University of South Carolina School of Medicine, Department of Medicine, Division of Infectious Diseases, Two Medical Park, Columbia, South Carolina, USA.
AIDS Patient Care STDS. 2009 Dec;23(12):1025-32. doi: 10.1089/apc.2009.0197.
To quantify the extent that South Carolina HIV/AIDS cases could have been diagnosed during a prior arrest we designed a retrospective population-based cohort study linking case reports from HIV/AIDS Reporting System (HARS) and the South Carolina Law Enforcement Division database. Data from individuals newly diagnosed between January 2001 and December 2005 were linked with statewide arrest records from April 1991 through November 2005. Criminal history data for this report were derived from 28 state prisons and more than 250 law enforcement agencies (jails, lockups, detention centers). Odds ratios and 95% confidence intervals were used to determine how demographic variables and arrest reasons affects receipt of HIV testing. There were 1961/4036 (48.6%) incident cases of HIV diagnosis that had at least one arrest prior to their first positive HIV test. When restricted to 1286/1961 (65.6%) individuals most likely to have been HIV-infected at the time of arrest, 592 (46%) were early testers (no AIDS within 1 year) and 694 (54%) developed AIDS more than 1 year of testing (late testers). After controlling for gender, age, race, behavioral risk and source of HIV report, the odds of being a late tester increased with age (p < 0.001). Overall, 3750 separate arrests were recorded for these 1286 individuals and 491 (13%) arrests were for drug and alcohol or sex crimes. Individuals with 4 or more arrests were more likely to be late testers when compared to those with fewer than 4 arrests (adjusted odds ratio [AOR] 3.30; 95% confidence [CI] 2.28, 4.72). Correctional facilities present considerable opportunities to identify individuals with undiagnosed HIV infection. Providing correctional facilities with the infrastructure for implementation of routine HIV testing would consequently have a significant impact on the health status of the entire community.
为了量化南卡罗来纳州艾滋病毒/艾滋病病例在之前被捕时被诊断的程度，我们设计了一项回顾性基于人群的队列研究，将来自艾滋病毒/艾滋病报告系统 (HARS) 的病例报告与南卡罗来纳州执法部门数据库联系起来。2001 年 1 月至 2005 年 12 月期间新诊断出的个人的数据与 1991 年 4 月至 2005 年 11 月期间的全州逮捕记录相联系。本报告的犯罪历史数据来自 28 所州立监狱和 250 多个执法机构（监狱、拘留所、拘留中心）。使用比值比和 95%置信区间来确定人口统计学变量和逮捕原因如何影响接受 HIV 检测。在首次 HIV 检测呈阳性之前，有 1961/4036（48.6%）例艾滋病毒诊断病例至少有一次被捕。当限制在 1286/1961（65.6%）最有可能在被捕时感染艾滋病毒的人中，592 人（46%）是早期检测者（1 年内无艾滋病），694 人（54%）在检测 1 年以上时出现艾滋病（晚期检测者）。在控制性别、年龄、种族、行为风险和 HIV 报告来源后，晚期检测者的几率随着年龄的增长而增加（p < 0.001）。总体而言，这些 1286 人共记录了 3750 次单独逮捕，其中 491 次（13%）被捕是因毒品和酒精或性犯罪。与逮捕次数少于 4 次的人相比，逮捕次数为 4 次或更多的人更有可能成为晚期检测者（调整后的比值比 [AOR] 3.30；95%置信区间 [CI] 2.28，4.72）。惩教设施为发现未确诊的艾滋病毒感染者提供了重要机会。为惩教设施提供实施常规 HIV 检测的基础设施，将对整个社区的健康状况产生重大影响。
