Opt-out HIV and Hepatitis C Testing at the Dallas County Jail: Uptake, Prevalence, and Demographic Characteristics of Testers

Carolina de la Flor, Esmaeil Porsa, Ank E. Nijhawan

Research output: Contribution to journalArticle

7 Scopus citations


Human immunodeficiency virus (HIV) and hepatitis C virus (HCV) infection are common in the criminal justice system. We offered opt-out HIV/HCV testing at the Dallas County Jail during intake from June 2015 to November 2016, after which testing was integrated into routine phlebotomy processes. The uptake of testing increased from 12.9% (118/915) in June 2015 to 80.5% (269/334) in January 2016. HIV was confirmed in 1.0% (30/3155) of inmates; 6 were new diagnoses and all were linked to care. HCV antibody positivity was found in 16.4% (500/4042) of inmates. Sixty percent (155/258) of HCV-positive inmates born between 1945 and 1965 (ie, baby boomers) were non-Hispanic black, whereas 56.2% (136/242) born after 1965 were non-Hispanic white. Testing only baby boomers would have missed approximately half of HCV infections, predominantly among young, non-Hispanic white people. Future efforts should expand HIV and HCV testing in jails, as it is feasible, acceptable, and increases prevention and engagement in care for a high-prevalence, hard-to-reach population.

Original languageEnglish (US)
Pages (from-to)617-621
Number of pages5
JournalPublic health reports (Washington, D.C. : 1974)
Issue number6
Publication statusPublished - Nov 1 2017



  • health disparities
  • hepatitis C virus
  • incarceration
  • opt-out
  • testing

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health

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