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Opt-Out HIV Testing of Inmates in North Carolina Prisons: Factors Associated with not Wanting a Test and not Knowing They Were Tested

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Abstract

Opt-out HIV testing is recommended for correctional settings but may occur without inmates’ knowledge or against their wishes. Through surveying inmates receiving opt-out testing in a large prison system, we estimated the proportion unaware of being tested or not wanting a test, and associations [prevalence ratios (PRs)] with inmate characteristics. Of 871 tested, 11.8 % were unknowingly tested and 10.8 % had unwanted tests. Not attending an educational HIV course [PR = 2.34, 95 % confidence interval (CI) 1.47–3.74], lower HIV knowledge (PR = 0.95, 95 % CI 0.91–0.98), and thinking testing is not mandatory (PR = 9.84, 95 % CI 4.93–19.67) were associated with unawareness of testing. No prior incarcerations (PR = 1.59, 95 % CI 1.03–2.46) and not using crack/cocaine recently (PR = 2.37, 95 % CI 1.21–4.64) were associated with unwanted testing. Residence at specific facilities was associated with both outcomes. Increased assessment of inmate understanding and enhanced implementation are needed to ensure inmates receive full benefits of opt-out testing: being informed and tested according to their wishes.

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Acknowledgments

We would like to thank Rebecca Ochtera for her thoughtful input into the analysis plan for this manuscript, and to Becky White, Jeanine May, Robert DeVellis, J. Michael Bowling, and members of the UNC Criminal Justice Working Group for their work on the parent study. This work would not have been possible without NC Department of Public Safety staff and study participants who generously gave their time and energy to the study. This research was funded by National Institute of Health (NIH) Grant R01 MH079720-01A1 and supported by the University of North Carolina at Chapel Hill Center for AIDS Research (CFAR), an NIH Funded program P30 AI50410.

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Authors and Affiliations

  1. Center for AIDS Research, University of North Carolina at Chapel Hill, Chapel Hill, NC, USA

    Catherine A. Grodensky & Carol E. Golin

  2. Department of Medicine, University of North Carolina at Chapel Hill School of Medicine, Chapel Hill, NC, USA

    David L. Rosen, Sayaka Hino, Carol E. Golin & David A. Wohl

  3. Department of Health Behavior, University of North Carolina at Chapel Hill Gillings School of Global Public Health, Chapel Hill, NC, USA

    Carol E. Golin

  4. 725 Martin Luther King Jr. Blvd., CB 7590, Chapel Hill, NC, 27599-7590, USA

    Catherine A. Grodensky

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  1. Catherine A. Grodensky
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  2. David L. Rosen
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  3. Sayaka Hino
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  4. Carol E. Golin
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  5. David A. Wohl
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Correspondence to Catherine A. Grodensky.

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Grodensky, C.A., Rosen, D.L., Hino, S. et al. Opt-Out HIV Testing of Inmates in North Carolina Prisons: Factors Associated with not Wanting a Test and not Knowing They Were Tested. AIDS Behav 20, 859–869 (2016). https://doi.org/10.1007/s10461-015-1203-y

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  • DOI: https://doi.org/10.1007/s10461-015-1203-y

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