Incorporating HIV and Viral Hepatitis Testing and Referral into Idaho Drug Court Programs

1. Incorporating HIV and Viral Hepatitis Testing and Referral into Idaho Drug Court Programs Presented by Idaho Advisory Council on HIV and AIDS, Bebe Thompson, Co-Chair

2. Idaho Advisory Council on HIV and AIDS • Community based group that advises the state • Planning, development and review of HIV care, prevention and viral hepatitis state program plans (continuum of care) • Develop a statewide comprehensive plan • Evidence based, relevant to Idaho’s populations and with meaningful community input • 3 year plan, requirement of federal partners

3. 2010 National HIV/AIDS Strategy The strategy’s three primary goals: • Reducing the number of people who become infected with HIV • Increasing access to care and improving health outcomes for people living with HIV • Reducing HIV-related health disparities

4. The Challenge HIV/AIDS Treatment Cascade

5. National HIV Infection Rates • New infections at 50 thousand per year in the US • Of those new infections: • 53 percent are men who have sex with men (MSM) • 31 percent high risk heterosexual contact • 12 percent injection drug use • Estimated 20 + percent of individuals do not know they are infected • The 20 percent are believed to cause as much as 50 percent of new infections

6. Trends in Hepatitis C in the US • 2.7 – 3.9 million) persons living with Hepatitis C virus (HCV) infection in the US • 17,000 new infections in 2010 • Acute HCV infection is usually asymptomatic • 75-85% of HCV infections persist as chronic infections placing at risk for liver transplant • 15-30 % of all HIV infected individual’s are co-infected with Hep C • Represents 5-10 % of all HCV cases

7. HIV in Idaho HIV/AIDS Prevalence in Idaho (12/31/2009) • 1,125 HIV or AIDS cases diagnosed in Idaho • 1,254 individuals are presumed to be living with HIV or AIDS (PLWH/A) in Idaho Three Primary Modes of Exposure • Of the 1,254 PLWH/A in Idaho: • 56% of males had MSM (Men who have Sex with Men) • 10% of men reporting heterosexual contact list injection drug use (IDU) • 14% of cases had the dual-category MSM/IDUs • Over 50% of females identified heterosexual contact as risk

8. Hep C in Idaho • See handout for some stats • Under reported in all populations at risk • National estimates likely ring true for Idaho’s highest risk groups • 50% - 90% of IDUS are infected with HCV • 14% - 42% of incarcerated people are infected • As many as 42% of homeless people may be infected with HCV • In Idaho the risks for Hep C • IDU • Tattooing and body piercing

9. HIV and Viral Hepatitis Testing • CDC funds HIV Prevention and Viral Hepatitis Programs • Federal funding must follow epidemic • Must focus on targeted risk groups • In Idaho the risks are similar for HIV and Hep C • Injection drug use • Tatoos and body piercing Drugs – Sex – Rock n Roll--- And/Or….

12. Issue Analysis • Currently, the Idaho Adult Drug Court Guidelines and Standards do not provide guidance on the importance or potential procedures for HIV and Hepatitis C testing.  • Should drug courts incorporate HIV and Hepatitis C testing and referral to counseling into the drug court program?

13. Recommendation: • IACHA recommends that the Guidelines and Standards for each of the problem-solving courts incorporate testing for HIV and Hepatitis C as part of their program, contingent upon available resources for such testing and counseling. • Training for drug court teams should include information on the specific risks for HIV and hepatitis C among this at-risk group, information on HIV testing, referral information, and information on treatment services

14. Questions???? • Discussion…..