Oral

The importance of continuity of health care between corrections and community has been increasingly recognized, including its heightened prominence in the 2008 National Commission on Correctional Health Care standards. Integrating primary healthcare with mental health care and substance abuse disorder treatment prior to release facilitates the transition into the community and should reduce recidivism. The prevalence of communicable diseases among inmates is higher than among almost any other domestic population [Greifinger, 2007]. HIV and viral hepatitis are related to injection drug use, although a substantial proportion of female inmates have sexually transmitted HIV infections. The New York City correctional system consists of eleven separate jails with an approximate daily census of 13,000 and 90,000 admissions annually. Approximately 5% of patients self-report HIV+ on arrival; however, testing in jail identifies a smaller number. Young adults in jails are at high risk for STDs, due to unprotected sex, multiple sex partners, and drug use. Notable changes with screening and treatment of sexually transmitted diseases among inmates could be an effective method of reducing the burden STIs on the correctional system. In the past three years, the NYC Department of Health and Mental Hygiene (DOHMH), which oversees medical care in this system, has managed outbreaks of Legionnaires' disease (LD), H1N1 influenza and Clostridium Difficile-associated diarrhea (CDAD). These outbreaks required multidisciplinary, multiagency collaboration to manage them effectively in this large correctional system and large metropolitan area. Management also required disparate interventions to assure proper patient care, screening for undiagnosed infected patients, and risk-reduction for new infections. This session will present how communicable diseases encountered by healthcare providers behind bars are interrelated no matter their etiology.

Session Objectives: Describe diversity of assessment and treatment among incarcerated persons. Analyze complexity of management challenges in prisons. Explain continuity of care for patient inmates between correctional systems and communit

CE Credits: Medical (CME), Health Education (CHES), Nursing (CNE), Public Health (CPH) , Masters Certified Health Education Specialist (MCHES)