Findings from STD screening of adolescents and adults entering corrections facilities: implications for STD control strategies.
BACKGROUND
Persons entering corrections facilities are at high risk for sexually transmitted diseases (STDs) because of risky sexual behavior and lack of access to routine screening.


OBJECTIVE
The goal of the study was to develop a national picture of STD prevalence in this population.


METHODS
We analyzed information on age, race/ethnicity, urethral symptoms (men only), and test results for approximately 85,000 chlamydia, 157,000 gonorrhea, and 293,000 syphilis tests for persons entering 23 jails and 12 juvenile detention centers in 13 US counties from 1996 through 1999.


RESULTS
At adult jails in nine counties, the median percentage of persons with reactive syphilis tests by county was 8.2% (range, 0.3-23.8%) for women and 2.5% (range, 1.0-7.8%) for men. At juvenile detention facilities in five counties, the median positivity for chlamydial infection was 15.6% (range, 8.0-19.5%) for adolescent girls and 7.6% (range, 2.8-8.9%) for adolescent boys; the median positivity for gonorrhea was 5.2% (range, 3.4-10.0%) for adolescent girls and 0.9% (range, 0.7-2.6%) for adolescent boys. Of adolescent boys testing positive for chlamydial infection at three juvenile facilities, approximately 97% did not report symptoms; of adolescent boys positive for gonorrhea, 93% did not report symptoms.


CONCLUSIONS
STD positivity among persons entering corrections facilities is high. Most chlamydial and gonococcal infections are asymptomatic and would not be detected without routine screening. Monitoring the prevalence of STDs in this population is useful for planning STD prevention activities in corrections facilities and elsewhere in the community.
Mertz
Kristen J
KJ
Division of STD Prevention, National Center for HIV/STD/TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. kjmertz@dhr.state.ga.us
Voigt
Richard A
RA
Hutchins
Kathleen
K
Levine
William C
WC
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002690:Chlamydia Infections / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D008297:Male; D008403:Mass Screening; D015995:Prevalence; D011330:Prisons / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012749:Sexually Transmitted Diseases / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control; D013587:Syphilis / Q000453:epidemiology; D014481:United States / Q000453:epidemiology