Innovative strategies for routine HIV/STD screening to reduce racial/ethnic HIV/STD disparities in correctional settings: A social justice mandate for incarcerated populations and their communities

Issues: Blacks and Hispanics comprise between 56%-58% of US jail and prison populations, and 25% of the US population (2008). HIV and STD rates among inmates are estimated at 4 and 10 times as high, respectively, as in the general US population. HIV and STDs disproportionately impact blacks and Hispanics more than other racial/ethnic groups. Routine HIV/STD screenings for inmates have yet to be widely implemented in correctional settings. Black and Hispanic communities, with already increased HIV/STD burden, have further risk for HIV/STD transmission when undiagnosed or untreated inmates return home. Description: Current recommendations for HIV and STD screenings for incarcerated persons per the National Commission on Correctional Health Care (NCCHC) were reviewed. Current correctional health HIV and STD screening practices, including Bureau of Justice Statistics' data, were also reviewed. Lessons Learned: NCCHC recommendations include: 1) promoting evidence-based guidelines for correctional settings to diagnose and treat HIV/STDs, and 2) identifying and eliminating barriers to successful implementation of HIV/STD screening. Twenty-four of 50 states (48%) reported testing inmates for HIV at admission or some point during custody; STD testing was not consistently reported by prisons or jails (2008). For 2007, black and Hispanic inmates were 2.8 and 1.4 times as likely to die of AIDS-related deaths (per 100,000 inmates) compared to whites. Recommendations: Partnerships between health departments, community health centers and correctional settings should be explored to fully implement current NCCHC recommendations. Routine HIV/STD screenings in correctional settings are warranted to decrease racial/ethnic disparities and community burden of HIV/STDs.