New Mexico in Focus; 2; Aids; Interview with UNMH Doctor

the loose needles and that there's steps in place to kind of prevent that from happening. Can you walk us through what some of those safeguards are? Right, sure. In the medical unit and most of our major facilities are equipped with a medical unit which uses sharps and all that. There is an accountability of sharps which is by the shifts or three shifts. All sharps are counted for and accounted for. The disposal program of all U sharps is very strict. They all kept in restricted areas where the inmates are not allowed to to go. That's on the medical side. Use of instruments and all that is very, very monitored very closely. From the visitor's point of view, the visitors who come in and may possibly bring things in. The security really does a very good job in screening and checking those those family members to not bring in sharps and all that to pass it on to the inmates. It's an ongoing security checks all day long, all night long, you know, random checking, random drug testing of inmates, you know,

who may be suspected of using something. So there are policies and procedures in place which kind of makes the staff, the security staff, a non-staff, non-security staff control all sharps by keeping an accountability of it. So when you don't have that much floating sharps around in the prisons, you know, that you minimize that with that. So as the quality assurance person, how confident are you that how confident are you that there is no dangerous needle sharing a Korean? I'm very confident, you know, that it's not the needle sharing is not at a dangerous level that people should lose sleep over it, you know, because of all these controls, checks and balances in place. Testing inmates after they have been initially tested and while incarcerated, the numbers are not showing us with large numbers of coin factions. So that is an assurance. As we do from the

correction department, we do quality assurance checks and audits once every quarter to check that these these things are in place and all that. So basically, you know, by not seeing large huge numbers of coin faction where the inmates come out positive while they're incarcerated on these things, that gives me the assurance that, yes, we have things under control. And on that kind of thought, because I know when we talked on the phone, you said, you know, it's impossible to pinpoint the where someone contracted HIV or hepatitis C if they haven't taken a mandatory test at the intake, because if they test three months in, they could have actually gotten infected when they report. But my question is, some of these people there are obviously there for quite long states. Have you ever encountered individual prisoners who well into their state and present tested negative and then further in that state? Did it end up

testing positive? Right. They have been some cases and that may have come through sharing needles, you know, which is a very, very low number. I have come across a few cases that were tested negative at the time of the intake or or testing. But then there is a possibility that the inmates are going back and forth, back and forth, you know, they get, they are in for a year or two years, then they are negative while they are first stay in the correction department, they go out, get infected, don't get them all tested, they come back in and don't give us the written consent to be tested. And then we find out, we find the clinical indication to test them and they come out positive. I can't say that they were infected in the prison, you know. So it's a very tricky area, you know, that you really cannot put your hands on that because if you can, if I can be assured that John Doe inmates incarcerated today has been in prison for two years, did

not have any family context during that two years, did not go out of the prison in those two years. And then if he tests positive, then I can say that something happened while he was incarcerated. Then I can say that there was, there was something but usually that it doesn't happen that way. People transfer from one facility to the facility. They do have little possibility of sharing needles. There is a possibility that some of our sharps are lost, you know. So all those things, but because the numbers are very, very small, I can truly say, you know, that it's a very, very remote possibility that they get infected while incarcerated in prison. And then don't forget tattooing. You know, tattooing is still going on, even though we don't allow tattooing, tattooing machines and all that in there. But people get creative and they rip open a tape recorder or

something that has a motor and make their own tattoo machines. You know, and we don't get to get it out and people share tattoo machines, you know. So there's all kinds of things. But overall, I've been with Corrections Department for almost 25 years now. And the numbers have been very low of inmates getting infected while they are incarcerated in our system. And that's, and that's due largely to this. And that is because of the security and all that watching and all that very closely. Have you all ever entertained the idea of doing some kind of clean needle exchange, just the way that there's this range exchange program on the outside that's been pretty successful? Has that ever been floating around? Well, the idea has been floating around, you know, allowing inmates to participate in these programs while incarcerated. But it has not satisfied our administration to implement that is because we, I think, we have

it all control of inmates having access to needles and be able to share, you know. So because we are very confident that we have it under control, that's why we have not seriously looked into those programs yet. And just one of their kind of train of thought, because you were talking about kind of the rotating door. And obviously there's a recidivism rate problem in this state with, you know, people kind of coming in and out of the prison system. What kind of, what kind of education or counseling, if any, do they get before they're released as far as kind of protecting their loved ones on the outside? Because that's a concern for a lot of people, right? Is that some of these IV drug users, you know, they're coming in and out of the prisons. They're doing states here and there and then they're going out and, you know, at re-interacting with their loved ones and they're kind of the innocent. Sure. And actually that's a good question. You know, our patient education towards these infectious diseases and on all that

starts the moment that it made first walks in in our system. At the time of intake, that is information patient education provided on tuberculosis. Hepatitis on HIV. And as an ongoing education program that we require from the medical vendor which provides medical care to provide these information either in written form or in classroom sessions like that is an ongoing thing. The inmate always has an opportunity to seek that upon request through the medical professionals while they incarcerated. Also, they can request it through addiction services in our department through the mental health. So it's an ongoing thing. It never stops, you know, and identifying those inmates with possible habits of risk factors. Those are kept in classrooms or make them participants of these programs. So it's an ongoing thing from day one till the

day they are disturbed or peralled out. So it is there. So you think you think it's are you will that maybe even some of these guys are more aware of risk like high risk behavior factors than if they hadn't gone to jail? If they just actually write. Actually, they learn more about these risk factors on all that while they are incarcerated in a system because we provide all that and make it available for them. Much more than what they would get in while in the community setting, you know, because once you're in the community, you don't have time to sit down or attend any of the things to find out all about it. So it's it's more they learn more while incarcerated about risk factors and all that which they can practice when they when they go out in the community to be with their families or with the community members. Okay, and just one last question. Again, I'm going back to the HEPC next. I know you said the HIV numbers are low with the HEPC numbers. They're not low. I mean, they're not low

in a lot of different states, but they're definitely not low here. Are you are we taking more steps to get more and more HEPC the try to see patients into treatment? That's our goal. That is our goal is to do a good identification, you know, diagnostic identification process in place, good surveillance program in place and and rolling all the inmates who are HEPC in chronic clinics that way we can monitor their health very closely and make them suitable candidates or patients for the treatment process, you know, and we would like to treat as whoever can benefit from it going through the treatment review committee process and select those inmates that can that need the treatment right away and they can benefit from it. But the goal of the correction department is yes, excuse me, we would like to do that. And we are headed towards that. Great, I think that's pretty much. And one little round. Just could you maybe kind of

explain what sharps mean? Sharps are all the syringes and needles that we use in providing medical care. Sharps can be your needle syringes, scalples, anything that makes an open wound in the body, you know, scalples for doing minor surgical procedures or procedures like that and you just throw it away. They have come in contact with blood and if they are not properly disposed, somebody else can use that and cut themselves or open the skin and coinfect themselves. Same thing with the needles and syringes is that they are used to giving injections or treating whatever and they do enter and come in contact with the blood of an individual and if reused, they can infect themselves. So that's what the sharps are, surgical instruments, syringes, needles, scalples, sewing needles or suturing needles, anything that we use in the medical side of the

shop to break open the skin and come in contact with the blood. And if not properly disposed, then it can just carry that in fact, possible infection to others if it's reused. So anything we're forgetting, anything you might want to have, something that you'll save. I think that's it. I'm as a QA manager for the health services for the correction department. I'm very satisfied and so is Dr. Polara, my medical director, my boss. We are very satisfied with the HEPC treatment plan, hand in hand working with our on-site physicians, providers and the echo program, Dr. especially Dr. Sanjivaroa and Dr. Carl Thornton, who provides us with all the expertise in that field. Thank you. Great. I know, I know that echo program.