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Hepatitis C and HIV screeningBackground: Chronic hepatitis C virus (HCV) affects more than 3 million people in the United States. Current HCV treatment offers a shorter treatment interval with fewer adverse reactions as well as improved cure rates of 96%. The increasing rates of hepatitis C infections in adults have been accompanied by multifaceted adverse health outcomes. The purpose of this screening program is to identify HCV-infected individuals, which will lead to clinical interventions and treatment that will improve health outcomes compared to no screening. Methods: The Centers for Disease Control and Prevention guidelines recommend that anyone with risk factors should be screened for HCV infection. In addition, all persons born between 1945 and 1965 should be screened once in their lifetime. Screening at Curtis V. Cooper Primary HealthCare Inc. (CVCPHC) includes individuals 18 and over for HCV and HIV. Results: CVCPHC’s screening program was implemented in January 2016. As of October 1, 2016, 4054 individuals had been screened for HCV with 187 antibody-positive. Of the individuals with positive antibody tests, 179 were RNA tested, and of these, 122 tested positive. Seventy four percent of those with a positive RNA test were linked to care. Eighty five percent of individuals with a positive RNA test were born between 1945 and 1965. The current case reports consist of 57 active HCV patients on medication and/or have completed therapy; 10 have a viral load not detected (ND) > 4-6 weeks after starting medication; 15 completed therapy with a ND viral load resulting in a 100% cure rate; 12 are currently on medication < 4 weeks; 15 were referred to GI; and five deferred treatment. Conclusions: Screening for HCV and HIV lead to the appropriate interventions and treatments for persons infected, preventing the progression of liver disease and reducing morbidity and possibly mortality.
Predictors of mammogram and Pap screenings among US womenBackground: The most common cancers among women are breast and cervical cancer. Although early detection of cancer has been shown to increase the likelihood of survival, many women are not screened for these cancers as often as practice guidelines recommend. The objective of this study was to examine the mammography and Papanicolaou (Pap) smear screening practices among women within the United States, and to determine predictors of screening. Methods: Data from the 2012 and 2014 Behavioral Risk Factor Surveillance System were used. The association between demographic predictors (age, marital status, education level, employment status, income, health insurance, and medical cost concerns) and having Pap or mammogram screening consistent with guideline recommendations was assessed using logistic regression analysis. Results: Pap and mammography screenings were positively associated with younger age, minority race, being married, having a higher level of education, being employed, having higher household income, having health insurance and not having financial concerns regarding affording doctor visits. Blacks and Hispanic women were more than twice as likely to have Pap screenings (Black: OR=2.16, 95% CI 1.97-2.36; Hispanic: OR=2.33, 95% CI = 2.11-2.58) and mammograms (Blacks: OR=2.11, 95% CI 1.88-2.36; Hispanics OR=1.82, 95% CI 1.60-2.07) compared to White women. Women earning less than $10,000 per annum were much less likely to have cervical cancer screenings (OR=0.57, 95% CI 0.51-0.65) compared to women with higher incomes while mammography screening was less likely among women who reported financial barriers to health care (OR=0.59, 95% CI 0.53-0.64). Conclusions: Women from minority ethnic groups were more likely to be screened for cervical cancer compared to White, non-Hispanic women. Women from low-income households and women who could not visit a doctor due to costs had the strongest association with lacking screenings.