Determinants of voluntary HIV testing among inmates

描述（由申请人提供）：尽管在押人员感染艾滋病毒的负担很重，但美国各州监狱系统的检测策略差异很大。在19个州，监狱系统强制执行艾滋病毒检测；其他31个州的监狱系统（占囚犯总数的70%）采用了某种程度的自愿检测。然而，很少有研究系统地探讨了州监狱系统中自愿艾滋病毒检测的程度或有效性。鉴于在自愿监狱系统中缺乏关于艾滋病毒检测的知识，以及受感染的囚犯和囚犯返回的社区所积累的检测的好处，我们建议在一个大型的南部州监狱系统的背景下实现以下具体目标：1)确定新入狱者的全系统和特定设施的艾滋病毒检测率，2)探索与艾滋病毒检测率相关的特定设施差异，3)确定与接受艾滋病毒检测相关的囚犯特征，以及4)确定与血清阳性相关的囚犯特征。这些目标将通过使用先进的统计技术，包括分层多元建模和主成分分析，分析一个大型（N=72,000）数据库来实现。

DESCRIPTION (provided by applicant): Despite the heavy burden of HIV infection among incarcerated people, testing strategies vary widely across US state prison systems. In 19 states, prison systems enforce mandatory HIV testing; the other 31 state prison systems, which incarcerate 70% of all inmates, employ some degree of voluntary testing. Few studies, however, have systematically explored the extent or effectiveness of voluntary HIV testing in state prison systems. Given the lack of knowledge regarding HIV testing in Voluntary' prison systems and the benefits of testing accrued by both infected inmates and communities to which inmates return, we propose to accomplish the following specific aims within the context of a large, southern state prison system: 1) determine system-wide and facility specific HIV testing rates among new prison entrants, 2) explore facility-specific differences associated with HIV testing rates, 3) identify inmate characteristics associated with receipt of an HIV test, and 4) identify inmate characteristics associated with positive serostatus. These aims will be achieved by analyzing a large (N=72,000) database using advanced statistical techniques including hierarchical multivariate modeling and principal components analysis.