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Sexually Transmitted Diseases:
doi: 10.1097/OLQ.0b013e318148b6b1
Article

Voluntary Rapid Human Immunodeficiency Virus (HIV) Testing in Jails

Macgowan, Robin MPH*; Margolis, Andrew MPH*; Richardson-Moore, April RN, MPH†; Wang, Terry MSPH*; Lalota, Marlene MPH‡; French, P Tyler MPH§; Stodola, James BSW∥; Mckeever, Jennifer MPH, MSW¶; Carrel, Jack MPH¶; Mullins, Jolene MPH#; Llanas, Michelle BA∥; Griffiths, Sean David MPH*; for the Rapid Testing in Corrections (RTIC) Team

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Abstract

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.

© Copyright 2009 American Sexually Transmitted Diseases Association

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