AIDS and Behavior

, Volume 23, Issue 4, pp 883–892 | Cite as

Underutilization of HIV Testing Among Men with Incarceration Histories

  • Claire E. FarelEmail author
  • Carol E. Golin
  • Rebecca D. Ochtera
  • David L. Rosen
  • Marjorie Margolis
  • Wizdom Powell
  • David A. Wohl
Original Paper


Annual HIV testing is recommended for individuals at high risk of infection, specifically incarcerated populations. Incarcerated men carry a higher lifetime risk of acquiring HIV than the general population, yet little is known about their HIV testing behaviors. We collected Audio Computer Assisted Self Interview data for 819 men entering a state prison in North Carolina. We assessed correlates of previous HIV testing, including stigmatizing attitudes and beliefs, and explored two outcomes: (1) ever HIV tested before current incarceration, and (2) recency of last HIV test. Eighty percent had been HIV tested before; of those, 36% reported testing within the last year. Being African American, having education beyond high school, prior incarceration, and higher HIV knowledge increased odds of ever having tested. Results of this study highlight the need to expand HIV testing and education specific to incarcerated populations. Additionally, efforts should be made to monitor and encourage repeat screening.


HIV/AIDS Utilization Prevention Incarcerated population Testing 



Human Immunodeficiency Virus


The Centers for Disease Control and Prevention


The National Institute of Mental Health


North Carolina Department of Public Safety


Prison Processing Centers


Auto Computer Assisted Self Interview


Behavioral Risk Factor Surveillance System



This research was funded by the National Institute on Mental Health (R01 MH079720), National Institute on Drug Abuse (K24DA037101), and Eunice Kennedy Shriver National Institute of Childhood and Human Development, National Institute of Allergy and Infectious Diseases (K24HD06920); University of North Carolina Center for AIDS Research (AI050410). Drs. Ochtera, Golin, Powell, Rosen and Wohl participated in the research design and execution. Dr. Ochtera performed data analyses with Dr. Golin. Drs. Ochtera, Golin, Farel and Ms. Margolis wrote this article with input from Drs. Wohl, Rosen and Powell and with editorial assistance from Caitlin Biddell, Allison Pack, and Breana Castonguay. Brian Barkley and Dr. David Rosen assisted with final data analyses and preparation. None of the authors of this paper have reported conflicts of interest or financial disclosures. The authors thank the study participants, the North Carolina Department of Public Safety, and the wardens and staff of the participating facilities for their support of this project. This research would not have been possible without the assistance of the University of North Carolina at Chapel Hill Center for AIDS Research Criminal Justice Working Group.

Compliance with Ethical Standards

Conflict of interest

No conflicts of interest were reported by the authors of this paper. The authors certify that they have no affiliations with or involvement in any organization or entity with any financial or non-financial interest in the subject matter or materials discussed in this manuscript.

Ethical Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Informed consent was received from all participants.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  1. 1.Division of Infectious Diseases, Department of MedicineUniversity of North Carolina at Chapel Hill School of MedicineChapel HillUSA
  2. 2.Division of General Internal Medicine and Clinical EpidemiologyUniversity of North Carolina at Chapel Hill School of MedicineChapel HillUSA
  3. 3.Department of Health BehaviorUniversity of North Carolina at Chapel Hill Gillings School of Global Public HealthChapel HillUSA
  4. 4.Health Disparities InstituteUniversity of ConnecticutHartfordUSA
  5. 5.Center for AIDS ResearchUniversity of North Carolina at Chapel Hill School of MedicineChapel HillUSA

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