Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:

 

Study confirms benefit of routine, jail-based HIV testing for inmates

25.06.2010
Routine, jail-based HIV testing of inmates can successfully identify a substantial proportion of people unknowingly infected with HIV and could play a critical role in preventing the spread of the disease, according to a new report in this week's U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

The analysis, conducted by researchers with The Miriam Hospital, The Warren Alpert Medical School of Brown University, Rhode Island Department of Corrections (RIDOC), Rhode Island Department of Health (RIDOH) and the CDC, supports previous CDC recommendations calling for HIV testing in jails and prisons as part of a routine medical evaluation.

During a eight-year period, 73 percent of all RIDOC inmates were provided HIV testing during a medical evaluation within 24 hours of incarceration. Nearly 170 new HIV diagnoses, representing more than 15 percent of all newly-diagnosed people with HIV in Rhode Island during the same time period, were identified through this RIDOC testing program.

According to lead author Curt G. Beckwith, MD, an infectious disease specialist with The Miriam Hospital, this testing rate is both noteworthy and encouraging, given that individuals who are unaware of their HIV infection are more than three times more likely to transmit the virus compared to those who are aware of their infection. In addition, HIV rates among prisoners are more than four times higher than in the general population.

"Jails and correctional facilities provide a golden opportunity to offer HIV testing to a population that is hard-to-reach and at increased risk of infection," says Beckwith. "Expansion of HIV testing within jails has the potential to increase HIV diagnoses and make more people aware of their HIV status, which could help reduce the spread of the disease in the United States."

HIV testing has been routinely offered to every person entering the RIDOC since 1991 as part an initial medical evaluation conducted within 24 hours of confinement. Test results are available within a week or two. Anyone who receives an HIV-positive result while incarcerated is notified by an HIV clinical nurse and receives prevention counseling and referrals to HIV care both in the prison setting and in the community. Individuals with a positive diagnosis who are released before they can be notified are contacted by a RIDOH outreach worker who also provides care referrals and prevention counseling.

Following a detailed review of RIDOC records and RIDOH surveillance data, researchers determined that if HIV testing had been conducted after the first 48 hours of incarceration, approximately 29 percent of detainees with new HIV diagnoses would not have been tested. What's even more troubling: if all testing had occurred beyond seven days of incarceration, 43 percent of HIV-positive inmates who had been released within that timeframe would not have been tested, resulting in a delay in their diagnosis and the opportunity for them to unknowingly spread the disease.

In addition, nearly half of the newly-diagnosed HIV-positive inmates did not disclose HIV risk behaviors, such as injection drug use or high risk sexual behaviors. Beckwith, who is also an assistant professor of medicine at Alpert Medical School and a physician with University Medicine, says this finding could be an issue for jurisdictions that rely on HIV testing based on known risk behaviors, since it appears they may miss a sizeable number of HIV-positive detainees.

"These results support policies for HIV testing upon jail intake and routinely providing voluntary, opt-out HIV testing to all detainees, regardless of reported risk factors, in order to maximize our ability to diagnose as many new cases as possible," he adds.

From 2000 through 2007, the RIDOC jail processed 140,739 criminal offenses and conducted 102,229 HIV tests. Due to multiple arrests of some detainees during this timeframe, the total number of HIV tests performed represents approximately 40,000 to 60,000 unique individuals. That's because some detainees may have been tested multiple times depending upon arrest frequency and the time between incarcerations.

The majority of newly-diagnosed detainees were male (90 percent) and more than three-quarters were between the ages of 30 and 49. Blacks and Hispanics represented 72 percent of all cases.

Study co-authors included Josiah D. Rich, MD, and Timothy P. Flanigan, MD, from The Miriam Hospital, Alpert Medical School and University Medicine; Michael M. Poshkus, MD, Ann-Marie Bandieri, Nicole Aucoin and Patricia Threats, RN, from the RIDOC; Sutopa Chowdhury, MBBS, MPH, Paul Loberti, MPH and Lucille Minuto, RN, BSN, Med, from the RIDOH; and Robin MacGowan, MPH, Andrew Margolis, MPH, Cari Courtenay-Quick, PhD, and Walter Chow from the CDC's National Center for HIV/AIDS, Viral Hepatitis, STD and TB Prevention.

The Miriam Hospital, established in 1926 in Providence, RI, is a private, not-for-profit hospital affiliated with The Warren Alpert Medical School of Brown University and a founding member of the Lifespan health system. For more information about The Miriam Hospital, please visit www.miriamhospital.org

University Medicine (www.umfmed.org) is a non-profit, multi-specialty medical group practice employing many of the full-time faculty of the department of medicine of the Alpert Medical School.

Jessica Collins Grimes | EurekAlert!
Further information:
http://www.lifespan.org

Further reports about: CDC HIV HIV diagnoses HIV-positive MPH Medical Wellness RIDOC risk factor

More articles from Studies and Analyses:

nachricht Win-win strategies for climate and food security
02.10.2017 | International Institute for Applied Systems Analysis (IIASA)

nachricht The personality factor: How to foster the sharing of research data
06.09.2017 | ZBW – Leibniz-Informationszentrum Wirtschaft

All articles from Studies and Analyses >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Neutron star merger directly observed for the first time

University of Maryland researchers contribute to historic detection of gravitational waves and light created by event

On August 17, 2017, at 12:41:04 UTC, scientists made the first direct observation of a merger between two neutron stars--the dense, collapsed cores that remain...

Im Focus: Breaking: the first light from two neutron stars merging

Seven new papers describe the first-ever detection of light from a gravitational wave source. The event, caused by two neutron stars colliding and merging together, was dubbed GW170817 because it sent ripples through space-time that reached Earth on 2017 August 17. Around the world, hundreds of excited astronomers mobilized quickly and were able to observe the event using numerous telescopes, providing a wealth of new data.

Previous detections of gravitational waves have all involved the merger of two black holes, a feat that won the 2017 Nobel Prize in Physics earlier this month....

Im Focus: Smart sensors for efficient processes

Material defects in end products can quickly result in failures in many areas of industry, and have a massive impact on the safe use of their products. This is why, in the field of quality assurance, intelligent, nondestructive sensor systems play a key role. They allow testing components and parts in a rapid and cost-efficient manner without destroying the actual product or changing its surface. Experts from the Fraunhofer IZFP in Saarbrücken will be presenting two exhibits at the Blechexpo in Stuttgart from 7–10 November 2017 that allow fast, reliable, and automated characterization of materials and detection of defects (Hall 5, Booth 5306).

When quality testing uses time-consuming destructive test methods, it can result in enormous costs due to damaging or destroying the products. And given that...

Im Focus: Cold molecules on collision course

Using a new cooling technique MPQ scientists succeed at observing collisions in a dense beam of cold and slow dipolar molecules.

How do chemical reactions proceed at extremely low temperatures? The answer requires the investigation of molecular samples that are cold, dense, and slow at...

Im Focus: Shrinking the proton again!

Scientists from the Max Planck Institute of Quantum Optics, using high precision laser spectroscopy of atomic hydrogen, confirm the surprisingly small value of the proton radius determined from muonic hydrogen.

It was one of the breakthroughs of the year 2010: Laser spectroscopy of muonic hydrogen resulted in a value for the proton charge radius that was significantly...

All Focus news of the innovation-report >>>

Anzeige

Anzeige

Event News

ASEAN Member States discuss the future role of renewable energy

17.10.2017 | Event News

World Health Summit 2017: International experts set the course for the future of Global Health

10.10.2017 | Event News

Climate Engineering Conference 2017 Opens in Berlin

10.10.2017 | Event News

 
Latest News

Terahertz spectroscopy goes nano

20.10.2017 | Information Technology

Strange but true: Turning a material upside down can sometimes make it softer

20.10.2017 | Materials Sciences

NRL clarifies valley polarization for electronic and optoelectronic technologies

20.10.2017 | Interdisciplinary Research

VideoLinks
B2B-VideoLinks
More VideoLinks >>>