RT Article
T1 HIV Transmission in a State Prison System, 1988–2005
JF PLOS ONE
VO 4
IS 5
A1 Borkowf, Craig B.
A1 Youngpairoj, Ae Saekhou
A1 Taussig, Jennifer
A1 Sullivan, Patrick S.
A1 Stratford, Dale
A1 Shouse, R. Luke
A1 Robbins, Ken
A1 McLellan-Lemal, Eleanor
A1 McElroy, Peter
A1 Margolis, Andrew
A1 MacGowan, Robin
A1 LaMarre, Madeleine
A1 Jafa, Krishna
A1 Heneine, Walid
A1 Greenberg, Alan
A1 Fitzpatrick, Lisa
A2 Youngpairoj, Ae Saekhou
A2 Taussig, Jennifer
A2 Sullivan, Patrick S.
A2 Stratford, Dale
A2 Shouse, R. Luke
A2 Robbins, Ken
A2 McLellan-Lemal, Eleanor
A2 McElroy, Peter
A2 Margolis, Andrew
A2 MacGowan, Robin
A2 LaMarre, Madeleine
A2 Jafa, Krishna
A2 Heneine, Walid
A2 Greenberg, Alan
A2 Fitzpatrick, Lisa
LA English
YR 2009
UL https://krimdok.uni-tuebingen.de/Record/1866598635
AB 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
K1 Medicine
DO 10.1371/journal.pone.0005416