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The following HTML text is provided to enhance online readability. Many aspects of typography translate only awkwardly to HTML. Please use the page image as the authoritative form to ensure accuracy. were first-time users of mobile health-van services (Mimiaga et al., 2008). Mobile vans have some drawbacks. Shrestha et al. (2008) reviewed the cost effectiveness of clinic-based versus mobile outreach efforts to identify HIV cases. They found that the cost of providing a new HIV diagnosis was considerably higher in the outreach settings than in the clinic (Clark et al., 2008). However, a clinic setting is effective only if clients are drawn to the facility. Hence, innovative approaches of this type should be considered for hard-to-reach populations. RecommendationIntegration of viral hepatitis services into venues such as STD-HIV clinics, shelters, and mobile health units, is likely to have long-term benefits because most of the people who use these types of clinics engage in high-risk behaviors or are in high-risk settings. Therefore, the committee offers the following recommendation: Recommendation 5-10. The Health Resources and Services Administration and the Centers for Disease Control and Prevention should provide resources and guidance to integrate comprehensive viral hepatitis services into settings that serve high-risk populations such as STD clinics, sites for HIV services and care, homeless shelters, and mobile health units. REFERENCESAhmed, S. M., J. P. Lemkau, N. Nealeigh, and B. Mann. 2001. Barriers to healthcare access in a non-elderly urban poor American population. Health & Social Care in the Community 9(6):445-453. Allen, S. A., A. C. Spaulding, A. M. Osei, L. E. Taylor, A. M. Cabral, and J. D. Rich. 2003. Treatment of chronic hepatitis C in a state correctional facility. Annals of Internal Medicine 138(3):187-190. Alter, M. J. 2006. Epidemiology of viral hepatitis and HIV co-infection. Journal of Hepatology 44(Suppl 1):S6-S9. Alter, M. J., W. L. Kuhnert, and L. Finelli. 2003. Guidelines for laboratory testing and result reporting of antibody to hepatitis C virus. Centers for Disease Control and Prevention. Morbidity and Morality Weekly: Recommendations and Reports 52(RR-3):1-13, 15; quiz CE11-CE14. Alter, M. J., L. B. Seeff, B. R. Bacon, D. L. Thomas, M. O. Rigsby, and A. M. Di Bisceglie. 2004. Testing for hepatitis C virus infection should be routine for persons at increased risk for infection. Annals of Internal Medicine 141(9):715-717. Appel, A., R. Everhart, P. S. Mehler, and T. D. MacKenzie. 2006. Lack of ethnic disparities in adult immunization rates among underserved older patients in an urban public health system. Medical Care 44(11):1054-1058.
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