Offer testing and they will come: A case study of implementing an HIV testing program in a community detention center

Issues

Historically, a discussion about HIV testing in community detention centers ended with the conclusion that implementation was idiosyncratic, dependent on the characteristics of a specific location. This assumption blunts consideration of factors that are important in successful testing implementation in many community detention centers.

Description

The following study provides a case history of the implementation of HIV testing in a community detention center in the South. Implementation is discussed in the context of eight factors, including timing of testing, marketing and advertising of services, and the manner in which testing is presented to inmates, testing protocols, methods of informing those tested of their results, confidentiality of results, HIV counseling associated with testing and consideration of administrative and implementation issues.

Lessons learned Process data demonstrated an acceptance rate that exceeded 90% for both males and females in a population of over 5,000 inmates. Testing acceptors had been in jail a mean of 11 days and dropouts only 2.5 days. Precise record-keeping demonstrated at what point individuals dropped-out of the process—over 25% before any description of the testing could be made and 50% following lengthy research consent.

Recommendations

Community detention centers that wish to implement HIV testing should consider the effect that individual testing steps have on inmate acceptance. The factors that improve inmate acceptance may at times be counterintuitive to detention center staff.