Voluntary Rapid Human Immunodeficiency Virus (HIV) Testing in Jails

• Published in: Sexually transmitted diseases 2009-02, Vol.36 (2), p.S9-S13, Article S9
• Main Authors: MACGOWAN, ROBIN, MARGOLIS, ANDREW, RICHARDSON-MOORE, APRIL, WANG, TERRY, LALOTA, MARLENE, FRENCH, P. TYLER, STODOLA, JAMES, MCKEEVER, JENNIFER, CARREL, JACK, MULLINS, JOLENE, LLANAS, MICHELLE, GRIFFITHS, SEAN DAVID
• Format: Article
• Language: English
• Subjects: Adult; AIDS Serodiagnosis - statistics & numerical data; Biological and medical sciences; Epidemiology. Vaccinations; Female; Florida; General aspects; Government Programs; HIV; HIV Infections - diagnosis; HIV Infections - drug therapy; HIV Infections - epidemiology; HIV Infections - prevention & control; HIV-1; Human immunodeficiency virus; Human infectious diseases. Experimental studies and models; Human viral diseases; Humans; Infectious diseases; Louisiana; Male; Medical sciences; Medical tests; Multivariate analysis; New York; Prisoners; Prisons; Risk-Taking; Sexual behavior; Time Factors; Viral diseases; Viral diseases of the lymphoid tissue and the blood. Aids; Wisconsin; Young Adult
• ISSN: 0148-5717; 1537-4521
• DOI: 10.1097/OLQ.0b013e318148b6b1

Objectives: To provide human immunodeficiency virus (HIV) rapid testing to persons in jails, identify previously undiagnosed cases of HIV infection, and refer HIV-infected inmates to care, treatment, and prevention services. Design: Four state health departments (Florida, Louisiana, New York, and Wisconsin) collaborated with jails to implement stand-alone voluntary rapid HIV testing programs. Inmates requested or were referred by medical staff for rapid HIV testing. HIV testing was provided by the health department, correctional facility, or a community-based organization. Inmates whose rapid test was reactive were offered confirmatory testing, medical evaluation, prevention services, and discharge planning. Results: From December 2003 through May 2006, rapid HIV testing was provided to 33,211 inmates, more than 99.9% of whom received their test results. Most of the inmates tested were male (79%), black (58%), and less than 35 years of age (60%). A total of 440 (1.3%) rapid HIV tests were reactive, and 409 (1.2%) of the results were confirmed positive. The testing programs identified 269 (0.8%) previously undiagnosed cases of HIV infection. In the multivariate analyses, new HIV diagnoses were associated with race/ethnicity, report of risky behaviors, and with no report of HIV risk behavior. Almost 40% of diagnoses were for inmates whose only reported risk was heterosexual contact. Conclusions: Rapid HIV testing in jails identified a considerable number of previously undiagnosed cases of HIV infection. Rapid HIV testing should be available to all inmates, regardless of whether inmates reported HIV risky behaviors.