title: Bloodborne sexually transmitted infections in patients presenting for substance abuse treatment in Jamaica.
abstract: BACKGROUND
  Substance use, including alcohol and illicit drugs, increases the risk for the acquisition and transmission of sexually transmitted infection (STI).
  
  
  OBJECTIVE
  To determine the prevalence of bloodborne STI including HIV, human T-cell lymphotrophic virus type 1, hepatitis B virus, and syphilis in residents of a detoxification and rehabilitation unit in Jamaica.
  
  
  METHODS
  The demographic characteristics and the results of laboratory investigations for STI in 301 substance abusers presenting during a 5-year period were reviewed. The laboratory results were compared with those of 131 blood donors.
  
  
  RESULTS
  The substances used by participants were alcohol, cannabis, and cocaine. None of the clients was an IV drug user. Female substance abusers were at higher risk for STI. The prevalence of STI in substance abusers did not differ significantly from that in blood donors (12% versus 10%); however, the prevalence of syphilis in substance abusers was significantly higher than that in blood donors (6% versus 3%, P < 0.05). The prevalence of syphilis was dramatically increased in female substance abusers and female blood donors (30%, P < 0.001 and 13%, P < 0.05, respectively). An excess of human T-cell lymphotrophic virus type 1 was also observed in female compared with male substance abusers. Unemployment was identified also as a risk factor for sexually transmitted disease in substance abusers.
  
  
  CONCLUSIONS
  The results endorsed the policy of screening detoxification clients for STI and indicate a need for gender-specific approaches to the control of substance abuse and STI in Jamaica.
authors.affiliation: Department of Microbiology, University of the West Indies, Kingston, Jamaica.
authors.forename: G
authors.initials: G
authors.lastname: Dowe
authors.forename: M F
authors.initials: MF
authors.lastname: Smilkle
authors.forename: C
authors.initials: C
authors.lastname: Thesiger
authors.forename: E M
authors.initials: EM
authors.lastname: Williams
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000437:Alcoholism / Q000097:blood / Q000150:complications; D001782:Blood Donors; D019970:Cocaine-Related Disorders / Q000097:blood / Q000150:complications; D005260:Female; D015658:HIV Infections / Q000453:epidemiology / Q000209:etiology; D015490:HTLV-I Infections / Q000453:epidemiology / Q000209:etiology; D006509:Hepatitis B / Q000453:epidemiology / Q000209:etiology; D006801:Humans; D007563:Jamaica / Q000453:epidemiology; D008297:Male; D002189:Marijuana Abuse / Q000097:blood / Q000150:complications; D008875:Middle Aged; D015995:Prevalence; D012189:Retrospective Studies; D017678:Sex Distribution; D015229:Sexually Transmitted Diseases, Viral / Q000453:epidemiology* / Q000209:etiology; D019966:Substance-Related Disorders / Q000097:blood / Q000150:complications*; D013587:Syphilis / Q000453:epidemiology* / Q000209:etiology; D014478:Unemployment