Infectious disorders drug targets 2017 05 17() doi 10.2174/1871526517666170518093529
To evaluate the feasibility of the revised "Clinical Guideline for HIV and TB" in the Great Tehran Prison during October 2013 to June 2014.
The guideline includes all aspects of HIV/TB diagnosis based on active case finding (ACF), treatment and care services. Before the implementation, a focus group discussion was conducted, and attended by experts on jail diseases. The objective was to identify defects and limitations of the guideline. After the discussion, the guideline was revised. The Great Tehran Prison contains three separate units. All prisoners are taken first to "reception and identification unit (quarantine)" and then send to two housing units according to their legal status. An HIV ACF strategy was employed in the quarantine, and two units through a voluntary provider-initiated HIV testing. Three staffs of the triangular clinic trained the prisoners about common routes of HIV transmission and the symptoms of TB in the units. In the quarantine, all prisoners were examined for HIV-risk factors and symptoms of TB, and offered HIV testing. In unit one, healthcare staff continued the ACF process, while in unit two, the trained prisoners were assigned as the healthcare communicators to proceed the strategy. When the test result was positive, then the process of care, treatment and follow ups were initiated. Also, the use of directly observed therapy (DOTs) for antiretroviral therapy (ART) and TB was initiated. There was a follow up for released prisoner to refer them to care and treatment services outside the prison.
The guideline was implemented in the prison successfully.
Regarding feasibility of the guideline, the investigators suggest that the guideline to be implemented in other prisons across the country.