H-471. Missed Opportunities for Early HIV Diagnosis in Jails: South Carolina January 2001 - December 2005
Session: Poster Session: HIV: Testing
Saturday, October 25, 2008: 12:00 AM
Room: Hall C
Background: Approximately 25% of all HIV- infected individuals in the United States pass through a correctional facility each year. This study investigated the extent to which incarcerated South Carolina (SC) HIV/AIDS cases could have been diagnosed earlier at a prior jail arrest. Methods: Retrospective cohort design linking case reports from the SC HIV/AIDS Reporting System and the SC Law Enforcement Divisions Computerized Criminal History database. HIV data from individuals first diagnosed with HIV infection between January 2001 and December 2005 were linked using variables such as race/ethnicity, gender, residence, and age with the statewide arrest records occurring from January 1996 through December 2005. Odds ratios and 95% confidence intervals were used to determine demographic variables and arrest reasons as determinants of testing. Results: Of the 4,117 newly diagnosed HIV-positive individuals, 1,969 (48%) were arrested within 10 years prior to testing HIV-positive. Of those arrested, 782 (39.7%) developed AIDS within one year of testing (late testers). Women were less likely than men to be late testers (OR 0.77; 95% CI 0.61-0.99). The odds of being a late tester increased with age (p <0.01). Persons over 50 years of age had an increased odds of late testing when compared to 20-24 year olds (OR 5.19; 95% CI 3.14, 8.61). Overall, 3,721 separate arrests were recorded for these 1,969 individuals and 845 (23%) were for drugs and alcohol or sex crimes. Individuals with more than 8 arrests were more likely to be late testers when compared to those with 1 arrest (OR 4.21; 95% CI 2.51,7.05).
Conclusion: Early identification of new HIV infection is of public health importance. Jails present missed opportunities to identify individuals with undiagnosed HIV infection. Implementation of routine HIV testing in jails should be of consideration.
Eren Youmans, MPH, Arnold school of public health, Columbia, SC, Wayne Duffus, MD, PhD, South Carolina Dept. of Health and Environmental Control, Columbia, SC and  E. Youmans, None.

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