HIV Testing in Prison: What's the Controversy?

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Important note: Information in this article was accurate in 1994. The state of the art may have changed since the publication date.

HIV Testing in Prison: What's the Controversy?

Lancet (12/17/94) Vol. 344, No. 8938, P. 1650
Diamond, Jan

In a Lancet commentary, Jan Diamond of Merrithew Memorial Hospital in Martinez, Calif., wonders whether HIV testing in prisons remains controversial. While the debate during the 1980s focused on mandatory testing for inmates and segregation of those who tested positive, the latest emphasis is on ways to increase voluntary testing and to improve the medical care of infected prisoners. Prison officials contend that protection--of the infected and uninfected inmates and of the correctional staff--is their main concern. The Centers for Disease Control and Prevention (CDC), however, has not found any instances of HIV infection or AIDS in correctional staff due to work-related transmission. Fifteen of the 16 U.S. prisons that conduct mandatory HIV testing do not segregate the HIV-infected inmates, which does not justify claims for any protective efforts. To maximize the effectiveness of voluntary testing and maintain the trust between staff and inmates, HIV testing should be performed by non-correctional staff. Anonymous testing should be considered. Testing must be followed by counseling, education, and good medical care, and interventions known to reduce transmission--such as condom distribution--should be adopted.

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