The potential role of custody facilities in controlling sexually transmitted diseases.
BACKGROUND
The National Commission on Correctional Health Care recommends that medical screening, including tests for syphilis and other sexually transmitted diseases, be performed by the 14th day after initial booking procedures. Because the average length of stay in detention is usually less than 14 days, most detainees are not screened or treated for asymptomatic communicable diseases.


METHODS
In order to determine the incidence and prevalence of syphilis among those booked through a large county jail, a rapid screening procedure to test newly incarcerated inmates and treat those infected was implemented over a 3-week period.


RESULTS
Among 6309 detainees eligible for testing during the 3-week period of the study, 129 (2%) were diagnosed with syphilis. During the preceding month when only those reporting symptoms or high-risk behaviors were screened, 20 cases were diagnosed. The sensitivity and predictive value of self-reported risk factors for syphilis infection were low. Among the first 110 diagnosed cases, 17 (15.5%) were released within 3 days and 86 (78%) were released within 6 days.


CONCLUSIONS
If screening and treatment for syphilis are delayed until the 14th day after booking, the majority of infected inmates will be released prior to evaluation and treatment. Rapid screening and treatment for selected sexually transmitted diseases are likely to be an effective public health measure when implemented in custody settings.
Cohen
D
D
Los Angeles County Department of Health Services, CA.
Scribner
R
R
Clark
J
J
Cory
D
D
D000293:Adolescent; D000328:Adult; D016358:Contact Tracing; D004522:Educational Status; D005189:False Positive Reactions; D005428:Flocculation Tests / Q000592:standards; D006302:Health Services Research; D006305:Health Status Indicators; D006801:Humans; D015994:Incidence; D015141:Los Angeles / Q000453:epidemiology; D008297:Male; D008393:Marriage / Q000706:statistics & numerical data; D008403:Mass Screening / Q000379:methods / Q000592:standards*; D008875:Middle Aged; D015995:Prevalence; D011330:Prisons; D044469:Racial Groups; D012307:Risk Factors; D012680:Sensitivity and Specificity; D016036:Seroepidemiologic Studies; D012725:Sexual Behavior; D012749:Sexually Transmitted Diseases / Q000150:complications; D019966:Substance-Related Disorders / Q000150:complications; D013587:Syphilis / Q000097:blood / Q000453:epidemiology / Q000517:prevention & control*