Prevalence of Chlamydia trachomatis and associated risk factors in women inmates admitted to a youth offenders institute in the UK

The aim of the study was to estimate the prevalence of Chlamydia trachomatis genital infections in young women inmates aged 17-21 located on the Youth Offenders Institute of HMP Holloway. The study consisted of a questionnaire and a urine sample for analysis. A health advisor administered a questionnaire to establish sociodemographic profile, sexual history and illicit drug use. C. trachomatis was diagnosed using a nucleic acid amplification test. Overall, the prevalence of C. trachomatis was 13.2%. Drug use was common with 41.2% using crack cocaine and 17.3% using intravenous heroin. A majority (80.2%) reported not using condoms during the last sexual encounter and 62.6% had a history of a previous pregnancy. Over half (53.3%) had a previous sexually transmitted infection (STI) screening and 74.7% had never been previously diagnosed with a STI. Sexual health programmes in prisons should include screening as well as education about STI risk reduction and drug prevention.

Chlamydia trachomatis and Neisseria gonorrhoeae infections among men and women entering California prisons

OBJECTIVE

We estimated the prevalence of Chlamydia trachomatis and Neisseria gonorrhoeae infection among newly arriving inmates at 6 California prisons.

METHODS

In this cross-sectional study in 1999, urine specimens collected from 698 men aged 18 to 25 years and 572 women aged 18 years or older were tested at intake for C trachomatis and N gonorrhoeae using ligase chain reaction. An analysis of demographic and arrest-related correlates of C trachomatis and N gonorrhoeae infection was performed.

RESULTS

The overall C trachomatis prevalence was 9.9% (95% CI=7.8%, 12.3%) among men aged 18 to 25 years, 8.9% (95% CI = 2.9%, 22.1%) among women aged 18 to 25 years, and 3.3% (95% CI=2.0%, 5.1%) among women overall. Three N gonorrhoeae cases were detected with an overall prevalence of 0.24% (95% CI=0.05%, 0.69%).

CONCLUSIONS

The prevalence of C trachomatis infection at entry to California prisons, especially among young female and male inmates, was high, which supports routine screening at entry into prison. In addition, screening in a jail setting where most detainees are incarcerated before entry into the prison setting may provide an excellent earlier opportunity to identify these infections and treat disease to prevent complications and burden of infection in this high-risk population.

Sexually transmitted diseases in incarcerated adolescents

PURPOSE OF REVIEW

The objectives of this review are to summarize recent developments in the epidemiology of sexually transmitted disease in incarcerated adolescents and to review screening and treatment recommendations for sexually transmitted disease in juvenile corrections facilities.

RECENT FINDINGS

The introduction of non-invasive, urine-based nucleic acid-amplification tests for chlamydia and gonorrhea has led to a dramatic increase in the ability to screen for chlamydia and gonorrhea in non-traditional settings, including corrections facilities. The prevalence of chlamydia and gonorrhea has been uniformly high in incarcerated adolescents. The prevalences of chlamydia and gonorrhea in adolescents aged 18-19 years incarcerated in adult corrections facilities were higher than those incarcerated in juvenile facilities. The prevalence was higher in incarcerated adolescent women than adolescent men and in black adolescents than non-black adolescents. Screening for chlamydia in incarcerated adolescents has been shown to be a cost-effective strategy for preventing adverse health consequences. Syphilis prevalence in incarcerated adolescents is relatively low. Hepatitis B is relatively common among incarcerated adolescents.

SUMMARY

The high prevalence of chlamydia in incarcerated adolescents and gonorrhea in incarcerated adolescent women suggests that screening of these populations should be a priority. The reasons for the higher prevalence of chlamydia and gonorrhea in young adults aged 18-19 years incarcerated in selected adult corrections facilities compared with those incarcerated in juvenile facilities should be investigated. Hepatitis B virus vaccination in juvenile correction facilities is recommended to prevent and control the transmission of this disease.