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Routine, rapid HIV jail screening effective
A 14-month HIV screening demonstration during jail intake was effective in identifying new HIV cases, according to findings published in Morbidity and Mortality Weekly Report.
The demonstration, held at Fulton County Jail in Atlanta, identified 52 previously undiagnosed cases of HIV, 48 of which were identified by rapid testing. Opt-out, rapid HIV testing by oral mucosal swab was provided by the jail nursing staff, and newly diagnosed cases were confirmed with Western blot testing.
“Without this HIV screening project, these persons would likely have been diagnosed later in the course of their infection, resulting in delayed access to care and treatment, and possible transmission of HIV to their partners,” researchers wrote.
Of the 31,314 inmates booked from 2011 to March 15, 2012, 59% received an intake medical evaluation and 12,141 HIV tests were taken. Each of the newly identified cases of HIV were in non-Hispanic black men (n=47) and women (n=5). Of the men, 18 reported previously having sex with a man. Of the 54 who tested positive for HIV, 36 reported prior testing from 4 months to 4 years earlier, and 22 had a negative HIV test within the past 2 years.
The mean CD4 cell count was 372 cells/mm3; however, only 22 of those who tested positive received a CD4 test due to short detainment times (nine ≤48 hours, 30 ≤14 days). The researchers noted a limitation in their study since the CD4 count could have been higher or lower had they been able to test more of those newly diagnosed before they were released.
“Making HIV screening a routine, rather than an exceptional, part of the medical evaluation process in jail in high HIV-prevalence, inner-city communities might help to decrease the stigma of HIV testing in jails and ultimately could decrease the number of persons in all risk categories who are unaware of their infection,” researchers wrote.