Prisoners with HIV/AIDS and TB/MDR-TB: the epidemic within the epidemic. Analysis, demographics and treatment access in New York state corrections facilities.

Important note: Information in this article was accurate in 1992. The state of the art may have changed since the publication date.

Prisoners with HIV/AIDS and TB/MDR-TB: the epidemic within the epidemic. Analysis, demographics and treatment access in New York state corrections facilities.

Int Conf AIDS. 1992 Jul 19-24;8(1):Mo12 (abstract no. MoD 0036). Unique Identifier : AIDSLINE ICA8/92399995
Machon SC; Correctional Assoc. of NY/ACT U.

Abstract: ISSUE/PROBLEM: The rapid escalation of HIV caseload in jails and prisons has also been accompanied by an even faster escalating number of diagnosed cases of TB. In addition is the number of mortalities linked to MDR-TB for the HIV infected, which approaches 100%. In NY State, and particularly NY City, the open door between the homeless, mentally impaired and the incarcerated is a direct conduit for the transmission of TB and MDR-TB. Within the burgeoning caseload of those living with HIV in these populations is a health care delivery system which is fragmented and ill-equipped with the reality of what is occurring. In addition security practices within the corrections system of NY City and State aid and abet the spread of TB and MDR-TB. It is through jails, prisons, and shelters for the homeless that the vector for wide-spread TB transmission is apparent. DESCRIPTION OF PROJECT: Assessment, analysis and identification of governmental systems affecting the homeless, the mentally impaired, and the incarcerated, as well as the demographics of TB and MDR-TB. RESULTS: The transmission of TB and MDR-TB and its link to HIV has become institutionalized within NY City and State systems for the homeless, mentally impaired and the incarcerated. The epidemic of TB and MDR-TB within the epidemic of HIV for those institutionalized has been assisted by a security and health care delivery system unable to cope with the enormity of the problem. LESSONS: New avenues and approaches for institutionalization and attendant health care delivery must be implemented to arrest the transmission of TB, MDR-TB and HIV.

Keywords: Comorbidity *Delivery of Health Care *Disease Outbreaks *Disease Reservoirs *Government Agencies *Homeless Persons Human HIV Infections/COMPLICATIONS/*EPIDEMIOLOGY/TRANSMISSION *Institutionalization Mental Disorders/COMPLICATIONS New York/EPIDEMIOLOGY New York City/EPIDEMIOLOGY Opportunistic Infections/COMPLICATIONS/*EPIDEMIOLOGY *Prisoners Social Control, Formal Tuberculosis/COMPLICATIONS/*EPIDEMIOLOGY/TRANSMISSION ABSTRACT
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