title: Epidemiology of Sexually Transmitted Infections Among Offenders Following Arrest or Incarceration.
abstract: OBJECTIVE
  We sought to estimate rates of sexually transmitted infections (STIs) among criminal offenders in the 1 year after arrest or release from incarceration.
  
  
  METHODS
  We performed a retrospective cohort study of risk of having a positive STI (chlamydia, gonorrhea, or syphilis) or incident-positive HIV test in the 1 year following arrest or incarceration in Marion County (Indianapolis), Indiana. Participants were 247,211 individuals with arrest or incarceration in jail, prison, or juvenile detention between 2003 and 2008.
  
  
  RESULTS
  Test positivity rates (per 100,000 and per year) were highest for chlamydia (2968) and gonorrhea (2305), and lower for syphilis (278) and HIV (61). Rates of positive STI and HIV were between 1.5 and 2.8 times higher in female than male participants and between 2.7 and 6.9 times higher for Blacks than Whites. Compared with nonoffenders, offenders had a relative risk of 3.9 for chlamydia, 6.6 for gonorrhea, 3.6 for syphilis, and 4.6 for HIV.
  
  
  CONCLUSIONS
  The 1-year period following arrest or release from incarceration represents a high-impact opportunity to reduce STI and HIV infection rates at a population level.
authors.affiliation: Sarah E. Wiehe, Marc B. Rosenman, and Michael L. Scanlon are with Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Sarah E. Wiehe and Marc B. Rosenman are also with Regenstrief Institute Inc, Indianapolis. Matthew C. Aalsma and J. Dennis Fortenberry are with Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine.
authors.forename: Sarah E
authors.initials: SE
authors.lastname: Wiehe
authors.affiliation: Sarah E. Wiehe, Marc B. Rosenman, and Michael L. Scanlon are with Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Sarah E. Wiehe and Marc B. Rosenman are also with Regenstrief Institute Inc, Indianapolis. Matthew C. Aalsma and J. Dennis Fortenberry are with Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine.
authors.forename: Marc B
authors.initials: MB
authors.lastname: Rosenman
authors.affiliation: Sarah E. Wiehe, Marc B. Rosenman, and Michael L. Scanlon are with Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Sarah E. Wiehe and Marc B. Rosenman are also with Regenstrief Institute Inc, Indianapolis. Matthew C. Aalsma and J. Dennis Fortenberry are with Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine.
authors.forename: Matthew C
authors.initials: MC
authors.lastname: Aalsma
authors.affiliation: Sarah E. Wiehe, Marc B. Rosenman, and Michael L. Scanlon are with Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Sarah E. Wiehe and Marc B. Rosenman are also with Regenstrief Institute Inc, Indianapolis. Matthew C. Aalsma and J. Dennis Fortenberry are with Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine.
authors.forename: Michael L
authors.initials: ML
authors.lastname: Scanlon
authors.affiliation: Sarah E. Wiehe, Marc B. Rosenman, and Michael L. Scanlon are with Children's Health Services Research, Department of Pediatrics, Indiana University School of Medicine, Indianapolis. Sarah E. Wiehe and Marc B. Rosenman are also with Regenstrief Institute Inc, Indianapolis. Matthew C. Aalsma and J. Dennis Fortenberry are with Section of Adolescent Medicine, Department of Pediatrics, Indiana University School of Medicine.
authors.forename: J Dennis
authors.initials: JD
authors.lastname: Fortenberry
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002690:Chlamydia Infections / Q000453:epidemiology; D003415:Crime / Q000706:statistics & numerical data*; D005260:Female; D006069:Gonorrhea / Q000453:epidemiology; D015658:HIV Infections / Q000453:epidemiology; D006801:Humans; D007196:Indiana / Q000453:epidemiology; D008297:Male; D008875:Middle Aged; D011329:Prisoners / Q000706:statistics & numerical data; D012189:Retrospective Studies; D012307:Risk Factors; D012737:Sex Factors; D012749:Sexually Transmitted Diseases / Q000453:epidemiology*; D013587:Syphilis / Q000453:epidemiology; D055815:Young Adult