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CDC HIV & Hepatitis C Screening & Services Guidelines / Recommendations - IDUs Highlighted
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Download the PDF here
November 9, 2012
guidelines or recommendations for the prevention and control of HIV infection, viral hepatitis, STDs, and TB for persons who use drugs illicitly
"All persons who use or inject drugs illicitly should routinely be offered screening and counseling for HCV infection. Persons with a history of risk, even those who have injected illicitly once or many years ago, should be offered screening and counseling for HCV infection. Facilities that provide counseling and testing should include services or referrals for medical evaluation and management of persons identified as infected with HCV."
"The 12 science-based public health strategies are as follows: 1) prevention and treatment of substance use and mental disorders; 2) outreach programs; 3) risk assessment for illicit use of drugs; 4) risk assessment for HIV infection, viral hepatitis, STDs, and TB; 5) screening, diagnosis, and counseling for HIV infection, viral hepatitis, STDs, and TB; 6) vaccination; 7) prevention of mother-to-child transmission of HIV infection, viral hepatitis, and STDs; 8) interventions for reduction of risk behaviors; 9) partner services and contact follow-up; 10) referrals and linkage to care; 11) medical treatment for HIV infection, viral hepatitis, STDs, and TB; and 12) delivery of integrated prevention services."
"Persons who use drugs illicitly can benefit from comprehensive (or at least combination) services that meet their individual clinical needs or community needs. They can be expected to benefit from synergy among services that are delivered jointly at the service delivery level as integrated services........seamless services from multiple programs or areas within programs without repeated registration procedures, waiting periods, or other administrative barriers........Persons who use drugs illicitly and who are identified to be infected with HIV, viral hepatitis, STDs, or TB should be referred and linked actively to medical care......Health-care providers might have negative perceptions of persons who use drugs illicitly.......Researchers have formulated 13 principles for managing health-care relationships with users of heroin and cocaine (332,428). Although these principles were developed specifically for HCV treatment.........develop a personal plan that includes meetings with case managers to acquire needed resources........health-care visits accompanied by a linkage coordinator or case manager......Linkage-to-care approaches are effective in improving health-care outcomes........Supportive strategies or incentives can be helpful in increasing adherence and linkage to care, e.g., co-location of services, deployment of outreach workers, peer navigators, monetary incentives, and motivational enhancements........Persons who use drugs illicitly need to receive appropriate treatment for infectious diseases and relevant health education messages from trained personnel. An infected person who receives a diagnosis of HIV infection, viral hepatitis, STDs, or TB should be referred to care providers and receive primary medical care and evaluation for progression of infection to disease, as well as treatment. In addition, infected persons need to be provided with counseling and guidance on how to stay healthy and prevent disease progression."
"The recommendations and guidelines of CDC, NIDA, SAMHSA, AHRQ, and the U.S. Preventive Services Task Force (USPSTF) for these science-based public health strategies are consistent across the agencies for this high-risk population, i.e., persons who use drugs illicitly. CDC's recommendations address prevention and treatment of HIV infection, viral hepatitis, STDs, and TB. The guidelines of NIDA and SAMHSA are for prevention and treatment of substance use and mental disorders. The Advisory Committee on Immunization Practices and CDC issued the vaccination recommendations. The recommendations for screening or testing of persons who use drugs illicitly for HIV infection, viral hepatitis, STDs, and TB made by AHRQ and the U.S. Preventative Services Task Force are consistent with those of CDC."
MMWR Recommendations and Reports
November 9, 2012 / Vol. 61 / No. RR-5
Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly: Summary Guidance from CDC and the U.S. Department of Health and Human Services
This report summarizes current (as of 2011) guidelines or recommendations published by multiple agencies of the U.S. Department of Health and Human Services for prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) for persons who use drugs illicitly. It also summarizes existing evidence of effectiveness for practices to support delivery of integrated prevention services for such persons. Consolidated guidance can strengthen efforts of health-care providers and public health providers to prevent and treat infectious diseases and disorders, use resources efficiently, and improve health care and outcomes in persons who use drugs illicitly.
Integrated Prevention Services for HIV Infection, Viral Hepatitis, Sexually Transmitted Diseases, and Tuberculosis for Persons Who Use Drugs Illicitly: Summary Guidance from CDC and the U.S. Department of Health and Human Services
Recommendations and Reports
November 9, 2012 / 61(rr05);1-40
Summary
This report summarizes current (as of 2011) guidelines or recommendations published by multiple agencies of the U.S. Department of Health and Human Services (DHHS) for prevention and control of human immunodeficiency virus (HIV) infection, viral hepatitis, sexually transmitted diseases (STDs), and tuberculosis (TB) for persons who use drugs illicitly. It also summarizes existing evidence of effectiveness for practices to support delivery of integrated prevention services. Implementing integrated services for prevention of HIV infection, viral hepatitis, STDs, and TB is intended to provide persons who use drugs illicitly with increased access to services, to improve timeliness of service delivery, and to increase effectiveness of efforts to prevent infectious diseases that share common risk factors, behaviors, and social determinants. This guidance is intended for use by decision makers (e.g., local and federal agencies and leaders and managers of prevention and treatment services), health-care providers, social service providers, and prevention and treatment support groups. Consolidated guidance can strengthen efforts of health-care providers and public health providers to prevent and treat infectious diseases and substance use and mental disorders, use resources efficiently, and improve health-care services and outcomes in persons who use drugs illicitly.
An integrated approach to service delivery for persons who use drugs incorporates recommended science-based public health strategies, including 1) prevention and treatment of substance use and mental disorders; 2) outreach programs; 3) risk assessment for illicit use of drugs; 4) risk assessment for infectious diseases; 5) screening, diagnosis, and counseling for infectious diseases; 6) vaccination; 7) prevention of mother-to-child transmission of infectious diseases; 8) interventions for reduction of risk behaviors; 9) partner services and contact follow-up; 10) referrals and linkage to care; 11) medical treatment for infectious diseases; and 12) delivery of integrated prevention services. These strategies are science-based, public health strategies to prevent and treat infectious diseases, substance use disorders, and mental disorders. Treatment of infectious diseases and treatment of substance use and mental disorders contribute to prevention of transmission of infectious diseases. Integrating prevention services can increase access to and timeliness of prevention and treatment.
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