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Rapid HIV screening in a jail setting: Addressing perceived barriers through a pilot project

142nd APHA Annual Meeting and Exposition (November 15 - November 19, 2014): http://www.apha.org/events-and-meetings/annual
Tuesday, November 18, 2014

Raees Shaikh, MPH , College of Public Health- Department of Health Promotion, Social and Behavioral Health, University of Nebraska Medical Center, Omaha, NE
Kari Simonsen, MD , Section of Pediatric Infectious Diseases, University of Nebraska Medical Center, Omaha, NE
Mary Earley, CJM , Department of Corrections, Douglas County, Nebraska, Omaha, NE
Mark Foxall, PhD , Department of Corrections, Douglas County, Nebraska, Omaha, NE
Cole Boyle , College of Public Health, University of Nebraska Medical Center, Omaha, NE
Monirul Islam, MD, PhD , Department of Epidemiology, University of Nebraska Medical Center, Omaha, NE
Heather Younger , Disease Prevention and Health Promotion- HIV prevention division, Nebraska Department of Health & Human Services, Lincoln, NE
Uriel Sandkovsky, MD, FACP , Division of Infectious Diseases and HIV Clinic, University of Nebraska Medical Center, Omaha, NE
Elizabeth Berthold , STD control, Douglas County Health Department, Omaha, NE
Ruth Margalit, MD , College of Public Health, University of Nebraska Medical Center, Omaha, NE
  
Background: Despite recommendations from the CDC, only 36% of jails offer HIV screening to inmates.  Perceived barriers to HIV screening in jails include rapid turnover of inmates, limited financial resources, maintaining confidentiality, establishing linkage to care and continuity of antiretroviral therapy at release. Our purpose was to evaluate the feasibility of rapid HIV screening in jail, and to explore potential barriers to such screening.

Methods: Over a 7 week period, 507 inmates were offered rapid HIV screening at the time of release. We used data for 302 inmates who opted to screen. Students from a local academic healthcare center provided testing services through the Do JuSTIce service learning project. All participating inmates received individual test results, education about HIV prevention, and linkage to care in the community prior to release.

Results: One inmate tested positive for HIV and was linked to care. The prevalence of risky sexual behaviors such as unprotected sex, multiple sexual partners, and sexual intercourse under the influence of drugs/alcohol was considerably high among the participants.  Almost two thirds of those that declined screening cited recent testing as the reason.

Discussion: The strong Do-JuSTIce service learning partnership and the support of the correctional administration allowed us to explore and understand perceived barriers to HIV screening. Health professions students providing testing services reduced perceived financial barriers and demands on jail medical staff, and testing upon exit of asymptomatic inmates allowed for linkage to care in the community. Our findings support feasibility of rapid HIV screening in jail setting.

Learning Areas:

Epidemiology
Implementation of health education strategies, interventions and programs
Protection of the public in relation to communicable diseases including prevention or control
Public health or related research
Social and behavioral sciences

Learning Objectives:
Describe the perceived barriers to rapid HIV testing in a jail setting. Discuss the strategies to overcome perceived barriers to HIV testing in a jail setting.

Keyword(s): HIV Interventions, Criminal Justice

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I have been involved with STD screening project and research in correctional setting for 3 years. I have coordinated two pilot screening projects in a local correctional facility including the one being presented in this abstract. Preventive services in correctional settings is one of my research areas of interest.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.

Back to: 4284.0: HIV Prevention Among Specific Populations 2