Re “State cuts jails’ HIV programs: Sheriffs caution on health impact” by Maria Cramer (Page A1, May 14): The proposed cuts to HIV prevention and testing programs in Massachusetts’ county jails would have not only devastating human consequences for incarcerated populations and their communities, but dire financial ones for an already overburdened health care system.
As an HIV physician, I take care of a large number of patients who received their diagnosis while incarcerated. Many of these patients had little prior contact with the health care system, and, had they not been tested while in jail, many might still not know they are infected.
The impact of knowing that one is HIV-positive is profound not only because it is a precondition for accessing treatment during the early stages of the illness, when its deadly and disabling effects can be prevented, but because this knowledge has been shown to reduce risky behaviors that lead to spreading the disease.
Prevention and testing activities in county jails are particularly critical given that the HIV prevalence among incarcerated populations is higher than in the general population, and that high-risk activity for HIV transmission occurs frequently among inmates.
Individuals who go through the county jail system are often incarcerated many times, with frequent returns to their own communities, where they may unwittingly pass the virus on.
we should be expanding, not reducing, access to HIV testing in settings such as county jails.