections and Community Supervision, Health Services, Albany, United States
Background: In many areas of the world, HIV care and treatment is sub-standard or non-existent in correctional settings, resulting in poor clinical outcomes for inmates. Over the last 20 years, the United States has had several HIV initiatives targeting correctional providers resulting in dramatic declines in AIDS-related mortality among inmates. One nationally recognized model is the New York State Department of Corrections and Community Supervision (NYSDOCCS).
Methods: To improve the care of HIV-infected inmates and decrease AIDS-related morbidity and mortality, NYSDOCCS collaborates with various institutions to improve providers' HIV clinical knowledge and treatment skills. One successful partnership began in the early 1990s between Albany Medical College and the NYSDOCCS. Funded by a unique public/private partnership, including a federal grant under the Health Resources and Services Administration HIV/AIDS Bureau called the New York/New Jersey AIDS Education and Training Center, the initiative includes a variety of discipline-specific trainings and technology-based training formats. These trainings have reached providers in the United States including Puerto Rico, Canada and Mexico with over 15,000 providers participating to date.
Results: The provision of intensive HIV clinical education has given providers an increased knowledge base and skill set to properly care for and treat HIV-infected inmates. The training and support provided to the NYSDOCCS has improved access to all FDA-approved HIV medications and resulted in significant declines in inmate mortality. Training priorities include antiretroviral therapy updates, adherence, treatment sequencing and drug interactions with the goal of improving providers' prescribing practices and implementation of clinical guidelines. These variables contribute to the dramatic declines in HIV mortality observed in Table 1 and 2.
Conclusions: There are victories in HIV correctional health care in the United States. Challenges, program models and quality improvement strategies should be shared.
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