Rapid HIV testing in jails

Atlanta has emerged as a hotbed for HIV, and many of those infected don't know it.

By the time they are finally diagnosed, about one-third of Atlanta patients will have advanced to clinical AIDS.

Anne Spaulding, associate professor of epidemiology, is trying to ensure infected people are diagnosed earlier through a project that incorporates voluntary rapid HIV testing into the medical intake process at Atlanta's Fulton County Jail. The rapid part is key, since the median jail stay is five days, which is why routine HIV testing has not been particularly successful.

Spaulding's project, which her team began as a cooperative agreement with the CDC, identified 89 new HIV cases in 12 months.

"Typically, Fulton County diagnoses 535 new cases every year, so for us to find that many was significant," says Spaulding.

Those who are identified as being infected with HIV are connected to HIV/AIDS treatment centers when they are released.

"This is not about detecting HIV/AIDS newly acquired within jails," says Spaulding. "This is about making sure previously infected people don't leave jails unaware that they are positive and inadvertently spread the infection. Like many public health interventions in a jail setting, this benefits society as a whole."

The Fulton County Jail program has been so successful, the jail in neighboring DeKalb County plans to replicate the program, using test kits donated by the Georgia Department of Public Health.