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Correctional facilities constitute an excellent opportunity to provide treatment, care, and prevention services for a population that may not otherwise access these services. The Centers for Disease Control and Prevention (CDC) and the Health Resources and Services Administration (HRSA) recognize the public health importance of correctional settings and have begun to develop formal strategies to address the HIV/AIDS-relevant needs of incarcerated individuals. The Centers for Disease Control and Prevention and HRSA have implemented policies, activities, and strategic plans to reduce the HIV/AIDS disease burden among the high-risk populations that pass through the nation's prisons and jails. They have also collaborated to address the HIV/AIDS needs of incarcerated populations and have initiated processes for expanding collaboration on these issues to include other federal agencies and prevention partners.

To evaluate partner notification of opposite-sex sexual partners of AIDS patients as a means of limiting sexual and vertical transmission of human immunodeficiency virus (HIV), the authors examined the first 27 months of their experience with partner notification. Overall, of 145 AIDS patients eligible to participate, 51 (35%) were interviewed and identified 135 opposite-sex sexual partners. Of the 135 partners, 59 (44%) were interviewed and 34 (25%) were tested, resulting in the diagnosis of 7 (5%) HIV-infected partners. Refusal rates for index patients and partners were low (9% and 12%, respectively). Costs for the program were $454 per partner interviewed and $2,203 per seropositive partners identified. The authors conclude that although partner notification is more expensive than more widely targeted AIDS prevention and education efforts, its ability to target case finding, education, and counseling to women at highest risk of infection makes it potentially cost-effective for prevention of vertically transmitted HIV infection.

Background and Methods: To evaluate the epidemiology of infection with human immunodeficiency virus type 1 (HIV-1) in selected urban communities in the United States, we instituted active surveillance at sentinel hospitals by anonymous testing of samples of blood specimens for HIV-1 antibody. To reflect better the rates of HIV-1 seroprevalence in the communities served by the sentinel hospitals, we excluded specimens from all patients with diagnoses that are often associated with HIV infection., Results: From January 1988 to June 1989, 89,547 specimens were tested at 26 hospitals in 21 cities. The overall rate of HIV-1 seroprevalence was 1.3 percent, but it ranged from 0.1 to 7.8 percent according to hospital (median, 0.7 percent). The age distribution of persons seropositive for HIV-1 was similar across hospitals and closely paralleled that of persons with the acquired immunodeficiency syndrome (AIDS). In areas of low seroprevalence, HIV-1 infections were highly concentrated among men. However, the male-to-female ratio (median, 7.0) decreased steadily with an increasing overall rate of seroprevalence (P less than 0.001); at the five hospitals with the highest rates of seroprevalence, the median male-to-female ratio was only 2.9. The median black-to-white ratio of HIV-1 seroprevalence was 1.8, but at hospitals with low rates of seroprevalence the rates in blacks and whites were nearly equal. At two hospitals in the communities with the highest prevalence of AIDS, 1.1 to 3.8 percent of adolescents 15 to 19 years old and 18 to 22 percent of all men 25 to 44 years old were seropositive for HIV-1., Conclusions: In these sentinel, urban populations there is tremendous variation in the rate of HIV-1 infection (over 70-fold). The very high seroprevalence at some sentinel hospitals indicates the need for routine screening for HIV-1 infection among some groups of patients, regardless of clinical presentation.