Black Religious Leaders, Public Health Officials in North Carolina Urge HIV Testing for Prison Inmates

Some black religious leaders and public health officials in North Carolina are urging prison officials to require routine HIV testing of inmates and treatment for those who test positive, the Raleigh News & Observer reports. The officials who are lobbying for mandatory testing maintain that "prisoners are impeding the state's effort to end the spread of HIV." North Carolina does not require HIV testing for inmates but recommends the test to new prisoners who admit to high-risk behaviors such as intravenous drug use or intercourse with a sex worker. Twenty-two states -- including the majority of Southern states, which have high numbers of new HIV cases -- require HIV tests for inmates.

There is little demand for the test under the current voluntary policy, the News & Observer reports. David Rosen, a medical and doctoral student at the University of North Carolina-Chapel Hill, found that about 25% of men not previously diagnosed with HIV requested testing upon arrival at one of the state's six prisons. Blacks were less likely than other inmates to ask for the test, Rosen found. At the two prisons housing the youngest men, ages 18 to 25, fewer than 5% of inmates requested testing. Some public health officials contend that the statistics show the prison system is missing the most at-risk population.

According to the News & Observer, "Some religious leaders blame prisons for the toll HIV has taken on the black community." In 2007, several black religious leaders lobbied for a bill that would require inmates to be tested upon release, but the bill never made it to a vote. Legislators said they will review the bill in May. "This is destroying our community," Larry Williams, a pastor who led the lobbying effort, said, adding, "Our women are sharing men who've gotten HIV. It's swirling around us. We cannot pretend it's not happening and can't ignore a chance to try and fix it." While 21% of the state's population is black, black women represented more than 80% of new HIV cases among women in 2006, the News & Observer reports, adding that a recent study found that most HIV-positive women reported that their last three sexual partners had been in prison the previous year.

Costs, Other Efforts
State prison officials said that they are not opposed to a screening mandate but that the cost of testing every inmate would exceed available funding. According to prison estimates, screening and treating HIV-positive inmates would cost $21 million annually. However, according to the News & Observer, the estimate is based on a 10% infection rate, which is much higher than any state has reported. An estimated 1.8% of North Carolina's prison population, about 700 inmates, has HIV or AIDS (Locke, Raleigh News & Observer, 4/13). This summer, researchers at UNC plan to begin a new study that will examine over several years the reasons why so few inmates are volunteering for HIV tests (Associated Press, 4/14).