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P6.058 Universal HIV Screening of Inmates in Israeli Prisons: Should the Policy Be Updated?
  1. Z Mor1,
  2. H Vider2,
  3. I Grotto3,4,
  4. D Tischler Aurkin5
  1. 1Ministry of Health, Ramla, Israel
  2. 2Israeli prison Services, Ramla, Israel
  3. 3Ministry of Health, Jerusalem, Israel
  4. 4Ben Gurion University, Beer Sheva, Israel
  5. 5Israeli Prison Services, Ramla, Israel

Abstract

Background HIV rates among inmates are mostly higher than the general population. Israel is a relative low-HIV prevalence country (107:100,000 population, 2011 data). All criminal inmates incarcerated in prisons/gaols at the Israeli Prison Services (IPS) are routinely screened for HIV. This retrospective study evaluates the necessity of the current policy of universal HIV-testing policy.

Methods We reviewed all inmates diagnosed with HIV/AIDS upon incarceration in Israel between 2003 and 2010, and assessed their risk-behaviours and the date of diagnosis.

Results During the 8 years follow-up, 108,866 new criminal inmates were incarcerated in 31 correctional facilities, and it is estimated that 95% of those were tested for HIV. Of those, 201 (0.2%) were tested positively with HIV, in a direct testing cost of 622,000 (US$).

Of all 201 HIV-infected inmates, 118 (58.7%) were intra-venous drug-users (IVDU), 55 (27.4%) originated in high-prevalence countries, 13 (6.5%) were men who have sex with men (MSM), 12 (6.0%) were heterosexuals not originating in endemic country, 2 (0.1%) the risk-group was undetermined and one (0.5%) was infected vertically.

Of all 201 HIV-infected inmates, 157 (78.2%) were diagnosed in the community, prior to their imprisonment, and were re-tested in prison; while 44 (21.8%) were firstly diagnosed in prison. Of those 44 inmates, 25 (56.8%) were IVDU, 13 (29.5%) originated in endemic country, three (9.1%) were MSM and in two (4.5%) the risk-group was not determined.

Conclusion HIV-infection rate is prison is twice higher than the general population. The majority (98.5%) of all inmates was diagnosed prior to their incarceration or had a key risk-behaviour exposing them to HIV. Therefore, questioning each new inmate upon incarceration about previous HIV-diagnosis, and targeted testing for other inmates who are IVDU, MSM or originating in endemic countries for HIV can detect almost all HIV-infected prisoners, presuming they respond reliably.

  • Prison
  • screening

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