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January 2009

Content

Authors

Introduction

Section I: Background: HIV AIDS in Correctional Settings

• Incarcerated Population at midyear 2007
• HIV testing and HIV/AIDS policies in U.S. Prisons at year-end 2006
• Survey of Prison Inmates
• Survey of Jail Inmates

Section II: Opt-out HIV Screening in Correctional Medical Clinics

• Benefits of adopting an opt-out HIV screening program
• Basic principles of opt-out HIV screening
• Alternative approaches to routine opt-out HIV screening
  • Risk-based screening
  • Clinical screening
  • Demographic screening
  • Custody-based screening
  • Multiple approaches
• Repeat screening

Section III: Inmate Privacy and Confidentiality of HIV-related Information in Correctional Settings

• Policies and procedures
• Confidentiality and privacy considerations
• Suggestions for providing HIV services
• Medical records
• Special recommendations for adolescents confined in adult correctional facilities

Section IV: HIV Testing Procedures

• Conventional HIV testing algorithm
• Additional HIV tests currently available
  1. Oral Fluid HIV test
  2. Rapid HIV testing
• Evolving rapid testing strategies
• Considerations for HIV testing in correctional settings
• Interpretation of test results
• Providing HIV testing results

Section V: Linkage to Services

• Immediate clinical management issues
  1. Medical evaluation
  2. Immunizations for inmates infected with HIV
  3. Special circumstances
• Linkage to appropriate medical care
  1. During incarceration
  2. Upon release from custody
• Linkage to HIV Case Management Services
• Provision of HIV medications
• Partner Services (PS) and disclosure

Section VI: Challenges and Solutions

• Challenges that could increase inmate refusal for routine testing
• Challenges associated with increased number of tests conducted

Section VII: HIV/AIDS reporting

• Why HIV/AIDS case reporting is critical
• HIV/AIDS case reporting requirements
• Initiating HIV/AIDS case reporting

Section VIII: References

Section IX: Appendices

• Glossary
• Clinical indications of HIV/AIDS
• Useful resources
• Federal Bureau of Prison criteria for testing