Woodman B. Franklin, BA¹, Reena Mahajan, MHS¹, Farah M. Parvez, MD, MPH², Michele D. McNeill³, Wanda D. Roberts⁴, Jay A. Heitzner, BS¹, Girma M. Teumelissan, MPH¹, and James L. Capoziello, JD⁵. (1) New York City Department of Health and Mental Hygiene, Office of Correctional Public Health, 225 Broadway, 23rd Floor, Room 1, New York, NY 10007, 212-788-3926, wfrankli@health.nyc.gov, (2) Office of Correctional Public Health, New York City Department of Health and Mental Hygiene, National Center for HIV, STD, and TB Prevention, Centers for Disease Control and Prevention, 225 Broadway Street, 23rd Floor, Room 27, New York, NY 10007, (3) Office of Correctional Public Health, New York City Department of Health and Mental Hygiene, 225 Broadway, 23rd Floor, Room 1, New York, NY 10007, (4) Correctional Health Services, New York City Department of Health and Mental Hygiene, 225 Broadway, 23rd Floor, New York, NY 10007, (5) Health Care Access and Improvement, New York City Department of Health and Mental Hygiene, 161 William Street, 5th Floor, New York, NY 10038

Background: Chlamydia Trachomatis and Neisseria Gonorrheae are the two most common bacterial sexually transmitted infections (STI) in the United States; incarcerated populations are at particularly high risk for acquiring infection. National chlamydia and gonorrhea prevalence rates in incarcerated males range from 3-18%; up to 90% of males are asymptomatic. To determine the prevalence of chlamydia and gonorrhea infection in newly incarcerated males, we conducted a urine-based testing program in New York City (NYC) jail facilities. Methods: We evaluated consecutive male admissions, excluding state transfers, to all NYC jail intake facilities, during December 8-22, 2003 (intervention period). In addition to the routine intake history and physical exam and screening urinalysis, patients were asked about recent STI risk behaviors and symptoms, and were tested for chlamydia and gonorrhea using a urine-based nucleic acid amplification test (Becton Dickinson [BD] ProbeTec). Results: During the intervention period, 2459 males were newly incarcerated in NYC jails and received the BD ProbeTec test; median age was 33 (range: 14-76) years. Of 2459 patients, 128 (5.2%) had an STI; 112 (4.6%) were positive for chlamydia only; 7 (0.3%) for gonorrhea only; and 9 (0.4%) for both. Of 128 STI patients, 109 (85%) had a normal screening urinalysis and were asymptomatic. STI diagnosis was significantly associated with age <30 years (102/2459 vs 26/2459, p<0.05). Of the 128 patients with chlamydia or gonorrhea, 62 (48%) were treated with appropriate antimicrobials prior to their release from jail. Conclusion: Our data reveal that 1) the prevalence of chlamydia and gonorrhea infection in newly incarcerated males was 5.2%; 2) most men with chlamydia and gonorrhea were asymptomatic and would have been undetected by current screening urinalysis methods; and 3) urine-based nucleic acid amplification tests are useful tools in identifying STIs in this population. Jail STI screening programs are useful in identifying and treating asymptomatic males with chlamydia or gonorrhea and may contribute to the reduction of STI transmission in the community.

Learning Objectives:

• At the end of this session, participants will be able to describe the infection rates for male chlamydia and gonorrhea in the New York City jail system and recognize the utility of simple and rapid screening for these infections in the jail setting.

Presenting author's disclosure statement:
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.