A Comprehensive Seek, Test, and Treat Project in a Detention Facility: Preliminary Findings

Background: Elevated rates of HIV are observed among prison populations. Many challenges to identification of new cases and linkage to post-release care remain. This project is evaluating the feasibility and cost-effectiveness of a comprehensive Seek, Test, and Treat program for people entering a short-term detention facility.

Method: Individuals entering the facility (probation/parole violation: 73%) are approached within 24-48 hours of admittance and asked to participate in a study to assess sexual and substance use risk behavior, receive a rapid HIV test and results, and complete a computerized risk reduction computer program. HIV-positive individuals are linked to post-release treatment.

Results: During the first 6 months of the project, 1,292 individuals (X=31.5 years; 66% African-American; 96% male) were enrolled (69.4% enrollment rate). 8 HIV-positive men (1 new) were identified (0.6%). 6 have been released: 4 linked to treatment; 1 not linked; 1 out of state. Among 1,204 unique participants (88 repeaters), high rates of ER visits, psychological help, and substance use treatment were reported. Median number of lifetime arrests was 9. 10% had used hard drugs in prior three months; 6% reported injection drug use. 44% reported sex with multiple partners. 15% were identified as high risk (hard and/or injection drug use; unprotected vaginal and/or anal sex with known HIV+ partner).

Conclusions: It is feasible to enroll people in short-term detention facility into an HIV testing study, and link positive individuals to post-release care. Moderate rates of HIV risk behavior and HIV seroprevalence were observed. Implications for prevention and treatment are discussed.