Division of Infections Diseases, Alpert Medical School of Brown University, Providence, RI, USA.
J Acquir Immune Defic Syndr. 2010 Apr 1;53(4):485-90. doi: 10.1097/QAI.0b013e3181c997b1.
Jail incarceration represents an opportunity to deliver HIV counseling and testing (C&T) services to persons at increased risk of infection. However, jails can be chaotic with rapid turnover of detainees. We conducted a pilot study to investigate the feasibility of comparing the effect of different approaches to HIV C&T in jail on subsequent HIV risk behaviors among persons testing HIV negative.
Consecutive cohorts of newly incarcerated jail detainees were recruited with 132 subjects completing standard HIV C&T as per jail protocol and 132 subjects completing rapid testing with an individualized counseling session. Risk behavior was assessed and compared at baseline and 6 weeks after jail release.
Among the 264 male participants, preincarceration substance use and sexual risk were common. The follow-up visit was completed by 59% of eligible participants. There were no differences in postrelease HIV risk behavior between the 2 arms but there was an overall decrease in risk behavior after jail release for the cohort. In addition, all participants in the rapid arm received rapid HIV test results compared with participants receiving 28% of conventional test results.
Jail incarceration represents an important public health opportunity to deliver HIV C&T. This study demonstrated (1) feasibility in delivering rapid HIV testing combined with individualized counseling to jail detainees, (2) improved test result delivery rates, and (3) success with evaluating risk behaviors during the transition from jail to the community. Further research is needed to determine the optimal approach to HIV C&T in jail with the goal of increasing awareness of HIV serostatus and decreasing HIV risk behavior.
监禁为感染风险增加的人群提供艾滋病咨询和检测（C&T）服务提供了机会。然而，监狱环境混乱，被拘留者流动迅速。我们进行了一项试点研究，以调查比较不同方法对艾滋病毒 C&T 在监狱中对随后艾滋病毒阴性检测者的艾滋病毒风险行为的影响的可行性。
连续招募新入狱的监狱被拘留者，其中 132 名完成了按监狱协议进行的标准 HIV C&T，132 名完成了快速测试和个性化咨询。在入狱前和入狱后 6 周评估并比较风险行为。
在 264 名男性参与者中，入狱前的物质使用和性风险很常见。有 59%的符合条件的参与者完成了随访。但在 2 个组间，出狱后的 HIV 风险行为没有差异，但队列在入狱后总体风险行为有所下降。此外，与接受常规检测结果的 28%的参与者相比，快速组的所有参与者都收到了快速 HIV 检测结果。
监禁为提供 HIV C&T 提供了一个重要的公共卫生机会。这项研究表明：（1）向监狱被拘留者提供快速 HIV 检测结合个性化咨询是可行的；（2）提高了检测结果的提供率；（3）在从监狱过渡到社区的过程中成功评估了风险行为。需要进一步研究以确定在监狱中进行 HIV C&T 的最佳方法，目标是提高对艾滋病毒血清阳性的认识并减少艾滋病毒风险行为。
