MMWR Morb Mortal Wkly Rep. 2010 Jun 25;59(24):742-5.
The prevalence of human immunodeficiency virus (HIV) infection among incarcerated persons in the United States (1.5%) is approximately four times greater than the prevalence among persons in community settings (0.4%). In 2006, CDC recommended HIV testing in correctional facilities and elsewhere as part of routine medical evaluation. However, jail-based testing can be difficult logistically because of rapid turnover among detainees. In 2009, the Rhode Island Department of Corrections (RIDOC) reviewed its HIV testing program to assess HIV case identification, characterize HIV risk factors, and estimate the proportion of detainees who might not have been tested if testing had been delayed. RIDOC reviewed records of HIV testing of jail detainees during 2000-2007. During this period, 102,229 HIV tests were administered (representing an estimated 40,000-60,000 unique jail detainees), and HIV infection was newly diagnosed in 169 detainees, including 80 (48%) with unknown HIV risk factors. HIV testing was completed within 24 hours of jail admission. If HIV testing had been delayed for 7 days, 72 detainees (43%) would have been released before they could be tested, resulting in a delay in their HIV diagnosis and care, and continued risk for HIV transmission. To maximize case identification, all detainees should be offered voluntary HIV testing early in their incarceration as part of the first clinical evaluation, regardless of reported risk factors.
在美国，被监禁者中人类免疫缺陷病毒（HIV）感染的流行率（1.5%）大约是社区环境中流行率（0.4%）的四倍。2006 年，CDC 建议在监狱和其他场所进行 HIV 检测，作为常规医疗评估的一部分。然而，由于被拘留者的快速更替，监狱内的检测在后勤上可能很困难。2009 年，罗得岛惩教署（RIDOC）审查了其 HIV 检测计划，以评估 HIV 病例的识别、HIV 风险因素的特征以及如果检测延迟，可能有多少被拘留者未接受检测。RIDOC 审查了 2000-2007 年期间监狱被拘留者的 HIV 检测记录。在此期间，进行了 102,229 次 HIV 检测（代表估计有 40,000-60,000 名独特的监狱被拘留者），新诊断出 169 名被拘留者感染了 HIV，其中 80 名（48%）的 HIV 风险因素未知。HIV 检测在入狱后 24 小时内完成。如果 HIV 检测延迟 7 天，将有 72 名被拘留者（43%）在接受检测之前被释放，这将导致他们的 HIV 诊断和护理延迟，并继续存在 HIV 传播的风险。为了最大限度地发现病例，所有被拘留者都应在被监禁的早期作为首次临床评估的一部分，自愿接受 HIV 检测，无论报告的风险因素如何。
