HIV testing in prisoners: is mandatory testing mandatory?

• Published in: American journal of public health (1971) 1989-07, Vol.79 (7), p.840-842
• Main Authors: Andrus, J K, Fleming, D W, Knox, C, McAlister, R O, Skeels, M R, Conrad, R E, Horan, J M, Foster, L R
• Format: Article
• Language: English
• Subjects: Acquired immune deficiency syndrome; Adolescent; Adult; Aged; AIDS; Biological and medical sciences; Confidentiality; Counseling; Disease prevention; Female; Health; Health care; Health Education - methods; Hepatitis B Antibodies; HIV; HIV Seropositivity - epidemiology; Homosexuality; Human immunodeficiency virus; Humans; Immunodeficiencies; Immunodeficiencies. Immunoglobulinopathies; Immunopathology; Injections, Intravenous; Male; Mass Screening - methods; Medical sciences; Middle Aged; Oregon; Prisoners; Prisons & prisoners; Risk Factors; Substance-Related Disorders - complications; Voluntary Programs
• ISSN: 0090-0036; 1541-0048
• DOI: 10.2105/AJPH.79.7.840

We studied 977 newly incarcerated Oregon inmates to compare voluntary versus mandatory human immunodeficiency virus antibody (HIVAb) testing in the prison setting. All inmates were offered HIVAb counseling and testing. Blood drawn for routine syphilis serology from those who declined this offer was also tested for HIVAb after personal identifiers had been removed. Only 1.2 percent (12) prisoners were HIV positive. However, 62.5 percent (611) inmates were at risk for HIV infection by being an intravenous drug user, a male homosexual, or hepatitis B core antibody (HBcAb) positive. The ratio of at-risk, as yet uninfected inmates to those already HIV infected was 53 to 1. Two-thirds of all inmates including those at-risk chose to receive counseling and testing. In areas where most at-risk inmates are not yet infected, it may be more appropriate for HIV prevention activities in prison to focus on voluntary programs that emphasize education and counseling rather than mandatory programs that emphasize testing.