Researchers find jail-based surveillance screening useful in monitoring HIV and sexually transmitted disease epidemics

July 10, 2000

A study by the San Francisco Department of Public Health, conducted at the San Francisco County Jail, has found that anonymous HIV screening of jail inmates offers an opportunity to track the epidemic in at-risk groups, particularly those who traditionally under-utilize health care services.

"This type of screening, called sentinel surveillance, offers an early warning system to monitor the extent of HIV infection in a generally low socioeconomic group that doesn't often access screening services," said the study's lead investigator, Willi McFarland, MD, PhD, of the San Francisco Department of Public Health HIV Seroepidemiology Unit and the University of California, San Francisco Center for AIDS Prevention Studies.

Research findings were reported today (July 11) at the XIII International AIDS Conference in Durban, South Africa.

The on-going effort, funded by the Centers for Disease Control and Prevention, involves a close collaboration of the San Francisco health department's AIDS Office, Sexually Transmitted Disease (STD) Prevention and Control Services, and Forensic AIDS program.

Researchers conduct the HIV testing through an STD services screening program established by the health department three years ago at the county jail. It offers voluntary screening for gonorrhea, syphilis, and chlamydia within hours of arrest to male inmates aged 18-35 and females 18-45. Most prisoners offered the services have chosen to participate in the program, and it has detected a higher number of STDs than are typically picked up in screening programs that are available to populations outside the jail setting, said McFarland. "We saw in this successful STD screening program an opportunity to conduct a completely blinded HIV surveillance survey in high-risk groups brought to the jail," said McFarland.

The study, which began in June 1999, tested for HIV in residual blood samples drawn for syphilis testing. Researchers did not track the patients by name, but were able to follow demographic characteristics and behaviors that put individuals at risk for HIV, such as intravenous (IV) drug use, or men having sex with men.

At the Durban meeting, results were reported for the period June 1999 to February 2000.

Researchers found HIV in about 2 percent of 3,019 inmates who underwent screening--a rate about 5 times greater than would be expected in the general heterosexual population of San Francisco. The highest levels of HIV infection (19 percent) were found in men who had sex with men and were also IV drug users. Men who had sex with men and did not inject drugs had a 16 percent level of infection. HIV-positive inmates of either sex were also more likely to report injection drug use, having sex with a man, and having sex with an HIV-infected partner.

The researchers were also able to determine which groups appeared to have been more recently infected with the virus, because the study used a new HIV diagnostic test that can determine whether infection has occurred within the last six months. Most recent infections found in the jail were associated with drug use.

Rates of others STDs in the study population were 2 percent for gonorrhea, 7 percent for chlamydia, and 0.1 percent for syphilis. Although this HIV surveillance screening program is conducted on an anonymous basis and inmates do not find out their test results, confidential HIV screening and treatment referral are available on request for inmates who want to know their HIV status, said McFarland.
Study co-investigators included Andrea Kim, MPH, of the SF Department of Public Health HIV Seroepidemiology Unit, who presented the findings at the Durban meeting; Tim Kellogg, MA, also of the HIV Seroepidemiology Unit; Charlotte Kent, MPH, Robert Kohn, MPH, and Ameera Snell, BA, of the SF Department of Public Health STD Prevention and Control program; Joe Goldenson, MD, of the SF Department of Public Health, Forensic Services; and Keith Bordelon, MPH, and Keith Sabin, PhD, MPH, of the US Centers for Disease Control and Prevention. Jeffrey Klausner, MD, MPH, director of STD Control for the SF Department of Public Health, is the co-principal investigator.

University of California - San Francisco

Related HIV Articles from Brightsurf:

BEAT-HIV Delaney collaboratory issues recommendations measuring persistent HIV reservoirs
Spearheaded by Wistar scientists, top worldwide HIV researchers from the BEAT-HIV Martin Delaney Collaboratory to Cure HIV-1 Infection by Combination Immunotherapy (BEAT-HIV Collaboratory) compiled the first comprehensive set of recommendations on how to best measure the size of persistent HIV reservoirs during cure-directed clinical studies.

The Lancet HIV: Study suggests a second patient has been cured of HIV
A study of the second HIV patient to undergo successful stem cell transplantation from donors with a HIV-resistant gene, finds that there was no active viral infection in the patient's blood 30 months after they stopped anti-retroviral therapy, according to a case report published in The Lancet HIV journal and presented at CROI (Conference on Retroviruses and Opportunistic Infections).

Children with HIV score below HIV-negative peers in cognitive, motor function tests
Children who acquired HIV in utero or during birth or breastfeeding did not perform as well as their peers who do not have HIV on tests measuring cognitive ability, motor function and attention, according to a report published online today in Clinical Infectious Diseases.

Efforts to end the HIV epidemic must not ignore people already living with HIV
Efforts to prevent new HIV transmissions in the US must be accompanied by addressing HIV-associated comorbidities to improve the health of people already living with HIV, NIH experts assert in the third of a series of JAMA commentaries.

The Lancet HIV: Severe anti-LGBT legislations associated with lower testing and awareness of HIV in African countries
This first systematic review to investigate HIV testing, treatment and viral suppression in men who have sex with men in Africa finds that among the most recent studies (conducted after 2011) only half of men have been tested for HIV in the past 12 months.

The Lancet HIV: Tenfold increase in number of adolescents on HIV treatment in South Africa since 2010, but many still untreated
A new study of more than 700,000 one to 19-year olds being treated for HIV infection suggests a ten-fold increase in the number of adolescents aged 15 to 19 receiving HIV treatment in South Africa, according to results published in The Lancet HIV journal.

Starting HIV treatment in ERs may be key to ending HIV spread worldwide
In a follow-up study conducted in South Africa, Johns Hopkins Medicine researchers say they have evidence that hospital emergency departments (EDs) worldwide may be key strategic settings for curbing the spread of HIV infections in hard-to-reach populations if the EDs jump-start treatment and case management as well as diagnosis of the disease.

NIH HIV experts prioritize research to achieve sustained ART-free HIV remission
Achieving sustained remission of HIV without life-long antiretroviral therapy (ART) is a top HIV research priority, according to a new commentary in JAMA by experts at the National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health.

The Lancet HIV: PrEP implementation is associated with a rapid decline in new HIV infections
Study from Australia is the first to evaluate a population-level roll-out of pre-exposure prophylaxis (PrEP) in men who have sex with men.

Researchers date 'hibernating' HIV strains, advancing BC's leadership in HIV cure research
Researchers have developed a novel way for dating 'hibernating' HIV strains, in an advancement for HIV cure research.

Read More: HIV News and HIV Current Events is a participant in the Amazon Services LLC Associates Program, an affiliate advertising program designed to provide a means for sites to earn advertising fees by advertising and linking to