Routine HIV screening during intake medical evaluation at a County Jail - Fulton County, Georgia, 2011-2012

Abstract

Fulton County Jail (FCJ) in Atlanta, Georgia, is one of the 50 largest jails in the nation, with an average daily census of 2,269 detainees. During January 1, 2011-March 15, 2012, FCJ implemented a demonstration project to integrate routine rapid human immunodeficiency virus (HIV) screening into the medical intake process. This report summarizes the results. Nearly 59% of persons booked (22,920 of 39,073) received an intake medical evaluation, and voluntary oral fluid HIV rapid screening was offered, except to those who disclosed a previous HIV diagnosis (473 [2.1%]) or were not able to provide consent. An HIV test was offered on 18,869 visits, and 12,141 HIV tests were conducted. All persons with a reactive result (120 [1.0%]) underwent confirmatory HIV testing unless they subsequently disclosed a previous HIV diagnosis. This project identified 52 persons with newly diagnosed HIV infection; 48 by rapid testing (0.4% of those tested) during the study period. All received medical care in the facility and referral for community services on release. Without this HIV screening project, these persons likely would have been diagnosed later in the course of their infection, resulting in delayed access to care and treatment, and possible transmission of HIV to their partners. Linkage to community services is critical, and coordination with the public health system and community-based organizations are essential to ensure access to HIV care and retention in treatment for persons with HIV released from jail.