title: Early syphilis in the United States identified in corrections facilities, 1999-2002.
abstract: BACKGROUND
  Corrections facilities offer public health practitioners an opportunity to gain access to large numbers of persons at risk for syphilis and other sexually transmitted diseases.
  
  
  OBJECTIVE
  The goals of this study were to estimate the number of early syphilis cases (primary, secondary, early latent) identified from corrections facilities from 1999 to 2002 and to determine characteristics of persons likely to be identified with syphilis in corrections facilities.
  
  
  METHODS
  We determined the proportion of cases identified from corrections facilities for the entire United States using case reports by state health departments to the Centers for Disease Control and Prevention (CDC). We calculated the proportion of cases identified in corrections facilities in the 30 counties with the largest number of cases in 2002 and determined the male-to-female syphilis rate ratios.
  
  
  RESULTS
  From 1999 to 2002, there were 63,293 cases of early syphilis reported to the CDC, of which 61,691 (97.5%) had a known source of report. Of these, 7725 (12.5%) noted corrections facilities as the source of information. Among men, 4747 (13.0%) cases were from corrections and in women 2974 (11.8%) of cases were. We found that counties with a higher proportion of cases from corrections facilities were likely to have lower male-to-female rate ratios (r = -0.66, P <0.001).
  
  
  CONCLUSIONS
  A substantial proportion of early syphilis cases is identified from corrections facilities. Among counties with the largest number of cases, a higher proportion of syphilis cases was identified from corrections facilities in counties with higher rates of heterosexually transmitted syphilis.
authors.affiliation: Division of STD Prevention, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, Atlanta, Georgia, USA. rhk0@cdc.gov
authors.forename: Richard H
authors.initials: RH
authors.lastname: Kahn
authors.forename: Richard F
authors.initials: RF
authors.lastname: Voigt
authors.forename: Emmett
authors.initials: E
authors.lastname: Swint
authors.forename: Hillard
authors.initials: H
authors.lastname: Weinstock
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D000368:Aged; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data*; D012307:Risk Factors; D012737:Sex Factors; D012725:Sexual Behavior; D013587:Syphilis / Q000453:epidemiology* / Q000209:etiology; D014481:United States / Q000453:epidemiology