From the Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX.
Beth Israel Deaconess Medical Center, Boston, MA.
Sex Transm Dis. 2023 Oct 1;50(10):675-679. doi: 10.1097/OLQ.0000000000001852. Epub 2023 Jul 19.
Incarcerated women experience high rates of HIV and sexually transmitted infections (STIs); few are offered HIV preexposure prophylaxis (PrEP). We aimed to examine HIV/STI screening rates in this population and identify PrEP eligibility.
Results of Chlamydia trachomatis (CT) and Neisseria gonorrhoeae (GC) urine and HIV/syphilis screening in cisgender women in the Dallas County Jail were compiled from January to October 2020. An electronic health record review was conducted for a subgroup in March 2020 to identify PrEP eligibility.
Overall, 4398 of 13,292 women were screened for CT and 4389 of 13,292 for GC, and among them, 479 (11%) screened for HIV and 562 (13%) for syphilis. Furthermore, 462 of 4398 (11%) were positive for CT, 323 of 4389 (7%) were positive for GC, 10 of 479 (2%) had positive HIV test results, of whom 6 (1.3%) were new diagnoses and 75 (13%) had a reactive rapid plasma reagin test. In March 2020, of 541 women screened, 90 tested positive for CT or GC. Of these 90, 70 (78%) did not receive HIV or syphilis screening, including women with these risk factors: 10 (14%) were homeless, 11 (16%) reported heroin use, and 10 (14%) reported methamphetamine use. Based on the presence of an acute bacterial STI, 17% (96 of 541) were PrEP eligible.
Incarcerated women had high STI rates and other risk factors for HIV acquisition, although only 1 in 5 with acute STIs (11% overall) was also screened for HIV or syphilis. HIV prevention efforts should include comprehensive STI/HIV screening, linkage to treatment, and identification of PrEP candidates.
被监禁的女性感染艾滋病毒和性传播感染（STIs）的比率很高；很少有女性接受艾滋病毒暴露前预防（PrEP）。我们旨在研究这一人群中的艾滋病毒/性传播感染筛查率，并确定 PrEP 的资格。
2020 年 1 月至 10 月，收集了达拉斯县监狱中顺性别女性的沙眼衣原体（CT）和淋病奈瑟菌（GC）尿液和艾滋病毒/梅毒筛查结果。2020 年 3 月，对一个亚组进行了电子病历审查，以确定 PrEP 的资格。
总体而言，13292 名女性中有 4398 人接受了 CT 筛查，13292 人中有 4389 人接受了 GC 筛查，其中 479 人（11%）接受了艾滋病毒筛查，562 人（13%）接受了梅毒筛查。此外，4398 人中 462 人（11%）CT 检测阳性，4389 人中 323 人（7%）GC 检测阳性，479 人中 10 人（2%）艾滋病毒检测阳性，其中 6 人（1.3%）为新诊断，75 人（13%）快速血浆反应素试验阳性。2020 年 3 月，在 541 名接受筛查的女性中，90 人 CT 或 GC 检测阳性。在这 90 人中，有 70 人（78%）未接受艾滋病毒或梅毒筛查，包括有以下风险因素的女性：10 人（14%）无家可归，11 人（16%）报告使用海洛因，10 人（14%）报告使用冰毒。根据急性细菌性 STI 的存在，有 17%（541 人中有 96 人）符合 PrEP 资格。
被监禁的女性 STI 发病率和其他艾滋病毒感染的风险因素很高，尽管只有 1/5 有急性 STI（总体 11%）的人也接受了艾滋病毒或梅毒筛查。艾滋病毒预防工作应包括全面的性传播感染/艾滋病毒筛查、与治疗的联系以及确定 PrEP 候选人。
