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| Testing, education and access |
| By Jim Montalto, News Editor |
| Published: 08/13/2007 |
The Infectious Diseases in Corrections Report
recently released its summer issue, and the editors use it to renew the call for more attention to inmates suffering from HIV/AIDS. While it has not been acknowledged as a health risk of epic proportions, many health care organizations, like the Centers for Disease Control and Prevention, think corrections could do more for those infected with HIV and are clamoring for correctional facilities to step up their procedures when it comes to identifying HIV inmates. The CDC’s recent recommendations on expanding HIV testing to general health care settings also has increased the latest debates about HIV screenings in correctional settings. Authors of IDCR’s main article, HIV Behind Bars: Meeting the Need for HIV Testing, Education, and Access to Care begin their argument for increased HIV identification methods with some sobering statistics:
In addition, there is a higher prevalence of HIV within the correctional setting compared to the community among both males and females. In a 1997 study, it was estimated that approximately one-quarter of all HIV-infected persons in the United States passed through the correctional system in one year. The AIDS rate has been estimated to be more than three times greater in prison than in the community. There are less data on the HIV prevalence in jails compared to prisons. However, the estimated jail HIV prevalence rates range from 2.1-2.5%. Given high rates of risk behavior in inmates and the increased HIV prevalence rates behind bars, correctional HIV testing programs provide an opportunity for persons at risk of infection to access HIV testing services, education, and for HIV-infected persons to receive care.” Despite these challenges, IDCR points out that because many inmates face active substance abuse, mental health disorders, and racial disparities, they risk decreased access to health care in the community. As is such, the authors believe that, “incarceration provides an opportunity to intervene and provide HIV testing, medical care, and linkage to HIV services upon release from the correctional setting,” and that a routine HIV testing policy is critical to having a quality correctional HIV health program. The report goes on to discuss the viability of HIV testing all incoming inmates, and approaches to HIV screenings. The authors suggest that the best strategy involves a universal, routine, opt-out HIV testing policy that had all inmates undergo HIV testing “upon entrance to the correctional facility unless declined." Of course, none of the information derived from screening will be helpful unless it is communicated with community clinics, so they can continue support and treatment once an inmate is released. The report also encourages developing a correctional HIV program that includes routine voluntary opt-out HIV testing upon incarceration; a comprehensive medical evaluation; HIV care; and detailed re-entry practices that engage community providers. Beyond this, the authors and editors maintain an underlying theme that is present in many prior issues; incarceration not only serves as an opportunity to engage and help society's most at-risk individuals, but it also can be a link to health care community services to help those leaving the corrections system. Click here for the full June/July report Related Resources: CDC Correctional Health and HIV page |
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