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U.S. News

"Sub-Optimal" HIV Care Continues at Alabama Prison Despite Some Improvements, Court-Ordered Monitor's Report Says

July 19, 2005

"Sub-optimal" HIV treatment continues to occur at the Limestone Correctional Facility in Harvest, Ala., according to a federal court-ordered monitor's report presented on Friday, the Birmingham News reports. The report -- which was conducted by prison medicine expert Joseph Bick after a visit to the prison in late May and filed on July 7 with Magistrate Judge John Ott -- says that Limestone has not provided an infectious disease specialist to treat the facility's more than 200 HIV-positive inmates for much of the past year despite an April 2004 federal court settlement in which the Alabama Department of Corrections promised to hire a specialist (Crowder, Birmingham News, 7/16). Under the settlement, which was reached in response to a 2002 federal lawsuit filed by HIV-positive inmates, the department is required to provide various improvements in living conditions and medical care for the inmates, including allowing a medical consultant to monitor the conditions of the HIV unit on a quarterly basis for two years and hiring a full-time nurse to coordinate infection control and medical care (Kaiser Daily HIV/AIDS Report, 5/3).

Report's Findings
During his weeklong visit to Limestone, Bick found that substitute physicians incorrectly combined drugs; patients who had rising HIV viral loads did not receive changes to their drug regimens; patients with failing regimens had their regimens changed by only one drug, going against standard treatment practice; and doctors made treatment changes without telling the patient. Bick's report also said that having one physician and one nurse practitioner in charge of care for 1,800 other inmates and 135 work-release prisoners is "inadequate." However, he lauded Prison Health Services -- the private company that oversees health care in Alabama prisons -- for improving Limestone's nursing staff, medical record-keeping and attention to inmate complaints, as well as for halting the sharing of medicines among inmates.

Recommendations, Reaction
Bick recommended that "every effort be made to retain physicians once they are hired" and said that the facility should hire three full-time physicians. PHS in a statement said, "It's difficult to recruit a highly qualified HIV specialist, especially to a rural area," adding, "The latest Bick report clearly indicates great progress has been made in delivering quality care to our patients" (Birmingham News, 7/16). State prison officials on Friday declined to comment on the report, saying it was supposed to have been sealed at their request (AP/Decatur Daily, 7/17).

Back to other news for July 19, 2005

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Reprinted with permission from kaisernetwork.org. You can view the entire Kaiser Daily HIV/AIDS Report, search the archives, or sign up for email delivery at www.kaisernetwork.org/dailyreports/hiv. The Kaiser Daily HIV/AIDS Report is published for kaisernetwork.org, a free service of the Kaiser Family Foundation, by The Advisory Board Company. © 2004 by The Advisory Board Company and Kaiser Family Foundation. All rights reserved.



  
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This article was provided by Henry J. Kaiser Family Foundation. It is a part of the publication Kaiser Daily HIV/AIDS Report. Visit the Kaiser Family Foundation's website to find out more about their activities, publications and services.
 
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