Sexually transmitted infection and blood-borne virus screening in juvenile correctional facilities: a review of the literature and recommendations for Australian centres.
BACKGROUND
Juveniles in custody are disproportionately affected by sexually transmitted infections (STI) and blood-borne viruses (BBV) due to high rates of risk behaviours.


METHODS
A literature review was undertaken with the aim of providing evidence-based recommendations on STI/BBV screening in Australian juvenile correctional facilities. Relevant research was identified using Premedline and Medline databases, followed by a manual search of reference lists in relevant articles identified in the database search. A total of 36 relevant publications were identified and reviewed.


RESULTS
STI/BBV knowledge in incarcerated youth is poor and accompanied by high rates of sexual and blood-borne risk behaviours. The prevalence of these infections is considerable. High rates of asymptomatic gonococcal and chlamydial infections exist, which can be easily diagnosed on self-collected specimens using new nucleic acid amplification technology. HIV infections are rare although continued vigilance is needed in view of substantial risk factors for infection. Hepatitis C prevalence is high, although much lower than that of adult prisoners, signifying a possible window of opportunity for Hepatitis C prevention. Many remain at risk of Hepatitis B, and it is important to assess the need for vaccination in this group.


CONCLUSIONS
Screening for STI/BBV in incarcerated juveniles is of major public health importance and all individuals should be offered screening in conjunction with risk-reduction education during their admission to juvenile detention centres.
Templeton
David J
DJ
Macquarie Area Health Service, 203 Brisbane Street, Dubbo, NSW 2830, Australia. david.templeton@mahs.nsw.gov.au
D000293:Adolescent; D000294:Adolescent Behavior; D016497:Adolescent Health Services; D000328:Adult; D005260:Female; D015658:HIV Infections / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006509:Hepatitis B / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006526:Hepatitis C / Q000097:blood / Q000453:epidemiology / Q000209:etiology / Q000517:prevention & control; D006801:Humans; D008297:Male; D008403:Mass Screening / Q000379:methods*; D009517:New South Wales / Q000453:epidemiology; D017410:Practice Guidelines as Topic; D015995:Prevalence; D011329:Prisoners; D012309:Risk-Taking; D012749:Sexually Transmitted Diseases / Q000097:blood / Q000453:epidemiology* / Q000209:etiology / Q000517:prevention & control*