MedPage Today (11.27.2013)
Medpage Today reported on a study showing that HIV screening among new inmates in North Carolina’s prison system identified few new diagnoses. David Wohl, MD, and colleagues at the University of North Carolina in Chapel Hill conducted a study of HIV testing in North Carolina from June 2008 to April 2009. During the time of the study, HIV testing at entry into the state’s prisons was voluntary, but a syphilis test was mandatory.
The researchers conducted an HIV assay using blood left from the syphilis test and compared results with data in the North Carolina Department of Health and Human Services HIV testing database. The researchers performed tests on the excess blood of 22,134 (94.7 percent) out of 23,373 individuals entering the system. Of those tested, 320 were HIV-positive (1.45 percent), but 300 already had been diagnosed. Hence, after testing of 22,134 persons, the researchers found 20 (0.09 percent) new infections. Of the 1,239 new inmates who did not have enough excess blood for HIV testing, 1,066 volunteered to be tested while imprisoned and 36 (4.8 percent) tested positive. However, these 36 inmates already were in the state health department records as HIV-infected.
Wohl expressed surprise that 94 percent of the individuals entering prison already were known to be infected. The prevalence of HIV among the new inmates was close to the CDC estimate of 1.4 percent among the national state and federal prison population. The researchers supposed that the inmates may have been screened during earlier imprisonment, but almost half of the inmates with previously diagnosed HIV had not been imprisoned before. The researchers noted that North Carolina has the eighth largest HIV prevalence in the United States and that these findings might not apply to other states.
The full report, “Detection of Undiagnosed HIV Among State Prison Entrants,” was published in the Journal of the American Medical Association (2013; 310(20):2198–2199).