Cook County, Ill., Jail to Expand HIV Testing; Inmates Can Opt Out

In late June, opt-out HIV testing was expanded to male inmates entering Cook County Jail, a process in place for female inmates since April 2011. Health officials plan to adopt a similar program for state prisons soon, hoping to increase the number of people who know their HIV status.

The program requires inmates to sign a form refusing to take the test during intake; otherwise, they will be tested. Undiagnosed inmates who leave prisons might infect their partners in the community, said experts.

"It's a window of opportunity for reaching them for education purposes," said Cajetan Luna, executive director of the Center for Health Justice. "Once people get out in the community, it's much harder to do that work."

According to CDC, each year one in seven people with HIV pass through a correctional facility. Inmates are more than twice as likely to have HIV as people in the general population, particularly inmates who used to engage in injecting drug use, sex work, and other risk behaviors.

Experts attribute misunderstandings about HIV and how it is transmitted for inmate reluctance to test, and fear of unwanted attention dissuades some from seeking treatment. "I try to give them plausible reasons on why they are seeing me other than they got it," said Dr. Chad Zawitz, director of infectious disease for Cook County Jail.

Compared to the previous year, the number of female inmates getting tested has about tripled since the opt-out program began, Zawitz said.

In the state prison system, opt-out testing will be paid for with part of a $7 million grant awarded two years ago to University of Illinois-Chicago researchers, who are also working to find and diagnose more HIV infections within inmate social networks.

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