Amid the 16,000 project proposals suggesting where federal stimulus money might go in Michigan are several that present ominous statistics about HIV and sexually transmitted infections in Wayne County Jail.

 

According to project descriptions of the proposals on the state’s Web site, Wayne County Jail would like $1.06 million to implement widespread HIV testing and STI screening for all incoming inmates.

The reason? From a proposal to increase testing for sexually transmitted diseases in the jail:

Prevalence estimates indicate that inmates are at greater risk of infectious diseases, sometimes approaching 58 times higher than that of the general population. Current risk data indicate that youth in the general population, under the age of 24, are at greatest risk for contracting Gonorrhea and Chlamydia.

or from another proposal, to increase testing of HIV in the jail population:

Approximately 1% of inmates tested were newly diagnosed in the facility. The estimated prevalence in the facility approaches 2% based on the number of inmates who enter the facility with HIV medication on their person or who self-disclose their status to a healthcare provider.

The county, in a third proposal, said it would like to institute an opt-out HIV rapid testing program for all incoming inmates. Rapid testing is a bloodless test that reveals HIV status in about 20 minutes. It’s use has been called into question because it has been associated with a high number of false positive readings, but a recent study from the San Francisco Health Department suggests the early expiration date of such rapid tests may be the culprit of the false positives.

Opponents of the stimulus bill, including Michigan’s Republican Congressional delegation, have lambasted the $335 million included in the bill for expanded HIV and STI screening and testing. That money would run through the Centers for Disease Control and Prevention in Atlanta to the states.

Stats from the Michigan Department of Community Health show that as of October, Wayne County, excluding the city of Detroit, had 1,357 cases of HIV/AIDS. The city had 5,336 cases of HIV/AIDS as of July 2008 (the most recent numbers available on the state Web site).

In 2007, the city of Detroit reported 13,656 cases of chlamydia while Wayne County had 2,356 cases. That same year the city reported 7,912 cases of gonorrhea and 256 cases of syphilis, while Wayne County reported 779 cases of gonorrhea and 63 cases of syphilis. The stats from 2007 are the most recent available on the state’s Web site.

The implementation of opt-out testing may prove tricky because Michigan law specifies that HIV testing is an opt-in test, which requires informed consent.