All inmates in North Carolina prisons will be tested for HIV as part of their routine intake screening starting November 1, The News & Observer reports. For current inmates, HIV tests will become a part of their annual physical.

According to the article, HIV infection rates are seven times greater in prisons than they are on the outside. North Carolina’s public health officials have been under increasing pressure to diagnose and treat this population and revise their prison testing policy.

“It was a moral imperative, not just for prisoners but for citizens out there, too,” said Peter Leone, MD, medical director of the HIV/STD Prevention and Care Branch of the N.C. Division of Public Health. “The taxpayers have a reason to be concerned about [prisoners] infecting others out in the community once they’re released.”

The testing will not be mandatory. However, prisoners will no longer need to ask for a test.

In North Carolina, only about a quarter of undiagnosed male inmates had requested to take an HIV test when they entered prisons. A University of North Carolina study found that African Americans were the least likely of ethnic and racial groups to request HIV testing.