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.
Subject(s)
Chlamydia Infections/epidemiology , Gonorrhea/epidemiology , Mass Screening/methods , Prisons/statistics & numerical data , Sexually Transmitted Diseases, Bacterial/epidemiology , Adult , Chicago/epidemiology , Chlamydia Infections/diagnosis , Chlamydia Infections/physiopathology , Chlamydia Infections/prevention & control , Female , Gonorrhea/diagnosis , Gonorrhea/physiopathology , Gonorrhea/prevention & control , Humans , Male , Mass Screening/statistics & numerical data , Prisoners , Sexually Transmitted Diseases, Bacterial/diagnosis , Sexually Transmitted Diseases, Bacterial/physiopathology , Sexually Transmitted Diseases, Bacterial/prevention & control , Young AdultABSTRACT
OBJECTIVES: To determine risk factors for chlamydial or gonococcal urethral infection among adult male detainees at Cook County Jail. To develop a screening algorithm with high sensitivity and specificity for detection of urethral infection. STUDY DESIGN: We interviewed adult male detainees and tested them for chlamydial or gonococcal urethral infection during jail intake from June 24 through July 29, 2004. We supplemented the cross-sectional survey with a nested case-control study. RESULTS: We screened 5,634 (93%) of 6,028 detainees; 348 (6.2%) had chlamydial or gonococcal urethral infection. Interviews were completed and collected for 35%. By multivariable analysis, infected detainees were more likely to be <31 years of age, have more than 6 sex partners in the previous 12 months, or have symptoms. Age less than 31 years or symptoms would have identified 73% of infected detainees while screening only 50%. CONCLUSIONS: A simple algorithm that included age and symptoms best identified detainees at increased risk for chlamydial or gonococcal urethral infection.
