North Carolina: HIV Testing Grows in Inmate Population

HIV testing uptake among state prisoners has risen to nearly 100 percent in the past three years thanks to a new approach, a study by University of North Carolina-Chapel Hill researchers finds.

Just three years ago, only 15 percent of male inmates and 80 percent of female inmates were screened for HIV, according to the researchers — making it difficult for officials to monitor the spread of the virus and treat those infected. Inmates had to elect whether they wanted to be tested when asked about their high-risk behaviors.

CDC presented a new approach in 2006, which was adopted by N.C. prison officials in November 2008. Under the revised policy, HIV testing is part of routine health screenings upon intake, with inmates having the choice to opt out. Now, 90 percent-95 percent of prisoners statewide are tested for HIV upon entering prison, said Dr. David Wohl, co-director of HIV Services for the N.C. Department of Correction.

Wohl noted that 97 percent of inmates who tested HIV-positive already knew they had HIV. That only 3 percent first learned they were HIV-positive through correctional-setting testing indicates there is a very small number of unreported HIV cases among North Carolina's prisoners, he added.

While Bureau of Justice Statistics (BJS) data show 20 states have adopted mandatory inmate HIV testing, Wohl believes opt-out testing is a better approach. Inmates are receptive to HIV prevention and treatment information when given the consent choice, said Wohl. "The idea of coercing inmates into being tested makes me uncomfortable," he said.

BJS data from 2008 showed North Carolina had the fifth-highest rate (1.5 percent-2 percent) of inmates with confirmed HIV or AIDS compared to other states.

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