Early Identification of HIV: Empirical Support for Jail-Based Screening

Voux, Alex de; Spaulding, Anne C.; Beckwith, Curt G.; Avery, Ann; Williams, Chyvette T.; Messina, Lauren C.; Ball, Sarah; Altice, Frederick L.

doi:10.1371/journal.pone.0037603

Cited by 40 publications

(34 citation statements)

References 38 publications

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“…This cohort has been described across many domains, including HIV treatment outcomes, 39 new HIV infections, 3 longitudinal retention in care, 14 gender differences in service needs 40 and HIV treatment outcomes, 41 pre-and post-release homelessness, 20,35 recidivism, 22 and SUDs. 17,36 Health care utilization among this cohort has not previously been described.…”

Section: Setting and Selection Of Participantsmentioning

confidence: 99%

Emergency Department Use among HIV-Infected Released Jail Detainees

Boyd

Song²,

Meyer

et al. 2014

J Urban Health

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Release from short-term jail detention is highly destabilizing, associated with relapse to substance use, recidivism, and disrupted health care continuity. Little is known about emergency department (ED) use, potentially a surrogate for medical, psychiatric, or social instability, by people living with HIV/AIDS (PLWHA) leaving jails. All ED visits were reviewed from medical records for a cohort of 109 PLHWA in the year following release from county jail in Connecticut, between January 1, 2008 and December 31, 2010. Primary outcomes were frequency and timing of ED visits, modeled using multivariate negative binomial regression and Cox proportional hazards regression, respectively. Demographic, substance use, and psychiatric disorder severity factors were evaluated as potential covariates. . Those in late or sustained HIV care used the ED sooner than those not retained in HIV primary care (median for late retention 16.3 days, median for sustained retention 24.9 days, median for no retention not reached at 12 months, p value 0.004). Using multivariate modeling, those who used the ED earliest upon release were more likely to be homeless ]), to be retained in HIV care ), and to have recently used drugs ), yet had a low lifetime drug severity (HR 0.01 [0.00-0.14]). Among PLWHA released from jail, frequency of ED use is high, often soon after release, and is associated with social and drug-related destabilizing factors. Future interventions for this specific population should focus on addressing these resource gaps, ensuring housing, and establishing immediate linkage to HIV primary care after release from jail.

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Section: Setting and Selection Of Participantsmentioning

confidence: 99%

Emergency Department Use among HIV-Infected Released Jail Detainees

Boyd

Song²,

Meyer

et al. 2014

J Urban Health

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“…4–6 New positives in correctional facilities also have reported riskier behavior, including sex with someone other than their main partner, unsafe vaginal/anal sex, and sex with an at-risk partner (i.e., injected drugs, HIV-infected, or men who have sex with men). 5,7 …”

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confidence: 99%

HIV Testing, HIV Positivity, and Linkage and Referral Services in Correctional Facilities in the United States, 2009–2013

Seth

Figueroa

Wang³

et al. 2015

Sexually Transmitted Diseases

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Background Because of health disparities, incarcerated persons are at higher risk for multiple health issues, including HIV. Correctional facilities have an opportunity to provide HIV services to an underserved population. This article describes Centers for Disease Control and Prevention (CDC)–funded HIV testing and service delivery in correctional facilities. Methods Data on HIV testing and service delivery were submitted to CDC by 61 health department jurisdictions in 2013. HIV testing, HIV positivity, receipt of test results, linkage, and referral services were described, and differences across demographic characteristics for linkage and referral services were assessed. Finally, trends were examined for HIV testing, HIV positivity, and linkage from 2009 to 2013. Results Of CDC-funded tests in 2013 among persons 18 years and older, 254,719 (7.9%) were conducted in correctional facilities. HIV positivity was 0.9%, and HIV positivity for newly diagnosed persons was 0.3%. Blacks accounted for the highest percentage of HIV-infected persons (1.3%) and newly diagnosed persons (0.5%). Only 37.9% of newly diagnosed persons were linked within 90 days; 67.5% were linked within any time frame; 49.7% were referred to partner services; and 45.2% were referred to HIV prevention services. There was a significant percent increase in HIV testing, overall HIV positivity, and linkage from 2009 to 2013. However, trends were stable for newly diagnosed persons. Conclusions Identification of newly diagnosed persons in correctional facilities has remained stable from 2009 to 2013. Correctional facilities seem to be reaching blacks, likely due to higher incarceration rates. The current findings indicate that improvements are needed in HIV testing strategies, service delivery during incarceration, and linkage to care postrelease.

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“…Rapid opt-out HIV testing at jails helps identify new HIV cases that may have otherwise progressed to a later stage of the disease. A previous study in which FCJ participated showed that HIV screening at jails detected cases in earlier courses of disease compared with screening at other types of venues; 28 the present study did not assess disease stage at diagnosis. Jail screening programs clearly benefit the newly diagnosed.…”

Section: Discussionmentioning

confidence: 64%

Establishing an HIV Screening Program Led by Staff Nurses in a County Jail

Spaulding

Kim

Corpening

et al. 2015

Journal of Public Health Management and Practice

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Context HIV testing in jails provides an opportunity to reach individuals outside the scope of traditional screening programs. The rapid turnover of jail populations has, in the past, been a formidable barrier to offering routine access to testing. Objective To establish an opt-out, rapid HIV testing program, led by nurses on the jail staff, that would provide undiagnosed yet infected detainees opportunities to learn their status regardless of their hour of entry and duration of stay. Design Jail nurses offered rapid, opt-out HIV testing Setting Fulton County Jail (FCJ) in Georgia, United States. Participants 30,316 persons booked to FCJ. Intervention In late 2010, we performed a preliminary evaluation of HIV seroprevalence. Starting January 1, 2011, HIV testing via rapid oral mucosal swab was offered to entrants. In March 2013, fingerstick was substituted. Detainees identified as positives were assisted with linkage to care. Main outcome measures To estimate an upper limit of overall HIV prevalence among entrants, we determined seroprevalence by age and gender group. To measure program performance, we checked offer and acceptance rates for tests and rate of linkage to care among previously known and newly identified HIV+ detainees. Results The initial seroprevalence of HIV in FCJ was at least 2.18%. Between March 2013 and February 2014, 89 new confirmed positives were identified through testing. During these 12 months, 20,947 bookings were followed by an offer of HIV testing (69.10% offer rate), and 17,035 persons accepted (81.32% acceptance rate). A total of 458 previously and newly identified persons were linked to HIV care. Linkage was significantly higher among those aged 40 years and older (p<0.05). Conclusions A nurse-led, rapid HIV testing model successfully identified new HIV diagnoses. The testing program substantially decreased the number of persons who are HIV-infected but unaware of their status and promoted linkage to care.

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Early Identification of HIV: Empirical Support for Jail-Based Screening

Cited by 40 publications

References 38 publications

Emergency Department Use among HIV-Infected Released Jail Detainees

Emergency Department Use among HIV-Infected Released Jail Detainees

HIV Testing, HIV Positivity, and Linkage and Referral Services in Correctional Facilities in the United States, 2009–2013

Establishing an HIV Screening Program Led by Staff Nurses in a County Jail

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