Peterman Thomas A, Newman Daniel R, Goldberg Martin, Anschuetz Greta L, Salmon Melinda, Satterwhite Catherine L, Berman Stuart M
Division of STD Prevention, Centers for Disease Control and Prevention, Mailstop E-02, 1600 Clifton Road NE, Atlanta, GA 30333, USA.
Sex Transm Dis. 2009 Jul;36(7):425-9. doi: 10.1097/OLQ.0b013e3181a2a920.
Chlamydia trachomatis screening test positivity among women in the United States has remained high, leading researchers to suggest that programs should also screen men. Men have been screened in Philadelphia prisons since 2002. Philadelphia prisons are similar to jails in other jurisdictions; in 2003 the median duration of incarceration was 17 days. We studied whether screening and treating men in prison influenced C. trachomatis infection among women living in their communities.
We divided the city into 2 areas: "high-treatment" (high percentage of men were treated for C. trachomatis detected in prison) and "low-treatment" (low percentage of men were treated for C. trachomatis detected in prison). We compared changes in test positivity among women from those areas, who were tested in family planning clinics during the 2 years before versus the 3 years after the male prison screening program began.
In 2002 to 2004, prison screening led to treatment of 1054 infections among 23,203 men aged 20 to 24 years living in high-treatment areas and 98 infections among 21,057 men aged 20 to 24 years in low-treatment areas. Test positivity declined among 20- to 24-year-old women in both areas. In high-treatment areas, positivity decreased 9.1% per year from 1999 to 2001 and 4.9% per year from 2001 to 2004. In low-treatment areas, positivity decreased 13.2% per year from 1999 to 2001 and 7.5% per year from 2001 to 2004.
C. trachomatis test positivity among 20- to 24-year-old women tested in family planning clinics continued to decrease after men were treated for C. trachomatis; however, we found no evidence that the continued decrease was due to the new prison screening program.
美国女性沙眼衣原体筛查试验阳性率一直居高不下，研究人员因此建议项目也应对男性进行筛查。自2002年起，费城监狱开始对男性进行筛查。费城监狱与其他司法管辖区的监狱类似；2003年，监禁的中位时长为17天。我们研究了在监狱中对男性进行筛查和治疗是否会影响其所在社区女性的沙眼衣原体感染情况。
我们将该市分为两个区域：“高治疗率”区域（在监狱中检测出沙眼衣原体并接受治疗的男性比例较高）和“低治疗率”区域（在监狱中检测出沙眼衣原体并接受治疗的男性比例较低）。我们比较了这两个区域女性的检测阳性率变化情况，这些女性在男性监狱筛查项目开始前两年和开始后三年期间在计划生育诊所接受检测。
在2002年至2004年期间，监狱筛查导致居住在高治疗率区域的23203名20至24岁男性中的1054例感染得到治疗，居住在低治疗率区域的21057名20至24岁男性中的98例感染得到治疗。两个区域20至24岁女性的检测阳性率均有所下降。在高治疗率区域，1999年至2001年阳性率每年下降9.1%，2001年至2004年每年下降4.9%。在低治疗率区域，1999年至2001年阳性率每年下降13.2%，2001年至2004年每年下降7.5%。
在男性接受沙眼衣原体治疗后，在计划生育诊所接受检测的20至24岁女性的沙眼衣原体检测阳性率持续下降；然而，我们没有发现证据表明这种持续下降是由于新的监狱筛查项目所致。
