routine opt-out hiv testing strategies in a female jail setting a prospective controlled trialu201c选择退出u201d的艾滋病毒检测策略在女性监狱设置前瞻性对照试验.pdfVIP

Routine Opt-Out HIV Testing Strategies in a Female Jail Setting: A Prospective Controlled Trial Ravi Kavasery, Duncan Smith-Rohrberg Maru, Joshua Cornman-Homonoff, Laurie N. Sylla, David Smith, Frederick L. Altice* Yale University School of Medicine, Section of Infectious Diseases, AIDS Program, New Haven, Connecticut, United States of America Abstract Background: Ten million Americans enter jails annually. The objective was to evaluate new CDC guidelines for routine opt- out HIV testing and examine the optimal time to implement routine opt-out HIV testing among newly incarcerated jail detainees. Methods: This prospective, controlled trial of routine opt-out HIV testing was conducted among 323 newly incarcerated female inmates in Connecticut’s only women’s jail. 323 sequential entrants to the women’s jail over a five week period in August and September 2007 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 108), early (next day, n = 108), or delayed (7 days, n = 107). The primary outcome was the proportion of women in each group consenting to testing. Results: Routine opt-out HIV testing was significantly highest (73%) among the early testing group compared to 55% for immediate and 50% for 7 days post-entry groups. Other factors significantly (p = 0.01) associated with being HIV tested were younger age and low likelihood of early release from jail based on bond value or type of charge for which women were arrested. Conclusions: In this correctional facility, routine opt-out HIV testing in a jail setting was feasible, with highest rates of testing if performed the day after incarceration. Lower testing rates were seen with immediate testing, where there is a high prevalence of inability or unwillingness to test