title: High rates of incarceration as a social force associated with community rates of sexually transmitted infection.
abstract: BACKGROUND
  The United States has the highest rate of incarceration in the world. Some populations experience both high rates of incarceration and high rates of sexually transmitted infections (STIs).
  
  
  METHODS
  To estimate the strength of this correlation, we calculated age-adjusted Pearson correlation coefficients between rates of incarceration and of reportable STIs in the 100 counties of North Carolina in 1999.
  
  
  RESULTS
  Moderately strong correlations were found for chlamydia (r=0.577) and gonorrhea (r=0.521). The correlations between rates of incarceration and reported cases of acquired immunodeficiency syndrome and syphilis were weak (r=0.205 and 0.004, respectively).
  
  
  CONCLUSIONS
  Hypothetical causes of the stronger associations included incarceration increasing the number of infected prisoners or the infectiousness of released prisoners; an imbalance in the community sex ratio; and the negative influences of high rates of incarceration on social disorganization and collective efficacy. The magnitude of incarceration as a major force in American society, its association with some STIs, and our lack of empirical data on the potential causal connections argue for a new direction in STI research.
authors.affiliation: Department of Epidemiology, School of Public Health, University of North Carolina at Chapel Hill, NC 27599, USA. jim.thomas@unc.edu
authors.forename: James C
authors.initials: JC
authors.lastname: Thomas
authors.forename: Lynne A
authors.initials: LA
authors.lastname: Sampson
mesh_terms: D002690:Chlamydia Infections / Q000453:epidemiology; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D006801:Humans; D008297:Male; D009657:North Carolina / Q000453:epidemiology; D011329:Prisoners / Q000706:statistics & numerical data; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*