Survey Finds That Many Prisons And Jails Have Room To Improve HIV Testing And Coordination Of Postrelease Treatment
- Liza Solomon ( [email protected] ) is a principal associate at Abt Associates in Bethesda, Maryland.
- Brian T. Montague is an assistant professor of medicine at Brown University and the Miriam Hospital, in Providence, Rhode Island.
- Curt G. Beckwith is an associate professor of medicine at Brown University and the Miriam Hospital.
- Jacques Baillargeon is an associate professor in the Department of Preventive Medicine and Community Health, University of Texas Medical Branch, in Galveston.
- Michael Costa is a senior associate at Abt Associates in Cambridge, Massachusetts.
- Dora Dumont is a senior epidemiologist at the Rhode Island Department of Health, in Providence. She was a research associate at the Miriam Hospital when this research was conducted.
- Irene Kuo is an associate research professor of epidemiology and biostatistics in the School of Public Health and Health Services, the George Washington University, in Washington, D.C.
- Ann Kurth is a professor in the College of Nursing, New York University, in New York City.
- Josiah D. Rich is a professor of medicine and epidemiology at Brown University and director and cofounder of the Center for Prisoner Health and Human Rights, the Miriam Hospital.
Abstract
Early diagnosis of HIV and effective antiretroviral treatment are key elements in efforts to reduce the morbidity and mortality associated with HIV. Incarcerated populations are disproportionately affected by HIV, with the disease’s prevalence among inmates estimated to be three to five times higher than among the general population. Correctional institutions offer important opportunities to test for HIV and link infected people to postrelease treatment services. To examine HIV testing and policies that help HIV-positive people obtain treatment in the community after release, we administered a survey to the medical directors of the fifty state prison systems and of forty of the largest jails in the United States. We found that 19 percent of prison systems and 35 percent of jails provide opt-out HIV testing, which is recommended by the Centers for Disease Control and Prevention (CDC). Additionally, fewer than 20 percent of prisons and jails conform to the CDC’s recommendations regarding discharge planning services for inmates transitioning to the community: making an appointment with a community health care provider, assisting with enrollment in an entitlement program, and providing a copy of the medical record and a supply of HIV medications. These findings suggest that opportunities for HIV diagnosis and linking HIV-positive inmates to community care after release are being missed in the majority of prison systems and jails.
