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Case 3: HIV Infection in the Correctional Setting

Authors: Lara B. Strick, MD
JA Clarke, MD, PhD

Case last updated: May 2, 2006

A 47-year-old man co-infected with HIV and hepatitis C virus (HCV) is brought to your clinic from the local jail by a correctional officer for evaluation of a soft tissue infection. He denies any other symptoms or active medical problems. The patient was recently arrested 2 weeks prior for an incident related to his active injection drug use (IDU). Routine laboratory testing done near the time of his arrest revealed a CD4 count of 238 cells/mm3 and HIV RNA of greater than 100,000 copies/mL. He has no history of HIV-related opportunistic infections and has never taken antiretroviral therapy.

Which one of the following statements is TRUE?

A All incarcerated persons are required by law to undergo HIV testing upon entry to jail or prison.
B Female inmates have a higher prevalence of documented HIV infection than male inmates.
C Most incarcerated HIV-infected persons acquire their HIV infection while in prison or jail.
D The percentage of HIV-infected inmates who achieve undetectable HIV RNA levels (while receiving HAART in prison) is significantly lower than typically achieved by HIV-infected persons taking HAART in a community setting.
E All incarcerated persons who take HAART receive directly observed therapy (DOT) while in a correctional facility.