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STDs
in Persons Entering Corrections Facilities
Public Health Impact
Multiple
studies and surveillance projects have demonstrated a high prevalence
of STDs in persons entering jails and juvenile detention facilities.1 Screening
for chlamydia, gonorrhea, and syphilis at intake offers an opportunity
to identify infections, prevent complications, and reduce transmission
in the community. In cities where routine syphilis screening in jails
occurs, a substantial percentage of all reported cases are identified
in jails.2 Compiling
data and analyzing trends in STD prevalence in this population can
provide one method for monitoring trends in STD prevalence in the
community.
Observations
- In 2000, 10 states
reported chlamydia, gonorrhea, or syphilis data to CDC as part
of the Jail STD Prevalence Monitoring Project. Five states reported
syphilis data as part of the Syphilis Elimination Initiative. Two
states reported syphilis data as part of the Innovations in Syphilis
Prevention Project. Fourteen states reported data (at least 100
test results) from corrections facilities as part of the Regional
Infertility Prevention Programs, and five additional states reported
data in response to CDC’s request for data.
- The maps shown
in this section represent approximately 273,000 syphilis tests
for men and 54,000 syphilis tests for women, 76,000 chlamydia tests
for men and 46,000 chlamydia tests for women, and 112,000 gonorrhea
tests for men and 33,000 gonorrhea tests for women.
- The median percentage
of reactive syphilis tests was 6.4% (range, 0.8% to 30.0%) for
women entering 29 adult jails and 0.5% (range, 0.0% to 0.7%) for
adolescent women entering three juvenile detention centers (Figure
EE). The median percentage of reactive tests was 2.5% (range,
1.1% to 7.2%) for men at 30 adult jails and 0.4% (range, 0.2% to
0.6%) at four juvenile facilities. The percentage of reactive syphilis
tests was higher for women than for men in 29 (91%) of 32 adult
and juvenile facilities reporting syphilis test results for both
sexes (Figures EE, FF). The percentage of reactive syphilis
tests representing cases of syphilis varied from site to site.
- The positivity
for chlamydia and gonorrhea among women was higher in juvenile
facilities than in adult facilities. Among adolescent women entering
juvenile detention facilities, the median positivity for chlamydia
was 15% (range, 1.5% to 28.9%); positivity was greater than 10%
in 17 (71%) of 24 facilities reporting data (Figure
GG).
- The median positivity
for gonorrhea among women entering juvenile facilities was 4.9%
(range, 0.5% to 13.0%); positivity was greater than 4% in 11 (73%)
of 15 juvenile facilities (Figure
II). The median positivity for chlamydial infection among men
entering juvenile facilities in 30 counties was 6.6% (range, 0.9%
to 13.0%) (Figure
HH).
- The median positivity
for gonorrhea among men entering juvenile facilities in 18 counties
was 2.4% (range, 0.6% to 4.2%) (Figure
JJ).
1Mertz KJ, Voigt
R, Hutchins K, Levine WC, and the Jail STD Prevalence Monitoring
Group. High prevalence of sexually transmitted diseases in persons
entering jails and juvenile detention centers in 13 United States
counties. (Submitted 2001).
2CDC. Syphilis screening among women arrestees at the
Cook County Jail – Chicago, 1996. MMWR 1998;47:432-3.
Figure
EE. Syphilis serologic tests — Percent seroreactivity in
women entering juvenile and adult corrections facilities†, 2000
†From facilities
reporting >100 test results.
SOURCE: Local and State STD Control Programs; Regional Infertility Prevention
Programs; Centers for Disease Control and Prevention
Figure
FF. Syphilis serologic tests — Percent seroreactivity in
men entering juvenile and adult corrections facilities†, 2000
†From facilities
reporting >100 test results.
SOURCE: Local and State STD Control Programs; Regional Infertility Prevention
Programs; Centers for Disease Control and Prevention
STDs in Persons Entering
Corrections Facilities figure continue on page 2
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