Palm Beach (FL) Post

Monday, August 14, 2006

Fast Tests To Help Jail's HIV Fight

By Antigone Barton

Palm Beach Post Staff Writer

With little to do and nowhere to go, nearly 700 Palm Beach County Jail inmates this year decided to settle a nagging question and take an HIV test.

By the time their test results returned three weeks later, though, most had served their time or been released on bond and were back on the streets.

All were squandered opportunities to fight the epidemic where it thrives, health and jail officials say.

They are the kind of opportunities officials are aiming to seize this fall with the introduction of "rapid" HIV testing, which delivers results within a half-hour.

The tests are "a match made in heaven" for the jail population, where the rate of HIV infection is estimated to be as much as five times the rate outside the walls and where inmates await trial and sentencing and serve terms of less than a year, said Dr. Pierre Dorsainvil, an infectious disease specialist who serves as the jail's medical director.

It is a population made up of the more than 40,000 drug abusers, prostitutes, repeat offenders, hapless bumblers and victims of circumstance who are booked into the jail each year, about 70 percent of whom are released within 10 days.

 It is also a transient population with little or no connection to health care, experts say. Of those who have tested for HIV at the jail so far this year, 10 were discovered to be infected with the virus that leads to AIDS. Two of them had served their time or bonded out before those results arrived. That left the health department to try to find them. And of those who tested negative, an estimated 75 percent were long gone by the time their good news arrived.

What most had in common -- lack of money and education, shaky housing and support systems -- should make correctional institutions a front line in the fight against AIDS, said state Sen. Frederica Wilson, D-Miami. For that reason, she pushed a $500,000 measure through the legislature last session to increase HIV testing at eight county jail systems, including Palm Beach County's.

"We're not going to be able to make an impact on HIV unless we make an impact in the prisons and jails," said Dr. John P. May,* regional director for Armor Correctional Health Services, which provides medical care at the jail.

A study at the Broward County Jail, which began rapid testing in December 2004 as part of a pilot program for the Centers for Disease Control and Prevention, highlighted the importance of HIV prevention efforts in jail, May said.

Among 62 inmates who learned they had HIV through rapid testing at the jail during a 14-month period, a third had developed full-blown AIDS.

Those who tested positive had been in jail an average of 6.7 previous times. One inmate had been jailed 24 times, May said.

"Imagine being in and out of jail 24 times and not getting tested any of those times," May said. "They've come in and out and we've missed opportunities to identify their disease, to treat them, to prolong their life and keep them healthy, to reduce the odds of transmission."

At the Palm Beach County Jail, medical compliance manager Susan Dean* believes more inmates will take a rapid test because it doesn't require blood to be drawn.

Even those who tested negative but had been released missed an opportunity to get the additional prevention counseling that would have come with the good news, she said.

"Unfortunately, many people who came in here just made a mistake," she said. "This is an opportunity for people to stop and think for a moment and start making responsible decisions for themselves."

_______________________________________________________________________________________

*ACHSA members