Voluntary rapid human immunodeficiency virus (HIV) testing in jails.
OBJECTIVE
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.


METHODS
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.
Macgowan
Robin
R
Division of HIV/AIDS Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. rmacgowan@cdc.gov
Margolis
Andrew
A
Richardson-Moore
April
A
Wang
Terry
T
Lalota
Marlene
M
French
P Tyler
PT
Stodola
James
J
McKeever
Jennifer
J
Carrel
Jack
J
Mullins
Jolene
J
Llanas
Michelle
M
Griffiths
Sean David
SD
D015492:AIDS Serodiagnosis / Q000706:statistics & numerical data*; D000328:Adult; D005260:Female; D005431:Florida; D006078:Government Programs; D015658:HIV Infections / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000517:prevention & control; D015497:HIV-1; D006801:Humans; D008145:Louisiana; D008297:Male; D009518:New York; D011329:Prisoners; D011330:Prisons; D012309:Risk-Taking; D013997:Time Factors; D014922:Wisconsin; D055815:Young Adult