A prospective controlled trial of routine opt-out HIV testing in a men's jail.
A prospective controlled trial of routine opt-out HIV testing in a men's jail.
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DOI：
10.1371/journal.pone.0008056
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发表时间：
2009-11-25
期刊：
影响因子：
3.7
通讯作者：
Altice FL
中科院分区：
文献类型：
--
作者：
Kavasery R;Maru DS;Sylla LN;Smith D;Altice FL
每年约有 1000 万美国人入狱。疾病控制和预防中心现在建议在这些环境中进行常规选择退出艾滋病毒检测。然而，在监狱内进行常规选择退出艾滋病毒检测的后勤工作仍然存在争议。本研究的目的是评估使用选择退出策略对新入狱的监狱被拘留者进行常规艾滋病毒检测的最佳时间。这项针对常规选择退出 HIV 检测的前瞻性对照试验是在康涅狄格州纽黑文市一所城市男子监狱的 298 名新入狱男性囚犯中进行的。 2008 年 3 月和 4 月的三周内，298 名连续进入男子监狱的人被分配在入狱后的三个时间点之一接受常规选择退出艾滋病毒检测：立即（同一天，n = 103）、提前（第二天，n = 98）或延迟（7 天，n = 97）。主要结果是每组中同意测试的男性比例。与延迟 (33%) 检测组相比，早期 (53%: AOR = 2.6; 95% CI = 1.5 至 4.7) 和立即 (45%: AOR = 2.3; 95% CI = 1.3 至 4.0) 检测组的常规选择退出 HIV 检测显着较高。然而，立即测试组和早期测试组没有显着差异（p = 0.67）。在多变量分析中，与常规选择退出 HIV 检测显着相关的因素被分配到“早期”检测组 (p = 0.0003)，并且提前释放的可能性较低（保证金≥5,000 美元、移民或联邦指控或预判 >30 天）(p = 0.04)。两名受试者获得了初步阳性结果，其中一名随后被确认为艾滋病毒血清阳性。在这所人员流失率很高的男子监狱中，常规选择退出 HIV 检测不仅可行，而且在监禁 24 小时内进行的 HIV 检测率最高。 ClinicalTrials.gov NCT00624247
Approximately 10 million Americans enter jails annually. The Centers for Disease Control and Prevention now recommends routine opt-out HIV testing in these settings. The logistics for performing routine opt-out HIV testing within jails, however, remain controversial. The objective of this study was to evaluate the optimal time to routinely HIV test newly incarcerated jail detainees using an opt-out strategy. This prospective, controlled trial of routine opt-out HIV testing was conducted among 298 newly incarcerated male inmates in an urban men's jail in New Haven, Connecticut. 298 sequential entrants to the men's jail over a three week period in March and April 2008 were assigned to be offered routine opt-out HIV testing at one of three points after incarceration: immediate (same day, n = 103), early (next day, n = 98), or delayed (7 days, n = 97). The primary outcome was the proportion of men in each group consenting to testing. Routine opt-out HIV testing was significantly higher for the early (53%: AOR = 2.6; 95% CI = 1.5 to 4.7) and immediate (45%: AOR = 2.3; 95% CI = 1.3 to 4.0) testing groups compared to the delayed (33%) testing group. The immediate and early testing groups, however, did not significantly differ (p = 0.67). In multivariate analyses, factors significantly associated with routine opt-out HIV testing were assignment to the ‘early’ testing group (p = 0.0003) and low (bond ≥$5,000, immigration or federal charges or pre-sentencing >30 days) likelihood of early release (p = 0.04). Two subjects received preliminary positive results and one of them was subsequently confirmed HIV seropositive. In this men's jail where attrition was high, routine opt-out HIV testing was not only feasible, but resulted in the highest rates of HIV testing when performed within 24 hours of incarceration. ClinicalTrials.gov NCT00624247
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