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Implementing a Routine, Voluntary HIV Testing Program in a Massachusetts County Prison

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Abstract

Although U.S. prison inmates have higher rates of HIV infection than the general population, most inmates are not routinely tested for HIV infection at prison entry. The study objective was to implement a routine, voluntary HIV testing program in a Massachusetts county prison. During admission, inmates were given group HIV pre-test counseling and were subsequently offered private HIV testing. This intervention was compared to a control period during which HIV testing was provided only upon inmate or physician request. Between November 2004 and April 2005, 1,004 inmates met inclusion criteria and were offered routine, voluntary HIV testing. Of these, 734 (73.1%) accepted, 2 (0.3%) were HIV-infected, and 457 (45.5%) had been tested for HIV in the previous year. The testing rate of 73.1% was significantly increased from the rate of 18.0% (318 of 1,723) during the control period (p<0.001). Among the inmates tested for HIV in the prior year, 78.2% had received their last HIV test in the prison setting. Careful attention should be paid to prevent redundancy of testing efforts in the prison population. Implementing a routine HIV testing program among prison inmates greatly increased testing rates compared to on-request testing.

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Acknowledgements

Supported in part by: Massachusetts Department of Public Health, HIV/AIDS Bureau; the Massachusetts State Laboratory Institute; Harvard Medical School Faculty Development and Fellowship Program in General Internal Medicine T32 HP11001 (RVL) and CFAR Scholar Award P30 AI060354 (RVL), National Institute of Allergy and Infectious Diseases R01 AI42006, K23 AI01794, K24 AI062476 and National Institute of Mental Health R01 MH65869. Presented in part at the Society of General Internal Medicine National Meeting, New Orleans, LA, USA, May 14, 2005.

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Correspondence to Rebecca V. Liddicoat.

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Liddicoat is with the Department of Medicine, Greater Los Angeles Veterans Administration, Mail 111G, 11301 Wilshire Boulevard, Los Angeles, CA 90073, USA; Zheng, Freedberg, and Walensky are with the Division of General Medicine, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Freedberg and Walensky are with the Division of Infectious Disease, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Zheng, Freedberg, and Walensky are with the Partners AIDS Research Center, Department of Medicine, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA; Internicola and Golan are with the Suffolk County House of Corrections, Boston, MA, USA; Golan is with the Department of Infectious Disease, Tufts University Medical School, Boston, MA, USA; Rubinstein is with the HIV/AIDS Bureau, Massachusetts Department of Public Health, Boston, MA, USA; Werner and Kazianis are with the Massachusetts State Laboratory Institute, Boston, MA, USA.

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Liddicoat, R.V., Zheng, H., Internicola, J. et al. Implementing a Routine, Voluntary HIV Testing Program in a Massachusetts County Prison. J Urban Health 83, 1127–1131 (2006). https://doi.org/10.1007/s11524-006-9095-9

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