Voluntary HIV testing in combination with early medical intervention has been shown to be effective in reducing the rate of new infections and improving the health and life expectancy of those living with HIV. There are however several high-risk populations in the US that remain largely unreached by HIV testing efforts, some of which could be reached while they spend time in prison or jail. Per current Bureau of Prisons (BOP) policy, HIV testing is routinely offered only to “high risk” pretrial and sentenced inmates. We conducted a cross-sectional study with 721 pretrial and sentenced inmates who entered a large urban federal prison between August 2012 and June 2013. We explored HIV testing data for the inmates during this period and in addition collected survey responses from 397 participating inmates. The survey was designed to help us better understand inmates’ attitudes about HIV testing. Bi-variable and multivariate analyses were used to determine inmates’ decision to test for HIV. While age, ethnicity, sentencing status, sexual orientation, and risk status were significantly related with inmates’ decisions to test for HIV in bivariable analyses, only perceived benefits retained its significance in the multivariable model. It is hoped that findings from this study will help guide HIV testing policies for federal prisons.


School of Public Health

First Advisor

Susanne Montgomery

Second Advisor

Ralph Ihle

Third Advisor

Daniel Pearce

Degree Name

Doctor of Public Health (DrPH)

Year Degree Awarded


Date (Title Page)




Library of Congress/MESH Subject Headings

HIV (Viruses) -- Prevention; HIV (Viruses) -- United States -- Statistics; HIV-positive persons -- psychology; Prisoners -- Diseases -- United States -- Statistics; Prisoners -- Health and hygiene -- United States -- Statistics; Prisoners -- Health risk assessment -- United States -- Statistics; HIV Infections -- prevention & control -- United States; Prisoners -- statistics & numerical data -- United States; AIDS Serodiagnosis -- statistics and numerical data -- United States; AIDS Serodiagnosis -- psychology; Prisoners -- psychology; Health Knowledge, Attitudes, Practice; Case-Control Studies.



Page Count

vii; 121

Digital Format


Digital Publisher

Loma Linda University Libraries

Usage Rights

This title appears here courtesy of the author, who has granted Loma Linda University a limited, non-exclusive right to make this publication available to the public. The author retains all other copyrights.


Loma Linda University Electronic Theses and Dissertations

Collection Website



Loma Linda University. Del E. Webb Memorial Library. University Archives