Voluntary rapid human immunodeficiency virus (HIV) testing in jails.

OBJECTIVES: To provide human immunodeficiency virus (HIV) rapid testing to persons in jails, identify previously undiagnosed cases of HIV infection, and refer HIV-infected inmates to care, treatment, and prevention services. DESIGN: Four state health departments (Florida, Louisiana, New York, and Wisconsin) collaborated with jails to implement stand-alone voluntary rapid HIV testing programs. Inmates requested or were referred by medical staff for rapid HIV testing. HIV testing was provided by the health department, correctional facility, or a community-based organization. Inmates whose rapid test was reactive were offered confirmatory testing, medical evaluation, prevention services, and discharge planning. RESULTS: From December 2003 through May 2006, rapid HIV testing was provided to 33,211 inmates, more than 99.9% of whom received their test results. Most of the inmates tested were male (79%), black (58%), and less than 35 years of age (60%). A total of 440 (1.3%) rapid HIV tests were reactive, and 409 (1.2%) of the results were confirmed positive. The testing programs identified 269 (0.8%) previously undiagnosed cases of HIV infection. In the multivariate analyses, new HIV diagnoses were associated with race/ethnicity, report of risky behaviors, and with no report of HIV risk behavior. Almost 40% of diagnoses were for inmates whose only reported risk was heterosexual contact. CONCLUSIONS: Rapid HIV testing in jails identified a considerable number of previously undiagnosed cases of HIV infection. Rapid HIV testing should be available to all inmates, regardless of whether inmates reported HIV risky behaviors.

Churches United to Stop HIV (CUSH): a faith-based HIV prevention initiative.

In 1999, the Broward County Health Department and local community faith-based organizations collaborated to develop Churches United to Stop HIV (CUSH). CUSH has provided HIV prevention services to over 32,000 people, trained over 2,850 faith leaders, conducted over 1,000 risk assessments and provided HIV counseling and testing for over 825 people and technical assistance for 48 churches, including the development of a training manual. We report the development of this innovative program that demonstrates how collaborations between public health and faith-based organizations can connect science with communities.

Strategies for reaching retirement communities and aging social networks: HIV/AIDS prevention activities among seniors in South Florida.

Since 1993, the HIV/AIDS Program Office of the Broward County Health Department has recognized the importance of targeting the population of those aged 50 years and older. Close examination of epidemiological data for the south Florida area and requests from health care providers showed that targeted intervention had to address the needs of the seniors as well as the beliefs and perceptions of their health practitioners. Originally designed to provide community training, identify and train volunteer peer educators, and increase awareness and sensitivity among providers of health services, the senior initiative was officially expanded with funding from the Florida Department of Elder Affairs in 1997. The resulting Senior HIV Intervention Project (SHIP) is more comprehensive than the original senior training program, addressing the increased need for early intervention activities, HIV counseling, and testing. SHIP also links HIV-positive seniors to care and treatment services through a network of trained staff and volunteers. SHIP's considerable experience in serving the needs of older adults offers useful insight for others developing successful HIV/AIDS programming for people aged 50 years and older.