The situation in for New York State prisons has improved significantly over the last year: hepatitis C testing is offered to everyone reporting a risk factor when they enter the prison system, with about 13% of men and 23% of women testing positive for hepatitis C antibodies upon entry. About 300 prisoners are receiving hepatitis C treatment at any time, and prisoners being released to New York City can begin treatment in prison and continue after release through links to city hospitals. Prisoners with any history of drug use or alcoholism still have to intiate a mandatory substance abuse treatment program in prison before beginning hepatitis C treatment, but do not have to wait until completing the program before starting hepatitis C treatment. Hepatitis B vaccination is offered to all prisoners.
Prison health care in New York is still far from perfect, as documented by a series of New York Times articles earlier this year that led to an on-going investigation of the state's for-profit contractor, Prison Health Services (see also Business Week's interview with their CEO, Michael Catalano). But activism and advocacy for prisoners with hepatitis C has clearly begun to pay off.
[More prison news below, plus hepatitis A outbreaks....]
Michigan's Republican-controlled House of Representatives submitted a budget plan that would cut a $1.2 million hepatitis C testing and treatment program in state prisons launched last fall. The plan is part of a broader package of deep cuts to human services that sets the stage for a budget showdown between the Republican-controlled legislature and Democratic Governor Jennifer Granholm.
The prison program came in response to an excellent series of reports by Stacey Range in the Lansing State Journal, showing that in 2003, only 55 prisoners were receiving treatment (see also this 2003 story from the Detroit Metro Times; more background on the Michigan state prison system here and here). An estimated 6,800 Michigan prisoners (13.8% of the total state prison population) are infected with hepatitis C, according to 2004 figures, though many consider this estimate low. The $1.2 million allocated in 2004 fell short of the $2.3 million initially requested to test and treat 465 prisoners, and $11 million requested for 2006 to test and treat an additional 3,720 prisoners.
Meanwhile, in California, the pharmaceutical company Roche is resisting disclosure of the financial details of its state contract to supply medications for hepatitis C treatment to prisoners and the mentally ill.
More encouraging news comes from Vermont, where 65 prisoners at the Rutland jail received hepatitis A and B vaccinations, courtesy of the Vermont Department of Health. Vaccinations will be offered in other Vermont correctional facilities in the coming weeks.
Public health officials worked to stave off a potential hepatitis A outbreak in Yuma County, Arizona, after a restaurant employee was diagnosed with acute hepatitis A infection. Hepatitis A outbreaks have recently been reported in Chiang Mai, Thailand, and in the Tver region of Russia.
Finally, the health department of Deschutes County in central Oregon has proposed starting a needle exchange program to reduce hepatitis C and HIV rates.
For more hepatitis C news, check out the HCV Advocate's Weekly News Review.