CDC: Expanded HIV Testing Initiative Effective

Opt-out HIV screening of prison inmates during medical intake exam ups number tested

THURSDAY, June 23 (HealthDay News) -- Initiatives to expand HIV testing, including an opt-out HIV screening approach used among inmates during prison medical intake evaluation, appear to be effective in identifying new HIV cases, according to two reports in the June 24 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

The CDC evaluated data from its Expanded HIV Testing Initiative, which was an effort that funded 25 health departments, starting in October 2007, to facilitate HIV screening and increase diagnoses of HIV infections and linkage to care among populations disproportionately affected by HIV, non-Hispanic blacks in particular. The data revealed that 2,786,739 HIV tests were conducted, of which 29,503 (1.1 percent) were positive and 18,432 (0.7 percent) resulted in new HIV diagnoses. The data also revealed that blacks accounted for 1,411,780 (60 percent) of tests and 11,638 (70 percent) of new HIV diagnoses. Clinical settings accounted for 90 percent of all tests and 81 percent of all new HIV diagnoses.

In another study, the Washington State Department of Corrections (WADOC) evaluated HIV testing data for male inmates undergoing intake medical evaluation between January 2006 and December 2010. Before September 2007, WADOC provided HIV testing to inmates on request only. But, starting at that time, WADOC began routine HIV opt-in screening, and in March 2010, it switched to opt-out screening. The data revealed that, between Jan. 1, 2006, and Aug. 1, 2007, 5 percent of 12,202 incoming inmates were tested for HIV at their request during the intake medical evaluation, and three (0.50 percent) of those tested had newly diagnosed HIV infection. Between Sept. 1, 2007, and March 15, 2010, 72 percent of 16,908 inmates agreed to opt-in HIV screening, and 13 (0.11 percent) tested positive for HIV. The data also revealed that 90 percent of 5,168 inmates agreed to opt-out HIV screening, and six (0.13 percent) tested positive for HIV between March 16, 2010, and Dec. 1, 2010.

"Compared with routine opt-in HIV screening, opt-out HIV screening was associated with a greater proportion of inmates tested, without decreasing the rate of case detection," the authors write.

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