Multiple studies and surveillance projects have demonstrated a high prevalence of STDs in persons entering jails and juvenile corrections facilities. 1-4 Screening for chlamydia, gonorrhea, and syphilis at intake offers an opportunity to identify infections, prevent complications, and reduce transmission in the general community. For example, one study has suggested that screening and treatment of women inmates for syphilis may result in reduction of syphilis in the general community.5Depending on locale, a substantial proportion of all early syphilis cases are reported from corrections facilities.4Collecting positivity data and analyzing trends in STD prevalence in the inmate population can provide a tool for monitoring trends in STD prevalence in the general community.4
Description of Population
In 2004, STD screening data from corrections facilities were reported from 34 states for chlamydia, 29 states for gonorrhea, and 10 states for syphilis. These data were reported in response to CDC's request for data, as part of the Corrections STD Prevalence Monitoring Project and/or the Regional Infertility Prevention Project.
The tables and figures shown in this section represent 103,595 chlamydia tests in men and 60,466 in women; 77,043 gonorrhea tests in men and 44,161 in women; and 235,017 syphilis tests in men and 56,200 in women entering corrections facilities during 2004.
Chlamydia
In adolescent men entering 81 juvenile corrections facilities, the median chlamydia positivity was 5.8% (range 1% to 27.5%) (Table
AA). In adolescent women entering 56 juvenile corrections facilities, the median chlamydia positivity was 14% (range 2.4% to 26.5%); positivity was greater than 10% in 42 of 56 facilities reporting data.
In men entering juvenile corrections facilities, chlamydia positivity increased from 1.0% for those aged 12 years to 8.0 % for those aged 17 years (Figure
DD). For those aged 17 years to 19 years, the rates were similar. In women entering juvenile corrections facilities, chlamydia positivity increased from 8.5% for those aged 12 years to 16.9% for those aged 15 years.
In men entering 35 adult corrections facilities, the median chlamydia positivity was 10.2% (range 0.7% to 30%) (Table
BB). In women entering 32 adult corrections facilities, the median positivity for chlamydia was 7.2% (range 1.2% to 22.7%).
In men entering adult corrections facilities, chlamydia positivity decreased
with age from 10.7% for those aged 18-19 years to 1.9% for those aged 35 to
65 years (Figure EE). Similar trends were also observed in adult women. Although
overall chlamydia positivity in women entering adult correction facilities
was significantly lower than in women entering juvenile corrections facilities,
chlamydia positivity in women aged 18-19 years attending adult corrections
facilities was higher than in women attending juvenile corrections facilities.
Similar patterns were also observed for men aged 20 years entering adult corrections
facilities compared to men entering juvenile corrections facilities.
Gonorrhea
The median positivity for gonorrhea in adolescent men entering 49 juvenile corrections facilities was 0.8% (range 0% to 18.2%) (Table
CC). The median positivity for gonorrhea in women entering 34 juvenile corrections facilities was 4.5% (range 0% to 16.6%); positivity was greater than 4% in 20 of 34 juvenile corrections facilities.
In men entering juvenile corrections facilities, gonorrhea positivity increased from 0.2% for those aged 12 years to 1.4% for those aged 19 years (Figure
FF). This trend was not observed in adolescent women.
In men entering 27 adult corrections facilities, the median positivity was 2.6% (range 0% to 33.8%) (Table
DD). In women entering 26 adult facilities, the median positivity for gonorrhea was 3.0% (range 0% to 8.4%).
In women entering adult corrections facilities, gonorrhea positivity decreased with age from 9.5% for those aged 18-19 years to 4.2% for those aged 35 to 65 years (Figure
GG). This trend was not observed in adult men. Women aged 18-19 years attending adult facilities had higher gonorrhea positivity than women attending juvenile detention facilities. This was also true for men.
Syphilis
The median reactive syphilis serology was 0.5% (range 0% to 2.4%) in adolescent
men entering 5 corrections facilities and 0.7% (range 0% to 5.1%) in adolescent
women entering 5 juvenile corrections facilities (Table
EE).
In men at 24 adult corrections facilities, the median reactive syphilis serology was 2.7% (range 0.2% to 5.9%) (Table
FF). In women entering 19 adult corrections facilities the median percentage of reactive syphilis tests by facility was 5.3% (range 0% to 19%).
1 Heimberger TS. Chang HG. Birkhead GS. DiFerdinando GD. Greenberg AJ. Gunn R. Morse DL. High prevalence of syphilis detected through a jail screening program. A potential public health measure to address the syphilis epidemic. Arch
Intern Med 1993;153:1799-1804.
2 Centers for Disease Control and Prevention. Syphilis screening among women arrestees at the Cook County Jail - Chicago, 1996. MMWR 1998;47:432-3.
3 Mertz KJ, Schwebke JR, Gaydos CA, Beideinger HA, Tulloch SD,
Levine WC. Screening women in jails for chlamydial and gonococcal infection using
urine tests: Feasibility, acceptability, prevalence and treatment rates. Sexually
Transmitted Diseases 2002;29:271-276.
4 Kahn R, Voigt R, Swint E, Weinstock H. Early syphilis in the United States identified in corrections facilities, 1999-2002. Sexually
Transmitted Diseases 2004;31:360-364.
5 Blank S, McDonnell DD, Rubin SR et al., New approaches to syphilis control. Finding opportunities for syphilis treatment and congenital syphilis prevention in a women's correctional setting. Sexually
Transmitted Diseases 1997; 24:218-26.
Persons
Entering Corrections Facilities 1 
