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. 2024 Jan 6;3(2):100185.
doi: 10.1016/j.focus.2024.100185. eCollection 2024 Apr.

Treating Hepatitis C Virus Infection in Jails as an Offset to Declines in Treatment Activity in the Community, New York City, NY, 2014-2020

Justin Chan  1   2 , Matthew J Akiyama  3   4 , Emily Julian  3 , Rodrigue Joseph  3 , Wendy McGahee  3 , Zachary Rosner  2   3 , Patricia Yang  3 , Ross MacDonald  2   5
Affiliations

Treating Hepatitis C Virus Infection in Jails as an Offset to Declines in Treatment Activity in the Community, New York City, NY, 2014-2020

Justin Chan et al. AJPM Focus. .

Abstract

Introduction: There are scant data on implementation of large-scale direct-acting antiviral treatment for hepatitis C virus in jails in the U.S. New York City Health + Hospitals/Correctional Health Services aimed to scale up hepatitis C virus treatment in the New York City jail system. This study describes the trends in annual hepatitis C virus treatment in New York City jails compared with those in Medicaid-funded treatment in the New York City community from 2014 to 2020.

Methods: In this observational study, we extracted annual counts of direct-acting antiviral prescriptions for hepatitis C virus for those (1) in the New York City community who were covered by Medicaid and (2) those detained in New York City jails for 2014-2020. Data sources were New York City Department of Health and Mental Hygiene annual reports and Correctional Health Services treatment records, respectively. We used linear regression analysis to test for significant trends in annual treatment in these 2 cohorts during 2015-2019.

Results: From 2015 to 2019, treatments started in New York City jails increased annually (p=0.001), whereas Medicaid-funded prescriptions in the New York City community declined since a peak in 2015 (p<0.001). In 2019, New York City jail-based treatment initiations totaled the equivalent of 10% of treatment covered by Medicaid in New York City, up from 0.3% in 2015.

Conclusions: Scale up of jail-based hepatitis C virus treatment is an important strategy to offset declines observed in the community. Addressing barriers to care in jail, such as improving testing, linkage to care, and affordability of direct-acting antivirals for jail-based health services, can help sustain high levels of treatment in U.S. jails and other carceral facilities.

Keywords: Hepatitis C; direct-acting antiviral; jails.

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Graphical abstract
Figure 1
Figure 1
Annual number of people prescribed direct-acting antiviral HCV treatment (A) among people covered by Medicaid in New York City from 2014 to 2020, and (B) among people detained in New York City jails from 2014 to 2020. Source: New York City Department of Health and Mental Hygiene. The tallies for Medicaid-funded treatment do not include treatment in jail because Medicaid coverage is suspended for those who are incarcerated. HCV, hepatitis C virus.
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