title: Prevalence and predictors of urethral chlamydia and gonorrhea infection in male inmates in an Ontario correctional facility.
abstract: OBJECTIVE
  To determine the prevalence of urethral chlamydia and gonorrhea in males in a correctional facility in Ontario, Canada, and to explore risk factors for infection.
  
  
  METHODS
  Between June and December, 2009, 500 adult males who had been newly admitted at a correctional facility in southern Ontario completed a survey of risk factors and provided a urine sample for testing. Those who tested positive were treated and their names were provided to the local public health unit for follow-up including contact tracing. Prevalence and 95% confidence intervals were calculated for infection with chlamydia and gonorrhea, respectively, and a multivariable model was used to look at risk factors for infection.
  
  
  RESULTS
  The study population reported high levels of sexual risk behaviours and drug use. The overall chlamydia prevalence was 2.9% (95% CI 1.6-4.8) and the overall gonorrhea prevalence was 0.6% (95% CI 0.1-1.8). Rates were particularly high for chlamydia in younger males, at 16% (95% CI 4.5-36) in 18-19 year olds and 3.7% (95% CI 1.0-9.3) in 20-24 year olds, and for gonorrhea in males aged 20-24 at 1.9% (95% CI 0.2-6.6). A multivariable logistic regression model revealed that though not statistically significant, younger age was associated with infection.
  
  
  CONCLUSIONS
  The relatively high prevalence of chlamydia and gonorrhea found in this study suggests that primary and secondary prevention programs should be instituted for males in correctional facilities, in particular among younger inmates. Further research is required to ensure internal and external generalizability of these results, as well as to determine the cost-effectiveness of potential interventions.
authors.affiliation: Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7. fiona.kouyoumdjian@utoronto.ca
authors.forename: Fiona G
authors.initials: FG
authors.lastname: Kouyoumdjian
authors.forename: Cheryl
authors.initials: C
authors.lastname: Main
authors.forename: Liviana M
authors.initials: LM
authors.lastname: Calzavara
authors.forename: Lori
authors.initials: L
authors.lastname: Kiefer
mesh_terms: D000328:Adult; D002690:Chlamydia Infections / Q000453:epidemiology* / Q000517:prevention & control; D006069:Gonorrhea / Q000453:epidemiology* / Q000517:prevention & control; D006801:Humans; D016015:Logistic Models; D008297:Male; D008403:Mass Screening; D015999:Multivariate Analysis; D009864:Ontario / Q000453:epidemiology; D015995:Prevalence; D011329:Prisoners / Q000706:statistics & numerical data; D012307:Risk Factors; D014522:Urethral Diseases / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control