Gonorrhea and Chlamydia Opt-Out Screening of Justice-Involved Women During Intake at the Los Angeles County Jail: The Pivotal Role of Correctional Health Systems.

IF 2.4 4区 医学 Q3 INFECTIOUS DISEASES Sexually transmitted diseases Pub Date : 2025-01-01 Epub Date: 2024-08-08 DOI:10.1097/OLQ.0000000000002066
Nazia S Qureshi, Sulma J Herrera, Loren G Miller, Stephen P Judge, Charles M Cardenas, Sean O Henderson
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Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusion: 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.

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洛杉矶县监狱在收监期间对涉案女性进行淋病和衣原体选择性筛查:惩教保健系统的关键作用》。
背景:衣原体和淋病是全球最常见的两种性传播感染(STI),给美国的公共卫生带来了重大挑战,并导致数十亿美元的直接医疗费用。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选择性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法研究了性传播感染和未开始治疗结果与各种人口统计学变量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中,有 10717 人(78%)完成了筛查,其中有 1151 人(11%)感染了衣原体,788 人(7%)感染了淋球菌,1626 人(15%)感染超过 1 次。性传播感染呈阳性与 18-34 岁、无家可归、使用安非他明以及先前的特异性抗原抗体检测呈阳性有关。在衣原体感染([aOR] = 87.4,95% CI (34.2,223.2))和淋球菌感染([aOR] = 9.0,95% CI (5.2,15.7))方面,未开始性传播感染治疗与监狱服刑时间较短有关:结论:接受检测的女性被拘留者的性传播感染率比普通人群高出许多倍。在囚禁环境中实施例行性传播感染筛查是一个难得的机会,不仅能为劳教人员的健康带来益处,还可能为周边社区的健康带来益处。
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来源期刊
Sexually transmitted diseases
Sexually transmitted diseases 医学-传染病学
CiteScore
4.00
自引率
16.10%
发文量
289
审稿时长
3-8 weeks
期刊介绍: ​Sexually Transmitted Diseases, the official journal of the American Sexually Transmitted Diseases Association​, publishes peer-reviewed, original articles on clinical, laboratory, immunologic, epidemiologic, behavioral, public health, and historical topics pertaining to sexually transmitted diseases and related fields. Reports from the CDC and NIH provide up-to-the-minute information. A highly respected editorial board is composed of prominent scientists who are leaders in this rapidly changing field. Included in each issue are studies and developments from around the world.
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