Routine opt-out HIV testing strategies in a female jail setting: a prospective controlled trial.
BACKGROUND
Ten million Americans enter jails annually. The objective was to evaluate new CDC guidelines for routine opt-out HIV testing and examine the optimal time to implement routine opt-out HIV testing among newly incarcerated jail detainees.


METHODS
This prospective, controlled trial of routine opt-out HIV testing was conducted among 323 newly incarcerated female inmates in Connecticut's only women's jail. 323 sequential entrants to the women's jail over a five week period in August and September 2007 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 108), early (next day, n = 108), or delayed (7 days, n = 107). The primary outcome was the proportion of women in each group consenting to testing.


RESULTS
Routine opt-out HIV testing was significantly highest (73%) among the early testing group compared to 55% for immediate and 50% for 7 days post-entry groups. Other factors significantly (p = 0.01) associated with being HIV tested were younger age and low likelihood of early release from jail based on bond value or type of charge for which women were arrested.


CONCLUSIONS
In this correctional facility, routine opt-out HIV testing in a jail setting was feasible, with highest rates of testing if performed the day after incarceration. Lower testing rates were seen with immediate testing, where there is a high prevalence of inability or unwillingness to test, and with delayed testing, where attrition from jail increases with each passing day.


BACKGROUND
ClinicalTrials.gov NCT00624247.
Kavasery
Ravi
R
Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, United States of America.
Maru
Duncan Smith-Rohrberg
DS
Cornman-Homonoff
Joshua
J
Sylla
Laurie N
LN
Smith
David
D
Altice
Frederick L
FL
D015492:AIDS Serodiagnosis / Q000379:methods*; D000328:Adult; D003237:Connecticut; D005260:Female; D015658:HIV Infections / Q000175:diagnosis* / Q000453:epidemiology*; D006801:Humans; D008403:Mass Screening / Q000379:methods*; D008875:Middle Aged; D017063:Outcome Assessment, Health Care; D010342:Patient Acceptance of Health Care; D011329:Prisoners; D011330:Prisons; D011446:Prospective Studies; D013997:Time Factors