FOCUS April-07 HIV in the Georgia State Prison System

prison inmates in the United States is more than four times higher than prevalence in the general U.S. population.1,2 However, the full extent of HIV transmission within prisons is unknown, in part because HIV testing strategies vary across state prison systems.1 The Georgia Department of Corrections has mandated HIV screening of all inmates upon entry since 1988 and offers HIV testing during incarceration upon inmate request, if medically indicated, following exposure to bodily fluids, or in response to a court order. The Department of Corrections also routinely offered voluntary HIV testing to inmates during annual physical examinations from July 2003 through June 2005. In mid-2003, a male Georgia Department of Corrections inmate who tested HIV-negative on entry into prison several years earlier was diagnosed with AIDS and died shortly thereafter. In early 2004, a second male inmate who had tested HIV-negative on entry was diagnosed with AIDS and died. Following these deaths, Department of Corrections medical staff reviewed routinely collected HIV testing data from 1988 through 2005 and identified an additional 86 male inmates who, having tested HIV-negative on entry, subsequently tested HIV-positive during the same incarceration. (Analysis of HIV testing histories is ongoing to determine if any inmates who seroconverted might have acquired HIV infection prior to incarceration.)