title: Test positivity for chlamydia, gonorrhea, and syphilis infection among a cohort of individuals released from jail in Marion County, Indiana.
abstract: BACKGROUND
  Individuals entering jails have high rates of sexually transmitted infections (STI), but there are few data on STI in the postincarceration period. This study aimed to describe rates of chlamydia, gonorrhea, and syphilis infection among individuals released from Marion County (Indianapolis), Indiana jails.
  
  
  METHODS
  We conducted a retrospective cohort study of individuals incarcerated in Marion County, Indiana jails from 2003 to 2008 (n = 118,670). We linked county jail and public health data to identify individuals with positive STI test results in the 1 year after release from jail. Rates per 100,000 individuals and Cox proportional hazard analyses were performed for each STI, stratified by demographic, STI, and jail characteristics.
  
  
  RESULTS
  We found significantly higher rates of STI in this cohort than in the general population, with rates in the 1 year after release being 2 to 7 times higher for chlamydia, 5 to 24 times higher for gonorrhea, and 19 to 32 times higher for syphilis compared with rates in the general population. Characteristics most associated with increased risk of a positive STI test result among this cohort were younger age for chlamydia and gonorrhea, older age for syphilis, black race for men, being jailed for prostitution for women, history of STI, and history of prior incarceration.
  
  
  CONCLUSIONS
  This study found high rates of STIs among a cohort of individuals recently released from jail and identified a number of risk factors. Further study is needed to improve targeted STI testing and treatment among this high-risk population.
authors.affiliation: From the *Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN; †Regenstrief Institute, Inc, Indianapolis, IN; ‡Department of Pediatrics and Department of Medicine, Johns Hopkins University School of Medicine, Baltimore, MD; §Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine, Indianapolis, IN.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wiehe
authors.forename: Nikita
authors.initials: N
authors.lastname: Barai
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rosenman
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Aalsma
authors.forename: Michael L
authors.initials: ML
authors.lastname: Scanlon
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002690:Chlamydia Infections / Q000175:diagnosis / Q000453:epidemiology*; D005260:Female; D006069:Gonorrhea / Q000175:diagnosis / Q000453:epidemiology*; D006801:Humans; D007196:Indiana; D008297:Male; D008875:Middle Aged; D011329:Prisoners; D011330:Prisons; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D012306:Risk; D012737:Sex Factors; D013587:Syphilis / Q000175:diagnosis / Q000453:epidemiology*; D013997:Time Factors; D055815:Young Adult