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An evaluation of HIV testing among inmates in the North Carolina prison system.

ABSTRACT: We examined the use of voluntary HIV testing among state prisoners in the North Carolina prison system.We calculated system-wide and facility-specific proportions and rates of adult inmates tested for HIV and estimated associations between testing status and inmate characteristics for prisoners in North Carolina.Of the 54 016 inmates who entered prison between January 2004 and May 2006, 20 820 (38%) were tested for HIV; of those tested, 18 574 (89%) were tested at admission. Across the 8 intake prisons, more than 80% of inmates in both female facilities but less than 15% of inmates in 4 of 6 male facilities were tested. Prisoners with a documented history of heroin use, crack or cocaine use, conventional HIV risk behavior, or tuberculosis were at least 10% more likely to be tested than were inmates without these characteristics. However, more than 60% of men reporting conventional risk behaviors were not tested. Before covariate adjustment, Black men were 30% less likely than White men to be tested; in the multivariable regression model, this difference was attenuated to 13%.Rates of HIV testing varied widely across intake prisons, and many male inmates with documented risk of infection were never tested.

SUBMITTER: Rosen DL

PROVIDER: S-EPMC2760001 | biostudies-literature | 2009 Oct

REPOSITORIES: biostudies-literature

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An evaluation of HIV testing among inmates in the North Carolina prison system.

Rosen David L DL Schoenbach Victor J VJ Wohl David A DA White Becky L BL Stewart Paul W PW Golin Carol E CE

American journal of public health 20091001

<h4>Objectives</h4>We examined the use of voluntary HIV testing among state prisoners in the North Carolina prison system.<h4>Methods</h4>We calculated system-wide and facility-specific proportions and rates of adult inmates tested for HIV and estimated associations between testing status and inmate characteristics for prisoners in North Carolina.<h4>Results</h4>Of the 54 016 inmates who entered prison between January 2004 and May 2006, 20 820 (38%) were tested for HIV; of those tested, 18 574 ( ...[more]

PMID: 19797758

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Project description:ObjectivesTo estimate the prevalence of HCV-infection and identify associated factors among inmates in the State Prison System of Guanajuato in Mexico (Sep-2011 to Feb-2012).MethodsCross-sectional, observational study in 10 prisons in the State of Guanajuato in Mexico (2011-2012). We offered HCV-testing and applied audio computer-assisted self-interviews to all adults imprisoned in the State Prison System. We used a complex survey analysis to estimate the distribution of variables and its corresponding 95% confidence intervals, taking into consideration the expected cluster effect by common characteristics within prisons. Inverse probability weights were applied to correct potential biased estimates arising from non-participation in accrual activities and non-response rates. We fitted multivariate logistic regression models to identify risk-behaviors associated to HCV-infection.ResultsWe included data of 2,519 participating inmates. Prevalence of HCV-infection was 4.9 (95%CI = 3.6-5.9). Most HCV-infected inmates were male (99%). Before being incarcerated, inmates with HCV-infection were more frequently tattooed, used and injected drugs more frequently, and were more likely to share materials for injecting, when compared with those non-infected. During incarceration, HCV-infected inmates got tattoos and used drugs more often than non-infected, including injecting-drugs and sharing materials. Injecting-drug use (OR = 7.6, 95%CI, 2.5-23.4), sharing materials for injecting-drugs (OR = 19.6, 95%CI, 4.7-81.7) and being tattooed at least once before incarceration (OR = 2.1, 95%CI, 1.1-3.9), but not during incarceration, were independently associated to HCV-infection.ConclusionsThe prevalence of HCV-infection among inmates in the State of Guanajuato in Mexico is considerably higher than in the general population. The most important risk factors for HCV in this inmate population were injecting-drugs and sharing materials for injections before incarceration. High-risk behaviors during imprisonment are very high particularly among those already infected. HCV diagnostic and treatment services, and harm-reduction programs for incarcerated injecting-drug users in Mexico should be integrated to control the HCV epidemic in Mexico.

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An evaluation of HIV testing among inmates in the North Carolina prison system.

Publications

An evaluation of HIV testing among inmates in the North Carolina prison system.

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