Clinical Manual for Management of the HIV-Infected ... - myCME.com

9–4 | Clinical Manual for Management of the HIV-Infected Adult/2006
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particularly if the facility does not allow inmates to
self-administer medications. Make arrangements
with prison authorities to provide food when
inmates are taking medications that require
administration with food.
Avoid complex regimens and regimens with large pill
burdens, if possible. Simple regimens with few pills
appear to help improve adherence.
Avoid drug-drug interactions. Some antiretroviral
medications have clinically significant interactions
with other drugs (eg, methadone, oral contraceptives,
cardiac medications, antacids). These interactions
may cause failure of either the antiretroviral drug
or the other medication, or may cause additional
toxicity. Consult an HIV specialist or pharmacologist
for information on drug interactions.
The patient should be questioned about medication
adherence at each appointment.
ART regimens need to fit into each patient's
schedule and lifestyle. This becomes a bigger issue
when the inmate is close to release. Education about
HIV management, including ART adherence,
should begin well before the inmate is discharged
back to the community.At the time of discharge
from the correctional facility, all HIV-infected
inmates should have a discharge plan that addresses:
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Housing
Health insurance
30-day supply of HIV medications
Follow-up appointments for medical care and, if
necessary, psychiatric and substance abuse care
A number of HIV education resources for inmates and
correctional health care providers are cited on Albany
Medical College’s Web site at http://www.amc.edu/
Patient/Services/HIV/HIVMedicine/index.html (go to
the section on correctional education).
Chapter contributors
Minda Hubbard, ANP-C, Research Nurse Practitioner;
Douglas G. Fish, MD, Medical Director; Sarah Walker,
MS, Correctional Education Coordinator; and Abigail
V. Gallucci, Director of HIV Education—Albany
Medical College’s Division of HIV Medicine (Upstate
Local Performance Site and Regional Resource for
Corrections, New York/New Jersey AIDS Education &
Training Center).
References
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Bartlett J, Rappaport E, Ruby W, et al. HIV in
Corrections, Correctional Medical Institute. Available
online at www.cm-institute.org/hivin.htm. Accessed
February 7, 2006.
Centers for Disease Control and Prevention. Drug
Use, HIV, and the Criminal Justice System. Available
online at www.cdc.gov/idu/facts/druguse.htm.
Accessed February 7, 2006.
DeGroot A, Cu Uvin S. HIV Infection among Women
in Prison: Considerations for Care. Infectious Diseases
in Corrections Report. Vol. 8, Issues 5 & 6; 2005.
Available online at www.idcronline.org/archives/
mayjune05/article.html. Accessed May 22, 2006.
Fischl M, Castro J, Monroid R, et al. Impact of
directly observed therapy on long-term outcomes in
HIV clinical trials. In: Program and abstracts of the
8th Conference on Retroviruses and Opportunistic
Infections; February 4-8, 2001; Chicago, IL.
Abstract 528.
Maruschak L. HIV in Prisons, 2000. Bureau of
Justice Statistics Bulletin, NCJ 196023; 2001.
Available online at www.ojp.usdoj.gov/bjs/abstract/
hivp00.htm. Accessed May 22, 2006.
Nerenberg R, Wong M, DeGroot A. HCV in
corrections: Front line or backwater? HEPP News.
Vol 5 (4); 2002. Available online at www.idcronline.
org/archives/april02/. Accessed May 22, 2006.
Nicodemus M, Paris P. Bridging the Communicable
Disease Gap: Identifying, Treating and Counseling
High Risk Inmates. HIV Education Prison Project;
August/September 2001. Accessed February 7, 2006.
Paltiel AD, Weinstein MC, Kimmel AD, et al.
Expanded screening for HIV in the United States--an
analysis of cost-effectiveness. N Engl J Med. 2005 Feb
10;352(6):586-95.
Ruby W, Tripoli L, Bartlett J, et al. HIV in
Corrections in Medical Management of HIV Infection.
Philadelphia: Lippincott, Williams & Wilkins; 2000.