Details:

Alternative Title:
PLoS ONE
Personal Author:
Jafa, Krishna ; McElroy, Peter ; Fitzpatrick, Lisa ; Borkowf, Craig B. ; MacGowan, Robin ; ... More +
Jafa, Krishna ; McElroy, Peter ; Fitzpatrick, Lisa ; Borkowf, Craig B. ; MacGowan, Robin ; Margolis, Andrew ; Robbins, Ken ; Youngpairoj, Ae Saekhou ; Stratford, Dale ; Greenberg, Alan ; Taussig, Jennifer ; Shouse, R. Luke ; LaMarre, Madeleine ; McLellan-Lemal, Eleanor ; Heneine, Walid ; Sullivan, Patrick S. Less -
Description:
Introduction

HIV prevalence among state prison inmates in the United States is more than five times higher than among nonincarcerated persons, but HIV transmission within U.S. prisons is sparsely documented. We investigated 88 HIV seroconversions reported from 1988–2005 among male Georgia prison inmates.

Methods

We analyzed medical and administrative data to describe seroconverters' HIV testing histories and performed a case-crossover analysis of their risks before and after HIV diagnosis. We sequenced the gag, env, and pol genes of seroconverters' HIV strains to identify genetically-related HIV transmission clusters and antiretroviral resistance. We combined risk, genetic, and administrative data to describe prison HIV transmission networks.

Results

Forty-one (47%) seroconverters were diagnosed with HIV from July 2003–June 2005 when voluntary annual testing was offered. Seroconverters were less likely to report sex (OR [odds ratio] = 0.02, 95% CI [confidence interval]: 0–0.10) and tattooing (OR = 0.03, 95% CI: <0.01–0.20) in prison after their HIV diagnosis than before. Of 67 seroconverters' specimens tested, 33 (49%) fell into one of 10 genetically-related clusters; of these, 25 (76%) reported sex in prison before their HIV diagnosis. The HIV strains of 8 (61%) of 13 antiretroviral-naïve and 21 (40%) of 52 antiretroviral-treated seroconverters were antiretroviral-resistant.

Discussion

Half of all HIV seroconversions were identified when routine voluntary testing was offered, and seroconverters reduced their risks following their diagnosis. Most genetically-related seroconverters reported sex in prison, suggesting HIV transmission through sexual networks. Resistance testing before initiating antiretroviral therapy is important for newly-diagnosed inmates.


Subject:
[+]
Adolescent
Adult
Cluster Analysis
Drug Resistance, Viral
HIV
HIV Infections
HIV Seropositivity
Humans
Male
Middle Aged
Phylogeny
Prisoners
Prisons
Risk-Taking
Young Adult

Source:
PLoS ONE. 2009; 4(5).
Document Type:
Journal Article
Place as Subject:
Georgia
Collection(s):
CDC Public Access
Main Document Checksum:
[+]
urn:sha256:1b6a5a304bb6581b72d3f7ed37f8d41ac38dd8d6c9f57f2904870e10bee8b735
File Type:

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