The 130th Annual Meeting of APHA

Abstract #44325

David C. Perlman, MD¹, Veronika Schoeb, MHA², Ann Nugent, BA², Leslie Horn, MPH², Patricia Friedmann, MS², and Don C. Des Jarlais, PhD². (1) Department of Medicine, Beth Israel Medical Center/Albert Einstein College of Medicine, First Avenue at 16th St., New York, NY 10003, 212-420-4470, dperlman@bethisraelny.org, (2) Department of Medicine, Beth Israel Medical Center, Milton and Carroll Petrie Division, First Avenue at 16th Street, New York, NY 10003

Introduction: Syringe exchange programs (SEPs) have proven to be valuable sites for tuberculin skin testing among active IDUs, and onsite delivery of tuberculosis (TB) preventive therapy at SEPs has been promising. Drug users have a high prevalence of TB infection, and the rates increase with age and years of drug use. Retention of IDUs in SEPs is incompletely characterized. Whether tuberculin-negative IDUs can be engaged in serial TB skin testing (TST) at SEPs is unknown. Methods: Tuberculin-negative IDUs at a storefront SEP in New York City were offered serial testing at 6-month intervals with a $20 incentive contingent on adherence. Reminder systems included a sticker placed on their SEP-identification cards, and either a letter or a phone call one month prior to their scheduled return date. Results: 154 tuberculin-negative IDUs (37% female, 44% Non-Hispanic white, mean age: 40) agreed to return in six months for a TST. 67 (44%) returned for a second TST (range: 2 - 25 months), 42/154 (27%) returned on schedule (5 - 7 months). 35/53 (66%) IDUs with a third negative TST returned again, 25/53 (47%) within the expected timeframe. 19/42 tuberculin-negative IDUs (45%) returned for a fourth skin test, 15/42 (36%) between 5 - 7 months. Conclusions: With a modest incentive and simple reminder system, some IDUs can be retained in serial TB testing. Efforts to characterize factors associated with non-retention including examinations of the relationship between TST- and SEP-retention are needed. However, further interventions to increase retention in serial TST at SEPs may be appropriate.

Learning Objectives:

At the conclusion of the session, the participants will be able to
• evaluate the retention to serial tuberculosis skin testing for drug users at a syringe exchange and
• examine the factors associated with non-retention.

Keywords: Adherence, Syringe Exchange

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.