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HIV treatment and care among Italian inmates: a one-month point survey

BACKGROUND: HIV infection, with an estimated prevalence be between 2 and 50 times those of the general adult population is a major health challenge for prison authorities worldwide. Since no nationwide surveillance system is present in Italy, data on HIV prevalence and treatment in prisons are limit...

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Autores principales: Monarca, R., Madeddu, G., Ranieri, R., Carbonara, S., Leo, G., Sardo, M., Choroma, F., Casari, S., Marri, D., Muredda, A. A., Nava, F. A., Babudieri, S.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676105/
https://www.ncbi.nlm.nih.gov/pubmed/26653247
http://dx.doi.org/10.1186/s12879-015-1301-5
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author Monarca, R.
Madeddu, G.
Ranieri, R.
Carbonara, S.
Leo, G.
Sardo, M.
Choroma, F.
Casari, S.
Marri, D.
Muredda, A. A.
Nava, F. A.
Babudieri, S.
author_facet Monarca, R.
Madeddu, G.
Ranieri, R.
Carbonara, S.
Leo, G.
Sardo, M.
Choroma, F.
Casari, S.
Marri, D.
Muredda, A. A.
Nava, F. A.
Babudieri, S.
author_sort Monarca, R.
collection PubMed
description BACKGROUND: HIV infection, with an estimated prevalence be between 2 and 50 times those of the general adult population is a major health challenge for prison authorities worldwide. Since no nationwide surveillance system is present in Italy, data on HIV prevalence and treatment in prisons are limited to only a few and small observational studies. We aimed to estimate HIV prevalence and obtain an overview on diagnostic and therapeutic activities concerning HIV infection in the Italian penitentiary system. METHODS: We piloted a multi-centre cross-sectional study investigating the prevalence of HIV infection and assessing HIV-related medical activities in Italian correctional institutions. RESULTS: A total of 15,675 prisoners from 25 institutions, accounting for approximately one-fourth of the prison inmates in Italy, were included in the study, of whom, 97.7 % were males, 37.1 % foreigners and 27 % had a history of intravenous drug addiction. HIV-tests were available in 42.3 % of the total population, with a known HIV Infection proportion of 5.1 %. In the month prior to the study, 604 of the 1,764 subjects who entered prison were tested for HIV, with a HIV-positive prevalence of 3.3 %. Among the 338 HIV-positive prisoners, 81.4 % were under antiretroviral treatment and 73.5 % showed undetectable HIV-RNA. In 23/338 (6.8 %) a coinfection with HBV and in 189/338 (55.9 %) with HCV was also present. Among the 67 (19.8 %) inmates with HIV who did not receive HIV treatment, 13 (19.5 %) had T-CD4+ count <350 cells/mm(3) and 9 (69.2 %) of these had refused the treatment. The majority of the inmates with HIV-infection were on a PI-based (62.5 %) or on NNRTIs-based (24.4 %) regimen. Only a minority of patients received once daily regimens (17.2 %). CONCLUSIONS: Although clinical and therapeutic management of HIV infection remains difficult in Italian prisons, diagnostics, treatment and care were offered to the majority of HIV-infected inmates. Specific programs should be directed towards the prison population and strict cooperation between prison and health institutions is needed to increase HIV treatment.
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spelling pubmed-46761052015-12-12 HIV treatment and care among Italian inmates: a one-month point survey Monarca, R. Madeddu, G. Ranieri, R. Carbonara, S. Leo, G. Sardo, M. Choroma, F. Casari, S. Marri, D. Muredda, A. A. Nava, F. A. Babudieri, S. BMC Infect Dis Research Article BACKGROUND: HIV infection, with an estimated prevalence be between 2 and 50 times those of the general adult population is a major health challenge for prison authorities worldwide. Since no nationwide surveillance system is present in Italy, data on HIV prevalence and treatment in prisons are limited to only a few and small observational studies. We aimed to estimate HIV prevalence and obtain an overview on diagnostic and therapeutic activities concerning HIV infection in the Italian penitentiary system. METHODS: We piloted a multi-centre cross-sectional study investigating the prevalence of HIV infection and assessing HIV-related medical activities in Italian correctional institutions. RESULTS: A total of 15,675 prisoners from 25 institutions, accounting for approximately one-fourth of the prison inmates in Italy, were included in the study, of whom, 97.7 % were males, 37.1 % foreigners and 27 % had a history of intravenous drug addiction. HIV-tests were available in 42.3 % of the total population, with a known HIV Infection proportion of 5.1 %. In the month prior to the study, 604 of the 1,764 subjects who entered prison were tested for HIV, with a HIV-positive prevalence of 3.3 %. Among the 338 HIV-positive prisoners, 81.4 % were under antiretroviral treatment and 73.5 % showed undetectable HIV-RNA. In 23/338 (6.8 %) a coinfection with HBV and in 189/338 (55.9 %) with HCV was also present. Among the 67 (19.8 %) inmates with HIV who did not receive HIV treatment, 13 (19.5 %) had T-CD4+ count <350 cells/mm(3) and 9 (69.2 %) of these had refused the treatment. The majority of the inmates with HIV-infection were on a PI-based (62.5 %) or on NNRTIs-based (24.4 %) regimen. Only a minority of patients received once daily regimens (17.2 %). CONCLUSIONS: Although clinical and therapeutic management of HIV infection remains difficult in Italian prisons, diagnostics, treatment and care were offered to the majority of HIV-infected inmates. Specific programs should be directed towards the prison population and strict cooperation between prison and health institutions is needed to increase HIV treatment. BioMed Central 2015-12-10 /pmc/articles/PMC4676105/ /pubmed/26653247 http://dx.doi.org/10.1186/s12879-015-1301-5 Text en © Monarca et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Monarca, R.
Madeddu, G.
Ranieri, R.
Carbonara, S.
Leo, G.
Sardo, M.
Choroma, F.
Casari, S.
Marri, D.
Muredda, A. A.
Nava, F. A.
Babudieri, S.
HIV treatment and care among Italian inmates: a one-month point survey
title HIV treatment and care among Italian inmates: a one-month point survey
title_full HIV treatment and care among Italian inmates: a one-month point survey
title_fullStr HIV treatment and care among Italian inmates: a one-month point survey
title_full_unstemmed HIV treatment and care among Italian inmates: a one-month point survey
title_short HIV treatment and care among Italian inmates: a one-month point survey
title_sort hiv treatment and care among italian inmates: a one-month point survey
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4676105/
https://www.ncbi.nlm.nih.gov/pubmed/26653247
http://dx.doi.org/10.1186/s12879-015-1301-5
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