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Revision and Implementation of “Clinical Guideline for Tuberculosis and HIV in Prisons”, Great Tehran Prison, Iran

[ Vol. 18 , Issue. 1 ]

Author(s):

Behnam Farhoudi, SeyedAhmad SeyedAlinaghi*, Payam Tabarsi, Minoo Mohraz, Raheleh Golrokhy, Marzieh Farnia, Mohammad Shahbazi, Ramin Alasvand, Bahman Ebrahimi, Jafar Esfehani and Mehrzad Tashakoriyan   Pages 72 - 80 ( 9 )

Abstract:


Aim: To evaluate the feasibility of the revised “Clinical Guideline for HIV and TB” in the Great Tehran Prison during October 2013 to June 2014.

Methods: 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 prison health. 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 staff 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 all HIV-risk factors, HIV testing and symptoms of TB. In unit one, healthcare staff continued the ACF process, while in unit two, the peers of prisoners were assigned as the healthcare communicators to proceed with the strategy. At this caring process, when the test result was positive, then the process of care, treatment and follow ups was initiated. Moreover, the use of directly observed therapy (DOT) for antiretroviral therapy (ART) and TB was applied to the sick prisoners. There was also a follow-up caring for released prisoner to refer them to care and treatment services outside the prison.

Results: The guideline was implemented in the prison successfully.

Conclusion: Regarding feasibility of the guideline, the investigators of this study suggest that the guideline should be implemented in other prisons across the country.

Keywords:

HIV, TB, prison, guideline, implementation, revision.

Affiliation:

Clinical Research Development Center, Amir-Almomenin Hospital, Tehran Medical Sciences Branch, Islamic Azad University, Tehran, Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Clinical Tuberculosis and Epidemiology Research Center, National Research Institute of Tuberculosis and Lung Diseases (NRITLD), Shahid Beheshti University of Medical Sciences, Tehran, Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Health and Treatment Office of Iranian Prisons Organization, Tehran, United Nations Development Program, Prisons Organization, Tehran, Health and Treatment Office of Iranian Prisons Organization, Tehran, Health and Treatment Office of Iranian Prisons Organization, Tehran, Health and Treatment Office of Iranian Prisons Organization, Tehran, Health and Treatment Office of Iranian Prisons Organization, Tehran

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