HIV and Mass Incarceration: Where Infectious Diseases and Social Justice Meet

More than 1% of all adults in the United States are currently in a jail or prison. This mass incarceration, particularly of African American men, fosters conditions that facilitate the spread of HIV in communities where both HIV and incarceration are endemic. Recognition of the role of mass incarceration in the perpetuation of the HIV epidemic is essential to development of effective HIV prevention policies

Screening of genital fluid for Ebola virus

Moses Soka and colleagues (October, 2016)1 describe their semen testing programme for survivors of Ebola virus disease. This programme provides an important service to male survivors of this disease in Liberia; however, we are concerned that the real-time RT-PCR assay used might not be validated for the detection of Ebola virus in semen. Although the assay was granted emergency use authorisation by the US Food and Drug Administration for the detection of Ebola virus RNA in blood, plasma, serum, and urine, Soka and colleagues do not include supporting data for the use of this assay with semen

Inadequate HIV care after incarceration: case closed

At any given moment, one in 99 adults in the USA are behind bars in prisons and jails, often for offenses related to the use or sale of illicit substances.1 This mass incarceration overwhelmingly affects racial and ethnic minority men; the lifetime risk of incarceration is more than 30% for African-American men, compared with 17% for white men.2 Drug laws that strictly penalise the possession, use, and sale of illicit substances, and the less overt targeting of minorities for search and arrest, have led to people with HIV infection also being disproportionately incarcerated

Moving Lassa Fever Research and Care into the 21st Century

Lassa fever, a viral hemorrhagic disease, is a growing threat to public health in West Africa and beyond. While Ebola virus disease (EVD) recently captured the attention of the global community, Lassa fever arguably represents an even more concerning cause of viral hemorrhagic fever (VHF). Unlike EVD, which causes sporadic outbreaks, Lassa virus (LASV) is endemic in West Africa and is responsible for an estimated 300 000 infections and >5000 deaths annually—figures that are likely underestimates, given the challenge of collecting epidemiologic data due to civil conflict and limited clinical research infrastructure in endemic countries

Responding to the global threat of high-consequence pathogens: Protecting health care workers and caring for patients

In the 40 years since the discovery of the Ebola virus, there have been 24 outbreaks, none of which has ever infected more than 450 people at a time (1). The 2014 to 2016 epidemic, which spread quickly across West Africa, infected more than 28,000 people and killed at least 11,000, quickly eclipsing all previous outbreaks combined. What was initially believed to be an isolated outbreak in Guinea crossed international borders for the first time, sparking outbreaks in neighboring Sierra Leone and Liberia and even in noncontiguous countries such as Nigeria, Senegal, and Mali. Sporadic cases among travelers returning from the region to North America or Europe elicited tremendous fear and exposed significant underlying susceptibilities within the North American and European infection control systems (1). Ebola has put the world on notice that rapid globalization has connected communities in such a way that emerging infectious diseases, once categorized as “tropical” in nature, are now worldwide threats that require urgent global responses

Reply

To the Editors: In their letter, Drobeniuc and Spaulding question the selected analytic approach to our randomized controlled trial of a comprehensive intervention to maintain plasma HIV RNA suppression after prison release. Specifically, issue is taken with the use of an intent-to-treat analysis comparing the rates of virologic suppression at 24 weeks after prison release between the 2 study arms

Group sex event participation: A link to STI risk among African-American heterosexual men incarcerated in North Carolina

Group sex events (GSEs) among heterosexuals and other groups may facilitate STI transmission by contributing to rapid partner exchange and links to high-risk partners

Great Expectations: HIV Risk Behaviors and Misperceptions of Low HIV Risk among Incarcerated Men

Incarcerated populations have relatively high HIV prevalence but little has been reported about their aggregate HIV risk behaviors or perceptions of risk. A random selection of HIV-negative men (n = 855) entering a US state prison system were surveyed to assess five risk behaviors and his self-perceived HIV risk. Using multivariate logistic regression, we identified factors associated with having elevated actual but low perceived risk (EALPR). Of the 826 men with complete data, 88% were at elevated risk. While 64% of the sample had risk perceptions concordant with their actual risk, 14% had EALPR (with the remainder at low actual but high perceived risk). EALPR rates were lower in those with a pre-incarceration HIV test but higher for those with a negative prison entry HIV test. HIV testing counseling should assess for discordance between actual and perceived risk and communicate the continued risk of HIV despite a negative result

Outpatient Treatment of Severe Acute Respiratory Syndrome Coronavirus 2 Infection to Prevent Coronavirus Disease 2019 Progression

As of March 2021, coronavirus disease 2019 (COVID-19) had caused more than 123 million infections and almost 3 million deaths worldwide. Dramatic advances have been made in vaccine development and nonpharmaceutical interventions to stop the spread of infection. However, treatments to stop disease progression are limited. A wide variety of "repurposed"drugs evaluated for treatment of COVID-19 have had little or no benefit. More recently, intravenous monoclonal antibody (mAb) combinations have been authorized by the US Food and Drug Administration for emergency use for outpatients with mild to moderate COVID-19 including some active against emerging severe acute respiratory syndrome coronavirus 2 variants of concern. Easier to administer therapeutics including intramuscular and subcutaneous mAbs and oral antivirals are in clinical trials. Reliable, safe, effective COVID-19 treatment for early infection in the outpatient setting is of urgent and critical importance. Availability of such treatment should lead to reduced progression of COVID-19

Detection of undiagnosed HIV among state prison entrants

substantial proportion of individuals infected with the human immunodeficiency virus (HIV) in the United States enter a correctional facility annually.1,2 Therefore, incarceration presents an opportunity for HIV detection. Even thoughmany states have adopted policies of mass HIV screening of inmates,2-4 the extent to which HIV testing on prison entry detects new infections is unclear