Rapid HIV testing programs in large urban jail systems feasible, successful

VANCOUVER — Large-scale rapid HIV testing programs successfully identified 162 new HIV cases in three large jail systems across Philadelphia, Baltimore and Washington D.C. According to Curt Beckwith, MD, rapid HIV testing in these jail systems is feasible and recommended, in an effort to provide timely treatment of persons with HIV and contain the risk of transmission between inmates.

Since 2006, the CDC has recommended HIV testing in correctional facilities as inmates are at increased risk for contracting HIV and other infectious diseases due to engaging in high-risk behaviors.

“There are 13 million people who pass through U.S. jails in a given year – and there are STDs and infections acquired in the community before going to jail. Therefore, [testing offers] a great opportunity to offer health intervention in jails,” Beckwith, of Alpert Medical School of Brown University, said during a press conference held here.

For the study, Beckwith and colleagues set out to identify the challenges and facilitators that may accompany implementation of rapid HIV testing programs in three large jail systems. Data were pooled on inmates tested, the number of rapid and confirmatory test results, and the number of those newly diagnosed with HIV.

Rapid HIV testing (OraQuick), conducted orally or through bloodwork, was voluntary and provided at all sites in an opt-out manner at the time of intake or within 3 days. Test results were delivered immediately after testing or between 1 and 3 days. Test results were available between 7 and 14 days across all sites.

Out of 253 confirmed HIV cases identified via the program, there were 142 newly identified HIV cases. According to Beckwith, facilitators that aided in successful implementation included: General acceptance of the program by inmates; local political support; and the use of electronic medical records which streamlined implementation.

Conversely, reported challenges of implementation included: Lack of space to conduct private testing; early release preventing delivery of test results; limited staffing; and not all staff members offered rapid testing.

“Despite these challenges,” said Beckwith, “testing in large jails is feasible and these jails have been successful in caring for those newly diagnosed. Further expansion of rapid HIV testing in jail systems is needed. Prisons should routinely test inmates, who are three to five times more likely to be HIV-positive.” – by Jennifer Henry

For more information:

Beckwith C. #1068. Presented at: the IDSA 48th Annual Meeting; Oct. 21-24, 2010; Vancouver, B.C.