Qureshi Nazia S, Herrera Sulma J, Miller Loren G, Judge Stephen P, Cardenas Charles M, Henderson Sean O
From the Integrated Correctional Health Services-Los Angeles County Department of Health Services, Los Angeles.
Sex Transm Dis. 2025 Jan 1;52(1):19-28. doi: 10.1097/OLQ.0000000000002066. Epub 2024 Aug 8.
Chlamydia and gonorrhea are 2 of the most common sexually transmitted infections (STIs) worldwide, presenting major public health challenges and resulting in billions of dollars in direct medical costs in the United States. Incarcerated women have a particularly elevated risk of these infections, which can result in serious sequelae if left untreated. On December 13, 2021, the Los Angeles County Jail system began offering opt-out urogenital chlamydia and gonorrhea screening to all newly incarcerated women.
We retrospectively analyzed electronic health record data for completed urogenital chlamydia/gonorrhea screening among newly incarcerated women between December 13, 2021, and May 31, 2023. We used multivariable logistic regression to examine the association of STIs and treatment non-initiation outcomes with various demographic and self-reported variables.
Of the 13,739 female entrants offered STI testing, 10,717 (78%) completed screening, with 1151 (11%) having a chlamydial infection, 788 (7%) having a gonococcal infection, and 1626 (15%) having ≥1 infection. Sexually transmitted infection positivity was associated with age 18 to 34 years, reported houselessness, amphetamine use, and history of a positive prior treponemal antibody test result. Sexually transmitted infection treatment non-initiation was associated with shorter jail stay for both chlamydial (adjusted odds ratio, 87.4; 95% confidence interval, 34.2-223.2) and gonococcal (adjusted odds ratio, 9.0; 95% confidence interval, 5.2-15.7) infections.
The STI prevalence among female detainees tested was many-fold higher than that of the general population. The implementation of routine opt-out STI screening in carceral settings provides a unique opportunity to benefit the health of both the correctional population and potentially that of the surrounding community.
衣原体感染和淋病是全球最常见的两种性传播感染（STIs），给公共卫生带来重大挑战，在美国造成了数十亿美元的直接医疗费用。被监禁的女性感染这些疾病的风险尤其高，如果不治疗，可能会导致严重的后遗症。2021年12月13日，洛杉矶县监狱系统开始为所有新入狱的女性提供非选择性的泌尿生殖道衣原体和淋病筛查。
我们回顾性分析了2021年12月13日至2023年5月31日期间新入狱女性完成泌尿生殖道衣原体/淋病筛查的电子健康记录数据。我们使用多变量逻辑回归来研究性传播感染及未开始治疗的结果与各种人口统计学和自我报告变量之间的关联。
在13739名接受性传播感染检测的女性入狱者中，10717人（78%）完成了筛查，其中1151人（11%）感染衣原体，788人（7%）感染淋病，1626人（15%）感染≥1种疾病。性传播感染阳性与18至34岁的年龄、报告无家可归、使用安非他明以及既往梅毒螺旋体抗体检测结果呈阳性的病史有关。衣原体感染（调整优势比，87.4；95%置信区间，34.2 - 223.2）和淋病感染（调整优势比，9.0；95%置信区间，5.2 - 15.7）未开始治疗均与较短的监禁时间有关。
接受检测的女性被拘留者中性传播感染的患病率比普通人群高出许多倍。在监禁场所实施常规非选择性性传播感染筛查为改善被监禁人群以及潜在的周边社区人群的健康状况提供了一个独特的机会。
