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Shaikh RA, Simonsen KA, O'Keefe A, Earley M, Foxall M, Islam KM, Person A, Boyle C, Sandkovsky U, Margalit R. Comparison of Opt-In Versus Opt-Out Testing for Sexually Transmitted Infections Among Inmates in a County Jail. JOURNAL OF CORRECTIONAL HEALTH CARE 2015; 21:408-16. [PMID: 26285597 DOI: 10.1177/1078345815600447] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
A majority of jails in the United States rely on an opt-in (voluntary) rather than opt-out (universal) approach to testing for sexually transmitted infections (STIs). This study compares an opt-out approach at intake to opt-in testing during incarceration and estimates the prevalence of common STIs among jail inmates. Data derive from a universal intake pilot testing program (n = 298) and an established, student-led voluntary testing program (n = 1,963), respectively. The adjusted prevalence as well as the odds of testing positive for chlamydia were significantly higher in the opt-out program (p = .025 and .008, respectively) than the opt-in program but not for gonorrhea (p = .402 and .300, respectively). These results demonstrate the potential public health benefit of implementation of universal STI testing of jail inmates.
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Affiliation(s)
- Raees A Shaikh
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Kari A Simonsen
- Department of Pediatrics, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Anne O'Keefe
- Douglas County Health Department, Omaha, NE, USA
| | - Mary Earley
- Douglas County Department of Corrections, Omaha, NE, USA
| | - Mark Foxall
- Douglas County Department of Corrections, Omaha, NE, USA
| | - K M Islam
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Austin Person
- College of Medicine, University of Nebraska Medical Center, Omaha, NE, USA
| | - Cole Boyle
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
| | - Uriel Sandkovsky
- Department of Internal Medicine, Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NE, USA
| | - Ruth Margalit
- Department of Health Promotion, Social and Behavioral Health, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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Fogel CI, Gelaude DJ, Carry M, Herbst JH, Parker S, Scheyette A, Neevel A. Context of risk for HIV and sexually transmitted infections among incarcerated women in the south: individual, interpersonal, and societal factors. Women Health 2015; 54:694-711. [PMID: 25204565 DOI: 10.1080/03630242.2014.932888] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Incarcerated women are disproportionately affected by HIV and sexually transmitted infections (STIs) due to risk factors before, during, and after imprisonment. This study assessed the behavioral, social, and contextual conditions that contribute to continuing sexual risk behaviors among incarcerated women to inform the adaptation of an evidenced-based behavioral intervention for this population. Individual, in-depth interviews were conducted with 25 current and 28 former women prisoners to assess HIV/STI knowledge, perceptions of risk, intimate relationships, and life circumstances. Interviews were independently coded using an iterative process and analyzed using established qualitative analytic methods. Major themes identified in the interviews involved three focal points: individual risk (substance abuse, emotional need, self-worth, perceptions of risk, and safer sex practices); interpersonal risk (partner pressure, betrayal, and violence); and risk environment (economic self-sufficiency and preparation for reentry). These findings highlight the critical components of HIV/STI prevention interventions for incarcerated women.
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Affiliation(s)
- Catherine I Fogel
- a School of Nursing , The University of North Carolina at Chapel Hill , Chapel Hill , North Carolina , USA
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Falasinnu T, Gilbert M, Hottes TS, Gustafson P, Ogilvie G, Shoveller J. Predictors identifying those at increased risk for STDs: a theory-guided review of empirical literature and clinical guidelines. Int J STD AIDS 2014; 26:839-51. [PMID: 25324350 DOI: 10.1177/0956462414555930] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2014] [Accepted: 09/24/2014] [Indexed: 11/16/2022]
Abstract
SummarySexually transmitted diseases (STDs) are leading causes of substantial morbidity worldwide. Identification of risk factors for estimating STD risk provides opportunities for optimising service delivery in clinical settings, including improving case finding accuracy and increasing cost-efficiency by limiting the testing of low-risk individuals. The current study was undertaken to synthesise the evidence supporting commonly cited chlamydia and gonorrhoea risk factors. The level of empirical support for the following predictors was strong/moderate: age, race/ethnicity, multiple lifetime sexual partners, sex with symptomatic partners and concurrent STD diagnosis. The following predictors had weak evidence: socio-economic status, transactional sex, drug/alcohol use, condom use and history of STD diagnosis. The most frequently listed predictors among nine clinical guidelines were younger age and multiple sexual partners; the least consistently listed predictor was inconsistent condom use. We found reasonably good concordance between risk factors consistently listed in the recommendations and predictors found to have strong empirical support in the literature. There is a need to continue building the evidence base to explicate the mechanisms and pathways of STD acquisition. We recommend periodic reviews of the level of support of predictors included in clinical guidelines to ensure that they are in accordance with empirical evidence.
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Affiliation(s)
- Titilola Falasinnu
- The School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
| | - Mark Gilbert
- British Columbia Centres for Disease Control, Vancouver, BC, Canada
| | | | - Paul Gustafson
- The Department of Statistics, University of British Columbia, Vancouver, BC, Canada
| | - Gina Ogilvie
- British Columbia Centres for Disease Control, Vancouver, BC, Canada
| | - Jean Shoveller
- The School of Population and Public Health, University of British Columbia, Vancouver, BC, Canada
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Brown CK, Earley M, Shaikh R, Fickenscher J, Ott J, Person A, Islam KMM, Simonsen K, Sandkovsky U, Kaiser KL, Foxall M, Margalit R. Voluntary STD testing and treatment program at a metropolitan correctional facility: evaluation of test acceptability and associated risk factors. JOURNAL OF CORRECTIONAL HEALTH CARE 2014; 20:70-80. [PMID: 24352406 DOI: 10.1177/1078345813508748] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Few studies have addressed challenges of diagnosis and treatment of sexually transmitted diseases (STDs) within correctional facilities. Initiatives that screen all inmates can be cost-prohibitive, while symptom-based screening undoubtedly fails to recognize significant numbers of asymptomatically infected persons. This study discusses a voluntary STD screening and treatment program developed at the Douglas County (Nebraska) Department of Corrections where student volunteers interviewed, screened, and educated 456 inmates. Inmate urine samples and interview responses about risk behaviors and motivators for participation in the screening program were analyzed. The results support the ongoing project method to screen and treat inmates in the community correctional facility. Risk factor analysis suggests that targeted testing and treatment efforts may have a role in providing cost-effective care for STD among the incarcerated population.
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Affiliation(s)
- Christopher K Brown
- 1Department of Biostatistics, College of Public Health, University of Nebraska Medical Center, Omaha, NE, USA
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Fogel CI, Crandell JL, Neevel AM, Parker SD, Carry M, White BL, Fasula AM, Herbst JH, Gelaude DJ. Efficacy of an adapted HIV and sexually transmitted infection prevention intervention for incarcerated women: a randomized controlled trial. Am J Public Health 2014; 105:802-9. [PMID: 25211714 DOI: 10.2105/ajph.2014.302105] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We tested the efficacy of an adapted evidence-based HIV-sexually transmitted infection (STI) behavioral intervention (Providing Opportunities for Women's Empowerment, Risk-Reduction, and Relationships, or POWER) among incarcerated women. METHODS We conducted a randomized trial with 521 women aged 18 to 60 years in 2 correctional facilities in North Carolina in 2010 and 2011. Intervention participants attended 8 POWER sessions; control participants received a single standard-of-care STI prevention session. We followed up at 3 and 6 months after release. We examined intervention efficacy with mixed-effects models. RESULTS POWER participants reported fewer male sexual partners than did control participants at 3 months, although this finding did not reach statistical significance; at 6 months they reported significantly less vaginal intercourse without a condom outside of a monogamous relationship and more condom use with a main male partner. POWER participants also reported significantly fewer condom barriers, and greater HIV knowledge, health-protective communication, and tangible social support. The intervention had no significant effects on incident STIs. CONCLUSIONS POWER is a behavioral intervention with potential to reduce risk of acquiring or transmitting HIV and STIs among incarcerated women returning to their communities.
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Affiliation(s)
- Catherine I Fogel
- Catherine I. Fogel, Jamie L. Crandell, A. M. Neevel, and Sharon D. Parker are with the School of Nursing, and Becky L. White is with the Division of Infectious Diseases, Department of Medicine, University of North Carolina at Chapel Hill (UNC). Monique Carry, Amy M. Fasula, Jeffrey H. Herbst, and Deborah J. Gelaude are with the Prevention Research Branch, Division of HIV/AIDS Prevention, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, Centers for Disease Control and Prevention (CDC), Atlanta, GA
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6
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Brewer RA, Magnus M, Kuo I, Wang L, Liu TY, Mayer KH. The high prevalence of incarceration history among Black men who have sex with men in the United States: associations and implications. Am J Public Health 2014; 104:448-54. [PMID: 24432948 DOI: 10.2105/ajph.2013.301786] [Citation(s) in RCA: 74] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined lifetime incarceration history and its association with key characteristics among 1553 Black men who have sex with men (BMSM) recruited in 6 US cities. METHODS We conducted bivariate analyses of data collected from the HIV Prevention Trials Network 061 study from July 2009 through December 2011 to examine the relationship between incarceration history and demographic and psychosocial variables predating incarceration and multivariate logistic regression analyses to explore the associations between incarceration history and demographic and psychosocial variables found to be significant. We then used multivariate logistic regression models to explore the independent association between incarceration history and 6 outcome variables. RESULTS After adjusting for confounders, we found that increasing age, transgender identity, heterosexual or straight identity, history of childhood violence, and childhood sexual experience were significantly associated with incarceration history. A history of incarceration was also independently associated with any alcohol and drug use in the past 6 months. CONCLUSIONS The findings highlight an elevated lifetime incarceration history among a geographically diverse sample of BMSM and the need to adequately assess the impact of incarceration among BMSM in the United States.
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Affiliation(s)
- Russell A Brewer
- Russell A. Brewer is with the Louisiana Public Health Institute, New Orleans. Manya Magnus and Irene Kuo are with the Department of Epidemiology and Biostatistics, School of Public Health and Health Services, The George Washington University, Washington, DC. Lei Wang and Ting-Yuan Liu are with the Vaccine and Infectious Disease Division, Fred Hutchinson Cancer Research Center, Seattle, WA. Kenneth H. Mayer is with The Fenway Institute, Fenway Health, Boston, MA
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The US Chlamydia trachomatis control program: successes, shortcomings and ideas for the future. Sex Transm Dis 2013; 39:913-6. [PMID: 23169170 DOI: 10.1097/olq.0b013e3182787e5e] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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8
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Brodsky JL, Samuel MC, Mohle-Boetani JC, Ng RC, Miller J, Gorman JM, Espain G, Bolan G. Syphilis outbreak at a California men's prison, 2007-2008: propagation by lapses in clinical management, case management, and public health surveillance. JOURNAL OF CORRECTIONAL HEALTH CARE 2012; 19:54-64. [PMID: 22989493 DOI: 10.1177/1078345812458088] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
This field report describes an investigation to identify cases to control a syphilis outbreak in a prison and determine whether clinical, case management, and surveillance practices influenced the outbreak occurrence, detection, or management. Key performance measures were assessed to evaluate timeliness and quality of clinical and case management activities and surveillance practices. Thirty cases were found. Prior to the investigation, median times for clinical and reporting/surveillance measures were 15 days from primary and secondary (P&S) symptom onset to exam, 7 days from P&S exam to treatment, and 63 days from serologic test to the state's receipt of case. After the investigation, these measures improved to 8, 4.5, and 28 days, respectively. Lack of adherence to surveillance and clinical management protocols likely contributed to this outbreak, which was curtailed by aggressive control measures.
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Affiliation(s)
- Jennifer L Brodsky
- Sexually Transmitted Disease Control Branch, California Department of Public Health, Richmond, CA 94804, USA.
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Kouyoumdjian FG, Leto D, John S, Henein H, Bondy S. A systematic review and meta-analysis of the prevalence of chlamydia, gonorrhoea and syphilis in incarcerated persons. Int J STD AIDS 2012; 23:248-54. [PMID: 22581947 DOI: 10.1258/ijsa.2011.011194] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
Communicable diseases are common in people who are incarcerated. We aimed to define the prevalence of chlamydia, gonorrhoea and syphilis in people who are incarcerated and to identify subgroups with the highest risk of infection. We searched for prevalence studies of chlamydia, gonorrhoea or syphilis in incarcerated populations. Pooled estimates were generated, and meta-regression was conducted. Random effects models yielded pooled prevalence estimates of 5.75% (95% confidence interval [CI] 5.01, 6.48) and 12.31% (95% CI 10.61, 14.01) for chlamydia in men and women, 1.4% (95% CI 1.09, 1.70) and 5.73% (4.76, 6.69) for gonorrhoea in men and women, and 2.45% (95% CI 2.08, 2.82) and 6.10% (95% CI 4.75, 7.46) for syphilis in men and women, respectively. Each infection was associated with female gender in meta-regression models. Chlamydia, gonorrhoea and syphilis are highly prevalent in these populations. Primary and secondary prevention efforts could improve individual and population health.
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Affiliation(s)
- F G Kouyoumdjian
- University of Toronto, Dalla Lana School of Public Health, Toronto, Canada.
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López Corbeto E, Carnicer-Pont D, Lugo R, Gonzalez V, Bascuñana E, Lleopart N, Barbero L, Humet V, Casabona J. [WITHDRAWN: Prevalence and associated factors of Chlamydia trachomatis infection in young prisoners of Catalonia, Spain.]. Med Clin (Barc) 2012:S0025-7753(12)00137-6. [PMID: 22440143 DOI: 10.1016/j.medcli.2012.01.024] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2011] [Revised: 01/09/2012] [Accepted: 01/10/2012] [Indexed: 11/22/2022]
Affiliation(s)
- Evelin López Corbeto
- Centro de Estudios Epidemiológicos sobre las Infecciones de Transmisión Sexual y Sida de Cataluña (CEEISCAT), Institut Catalàd'Oncologia/Department de Salut, Generalitat de Catalunya, Barcelona, España; Consorcio de Investigación Biomédica de Epidemiología y Salud Pública (CIBERESP), España; Departamento de Medicina Preventiva y Salud Pública, Universidad Autónoma de Barcelona, Bellaterra, Barcelona, España.
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11
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Comer KF, Grannis S, Dixon BE, Bodenhamer DJ, Wiehe SE. Incorporating geospatial capacity within clinical data systems to address social determinants of health. Public Health Rep 2011; 126 Suppl 3:54-61. [PMID: 21836738 DOI: 10.1177/00333549111260s310] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Linking electronic health record (EHR) systems with community information systems (CIS) holds great promise for addressing inequities in social determinants of health (SDH). While EHRs are rich in location-specific data that allow us to uncover geographic inequities in health outcomes, CIS are rich in data that allow us to describe community-level characteristics relating to health. When meaningfully integrated, these data systems enable clinicians, researchers, and public health professionals to actively address the social etiologies of health disparities.This article describes a process for exploring SDH by geocoding and integrating EHR data with a comprehensive CIS covering a large metropolitan area. Because the systems were initially designed for different purposes and had different teams of experts involved in their development, integrating them presents challenges that require multidisciplinary expertise in informatics, geography, public health, and medicine. We identify these challenges and the means of addressing them and discuss the significance of the project as a model for similar projects.
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Affiliation(s)
- Karen Frederickson Comer
- Indiana University-Purdue University Indianapolis, School of Liberal Arts, The Polis Center, Indianapolis, IN 46202, USA.
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Kouyoumdjian FG, Main C, Calzavara LM, Kiefer L. Prevalence and predictors of urethral chlamydia and gonorrhea infection in male inmates in an Ontario correctional facility. CANADIAN JOURNAL OF PUBLIC HEALTH = REVUE CANADIENNE DE SANTE PUBLIQUE 2011; 102:220-224. [PMID: 21714323 PMCID: PMC6974176 DOI: 10.1007/bf03404901] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/30/2010] [Accepted: 11/22/2010] [Indexed: 05/31/2023]
Abstract
OBJECTIVES To determine the prevalence of urethral chlamydia and gonorrhea in males in a correctional facility in Ontario, Canada, and to explore risk factors for infection. METHODS Between June and December, 2009, 500 adult males who had been newly admitted at a correctional facility in southern Ontario completed a survey of risk factors and provided a urine sample for testing. Those who tested positive were treated and their names were provided to the local public health unit for follow-up including contact tracing. Prevalence and 95% confidence intervals were calculated for infection with chlamydia and gonorrhea, respectively, and a multivariable model was used to look at risk factors for infection. RESULTS The study population reported high levels of sexual risk behaviours and drug use. The overall chlamydia prevalence was 2.9% (95% CI 1.6-4.8) and the overall gonorrhea prevalence was 0.6% (95% CI 0.1-1.8). Rates were particularly high for chlamydia in younger males, at 16% (95% CI 4.5-36) in 18-19 year olds and 3.7% (95% CI 1.0-9.3) in 20-24 year olds, and for gonorrhea in males aged 20-24 at 1.9% (95% CI 0.2-6.6). A multivariable logistic regression model revealed that though not statistically significant, younger age was associated with infection. CONCLUSION The relatively high prevalence of chlamydia and gonorrhea found in this study suggests that primary and secondary prevention programs should be instituted for males in correctional facilities, in particular among younger inmates. Further research is required to ensure internal and external generalizability of these results, as well as to determine the cost-effectiveness of potential interventions.
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Affiliation(s)
- Fiona G Kouyoumdjian
- Dalla Lana School of Public Health, University of Toronto, 155 College Street, Toronto, ON M5T 3M7.
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Screening Male Prisoners for Chlamydia trachomatis: Impact on Test Positivity Among Women From Their Neighborhoods Who Were Tested in Family Planning Clinics. Sex Transm Dis 2009; 36:425-9. [DOI: 10.1097/olq.0b013e3181a2a920] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Forrest G, Boonwaat L, Douglas J, Awofeso N. Enhanced chlamydia surveillance in New South Wales (Australia) prisons, 2005‐2007. Int J Prison Health 2009; 5:233-40. [DOI: 10.1080/17449200903343274] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Abstract
OBJECTIVE : To assess the availability of STD, HIV/AIDS, and hepatitis services provided at Illinois adult county jails. GOAL : Identify opportunities and barriers to service provision. STUDY DESIGN : Telephone survey to those providing medical services in Illinois county jails. RESULTS : Eighty-one (89%) of 91 Illinois jails responded. Half (49.3%) of the facilities offered on-site testing for STD, HIV/AIDS, and hepatitis on demand/with symptoms, although only 4 offered routine screening. Discharge planning services were offered in only 40% of facilities. Cost (43.2%) and limited staff (14.8%) were cited as primary barriers to service provision. CONCLUSIONS : Screening, treatment, and discharge planning services for STD, HIV/AIDS, and hepatitis are not universal in Illinois jails. Despite current levels of funding and staffing assistance from health departments to jails, further collaboration is needed to improve case identification and treatment in this high-risk population. Needs assessments are useful in identifying opportunities and barriers to service provision.
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The impact of discontinuation of male STD screening services at a large urban county jail: Chicago, 2002-2004. Sex Transm Dis 2009; 36:S49-52. [PMID: 19131909 DOI: 10.1097/olq.0b013e318156159a] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
BACKGROUND Before April 2003, all male detainees were offered chlamydia (CT) and gonorrhea (GC) screening tests, after which services were limited to symptom-based testing. In 2003, male screening was discontinued at a large urban county jail. OBJECTIVE To evaluate the impact of discontinuing universal male sexually transmitted disease screening in a large county jail. METHODS We compared the number of male CT/GC cases during the periods of universal screening (April 2002 to March 2003) with symptom-based testing (April 2003 to March 2004). RESULTS The number of reported CT/GC cases among male detainees declined by -91.7% (3329-277) and -90.5% (1133-108), respectively after universal screening was discontinued. Citywide, CT/GC cases among males and females declined by -9.3% (24,885-22,563) and -12.9% (13,249-11,541), respectively. CONCLUSIONS Discontinuation of universal male CT/GC screening services at a large county jail represents a missed opportunity to screen a high-risk population and was associated with substantial declines in reported morbidity.
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The Contribution of a Urine-Based Jail Screening Program to Citywide Male Chlamydia and Gonorrhea Case Rates in New York City. Sex Transm Dis 2009; 36:S58-61. [DOI: 10.1097/olq.0b013e31815615bb] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Chlamydia trachomatis positivity rates among men tested in selected venues in the United States: a review of the recent literature. Sex Transm Dis 2008; 35:S8-S18. [PMID: 18449072 DOI: 10.1097/olq.0b013e31816938ba] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The cost-effectiveness of screening men for Chlamydia trachomatis depends in part on the prevalence of chlamydia in the screened population and the ease with which screening programs can be implemented. Screening in venues with high rates of chlamydia positivity among men may therefore be an important adjunct to chlamydia control. To evaluate the recent US literature on chlamydia positivity in chlamydia screening programs among asymptomatic men in nonsexually transmitted disease clinic settings, we reviewed published articles between 1995 and June 2007, using PubMed as the primary search tool. Articles were abstracted and positivity rates summarized by type of venue, race/ethnicity, age group, and US region. The overall median positivity rate was 5.1%. The highest rates were observed among men tested in juvenile (7.9%) and adult (6.8%) detention facilities, among blacks (6.7%), the 15 to 19 years old (6.1%) and 20 to 24 years old (6.5%) age groups, and among men screened in the southern United States (6.4%). Chlamydia rates among men are high in certain venues, particularly correctional settings, but also depend on the demographic composition of the target population and location. Programs considering male chlamydia screening programs should conduct pilot programs to assess chlamydia positivity as well as feasibility and cost in target venues.
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Thomson N, Sutcliffe CG, Sirirojn B, Keawvichit R, Wongworapat K, Sintupat K, Aramrattana A, Celentano DD. Correlates of incarceration among young methamphetamine users in Chiang Mai, Thailand. Am J Public Health 2008; 99:1232-8. [PMID: 18923109 DOI: 10.2105/ajph.2008.136648] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
OBJECTIVES We examined correlates of incarceration among young methamphetamine users in Chiang Mai, Thailand in 2005 to 2006. METHODS We conducted a cross-sectional study among 1189 young methamphetamine users. Participants were surveyed about their recent drug use, sexual behaviors, and incarceration. Biological samples were obtained to test for sexually transmitted and viral infections. RESULTS Twenty-two percent of participants reported ever having been incarcerated. In multivariate analysis, risk behaviors including frequent public drunkenness, starting to use illicit drugs at an early age, involvement in the drug economy, tattooing, injecting drugs, and unprotected sex were correlated with a history of incarceration. HIV, HCV, and herpes simplex virus type 2 (HSV-2) infection were also correlated with incarceration. CONCLUSIONS Incarcerated methamphetamine users are engaging in behaviors and being exposed to environments that put them at increased risk of infection and harmful practices. Alternatives to incarceration need to be explored for youths.
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Affiliation(s)
- Nicholas Thomson
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, 615 North Wolfe St, Baltimore, MD 21205, USA
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Abstract
Incarceration is a crisis among African Americans, and the prevalence of HIV/AIDS in incarcerated men and women is 3-5 times that of the general population. We explore the potential implications of the widespread incarceration of African Americans on HIV risk and HIV outcomes in: 1) the current and formerly incarcerated, 2) their sexual partners, and 3) the communities impacted by incarceration. We set forth a research agenda for understanding and ameliorating the negative impacts incarceration and conclude that the African-American population's ability to successfully address the HIV/AIDS epidemic requires a coordinated and evidence-based response to the challenge of effectively preventing, managing and treating HIV in populations affected by incarceration.
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Affiliation(s)
- Nina Harawa
- Department of Research, Charles R. Drew University of Medicine and Science
| | - Adaora Adimora
- School of Medicine, University of North Carolina at Chapel Hill
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Chlamydial Infections. Sex Transm Dis 2006. [DOI: 10.1007/978-1-59745-040-9_6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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