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Screening women in jails for chlamydial and gonococcal infection using urine tests: feasibility, acceptability, prevalence, and treatment rates.
Sexually Transmitted Diseases 2002;29:(5):271-276.
Mertz KJ, Schwebke JR, Gaydos CA, Beidinger HA, Tulloch SD,
Levine WC.
Abstract
BACKGROUND: Women entering jails are at high risk for sexually transmitted
diseases; however, screening for chlamydial and gonococcal infection is not
routinely performed in most jails. New urine tests have made it easier to
screen for these infections in nonclinical settings. GOAL: The feasibility
and acceptability of urine-based screening for women entering jails and the
prevalence of and treatment rates for chlamydial and gonococcal infections
were determined. STUDY DESIGN: Women entering jails in Chicago, Illinois;
Birmingham, Alabama; and Baltimore, Maryland, who signed consent forms were
tested for chlamydial and gonococcal infection by means of the urine ligase
chain reaction assay. Those testing positive were treated in jail; health
department staff members attempted to contact those already released. RESULTS:
Most women who were approached agreed to be tested (range, 87-98%, depending
on city), and most of these women provided a specimen (range, 92-100%). Among
5364 women aged 16 to 75 years who were tested, the prevalence of chlamydial
and gonococcal infections was high, especially among those <25 years of
age (range, 15.3-21.5% for chlamydial infection and 8.2-9.2% for gonorrhea,
depending on city). The majority of women testing positive were treated in
jail or outside of jail (61-85%). CONCLUSIONS: Screening women in jails for
chlamydial and gonococcal infection with urine tests is feasible, is acceptable
to most women, and leads to detection and treatment of many infections. Routine
screening should reduce medical complications in this population and should
prevent transmission in the community, given that many women are soon released.